Anyone tried non stimulant after medikinet

[Isitorisitnot12]

Ds almost 14 has been on medikinet for almost a year. Long acting didn’t work for him as rebound was awful so he has been on short acting for a while.
While we know it definitely works to reduce his impulsive behaviour, he tells me it also gives him high anxiety while on it.
It’s a constant struggle to get him to take the second dose at school so he ends up in trouble by the afternoon.
We are about to have a review and i’m thinking of suggesting to try something different in the hope that he wouldn’t be so reluctant to take it.
Any advice?

Watching with interest because I'm on Medikinet and I feel really really shit as it wears off. I used to be on a much higher dose of Concerta/Xaggatin but my prescription was changed due to the shortages last year so I'm actually on a lower dose but I've never got on with the Medikinet. It also only lasts 7-8 hours which is useless if if you've got a full 16 hrs worth of life to do every day.

If he's reluctant to take it, I'd really listen to him, because I'm not an anxious person and I feel really panicky on it sometimes. I can deal with it because I know it's just chemical but I'd be really upset if I felt pressured to take it. I think being naughty in school is preferable to feeling mental on prescription drugs.

Thanks for your reply.
i don’t want him to feel anxious but being manic and causing havoc and being expelled from school is not a solution either.
Unfortunately teenagers especially after spending most of their lives unmedicated, can often perceive the calmness of the meds ‘boring’ as he is not being the centre of the attention plus as spent all his life eating for dopamine his body suddenly not craving it, must feel quire a depressed state.
He needs to take meds during the week to be able to get on with things but hoping to maybe to swap him to something else to meet him in the middle.
Hope someone comes along with some suggestions

I'm no expert but it doesn't seem like the right dosage/drug for him if the side effects are so intolerable that he doesn't want to take the second dose, especially after a year. It's normal to feel a bit anxious when starting new stimulants/titrating the dose but not after that long.

I have felt that calmness on the right meds and it is a bit boring but it's very useful for doing boring things. It doesn't sound like he feels calm though if he feels highly anxious?

I don't think increased dopamine levels result in a depressed state. Stimulants can make you feel very anxious though, it's one of the most common side effects.

I'm not trying to shame anyone for choosing the meds, they're a useful tool. I appreciate it's a difficult balance with a teenager with behavioural problems in school. Is the school doing enough to meet his needs? Is he being annoying or starting fights? Some schools these days seem incredibly harsh for ND kids. Is his work/learning ability better whilst on them?

As pp posted, stimulants can increase anxiety in some.

DS2 takes atomoxetine. Although he started straight onto non-stimulants for medical reasons. It has helped in other ways but it hasn’t improved his impulsivity and risk-taking behaviour really.

That’s interesting @perpetualplatespinning in what are are they helping him if not the impulsivity?
Ds is very academic and so no issues there can even focus Ok. His issue is the social side of things (probably on the spectrum too but but not diagnosed)
Can be quite particular and ODD like about social situations and end up huffing and puffing and being rude to teachers.
He is also still denial about the meds helping him. He tells me he can behave without them.

These incidents dramatically reduced when started taking the meds but as they affect his appetite and coming off them makes him grumpy, he isn’t keen on taking them.
I suggested when we see his peadiatrician on monday we can change to something new. He said no i don’t want the hassle having to talk to anyone about his adhd.
This has now made me think about moving on to non stimulant as our big focus is impulsivity so really need something that helps with that

DS2 is academically able. He is outgoing and craves social interaction. His difficulties are mainly around impulsivity and risky behaviour - things like climbing over a fence with spikes on top because it is quicker and climbing on a roof at school to get a football. The medication has helped with his staying on task, distractibility, executive function, and knowing where the line is with ‘banter’ (although the latter might just be the fact he no longer has the teacher who liked to ‘banter’ then expected to be able flick a switch and have the class be serious).

Non-stimulants work well for impulsivity in some.

Very interesting. My ds is very outgoing (sometimes it feels a bit too much and almost desperate to have lots of people like him) and has lots of friends when i say social side of things i meant for example responding to a situation where if he is told no or being made to be ashamed of his action (usually by and adult or teacher) he will be lose it and will say or do things which he later regrets. It’s always been his weakness.
I will try and speak to his dr on monday and see what they suggest. Thank you again

Have you looked at rejection sensitive dysphoria?

Yes thank you. No question he and one of my other boys have it. it’s making it very hard to raise them without letting them get away with everything as the slightest advice/telling off sets them off

Meds are a gamble. Regarding trying to get the sweet spot. Also what is annoying you are limited to what a prescriber will prescribe! Some are point blank no and others might consider …..

Any anxiety there is literally 2 non stims - my child has done them both one was ok / good one was horrific, every child is different.

There are “nicer” versions of mediknet - that’s is the cheapest and harsh - need to try out other ones that cost more cash to the nhs. As mediknet is the “first line of defence”

Good luck keep going

Thank you. We started out private so tried a couple of fancy ones long acting ones but didn’t work. Let’s see what they suggest