Short or long acting Ritalin

[henryhsmum]

My DS (age 6) was diagnosed with ADHD about 6 weeks ago having had an autistic diagnosis since age 3.

The consultant said he has quite severe ADHD and immediately started him on 5mg of Ritalin 3 times a day, doses spaced 4 hours apart. He anticipated he would need a higher dose but this was just the starting dose. We noticed that the Ritalin would wear off after
about 3 hours so we explained this to the consultant when we saw him 2 weeks ago.

He therefore suggested prescribing a long acting Ritalin tablet of 27mg which lasts about 12 hours. It is equivalent to 1.5 times his dose of the short acting Ritalin. We are finding that whilst his behaviour is still improved it seems to have less of an effect and wears off after about 8 hours as opposed to 12. Maybe as the dose is released slowly he is getting less Ritalin as it is spaced over a longer period than with the short acting Ritalin?

I am wondering what other people's experiences of long vs short acting Ritalin are and what dosage are your children on? As I understand it we could ask for our son to have a higher dose and this was sort of half expected as the consultant said he would need more than the dose he started him on long term. We are unsure whether the long or short acting is better though. I realise this is a medical decision to a point but the consultant will very much go off our experiences of our son's behaviour. It is really critical that we get his dose right by end of summer as he is transferring from special school to mainstream and will need it to help him fit into a classroom.

Bump!

ds1 is on slow release ritalin - i think as the name suggests, it releases gradually over time so there is not instant hit and then comedown as you get with short release ritalin so you probably will not see such a marked effect and the wear off time is slower and harder to tell when it is wearing off ! I think there is no clear medical answer to any of this esp as the effects vary on different children. it's going to depend on how the medication improves your ds's quality of life and ability to focus and concentrate.

HI, hope you don't mind me jumping on this old thread. But I am at the same stage as the original poster, with just changing from short acting to long acting ritalin, and the difference between the two is huge in my sons behaviour.

It was explained to me that the short acting would be 10mg lasting 3 hours and the equivalent is 20mg lasting 6 hours with the LA, that the dosage over the time is the same.

However with the short acting that we tried for a week, we had huge improvements that lasted about 4.5hours each day, the school were amazed at the difference as were we at home. We had all the positive effects we had hope for, and none of the negative effects we dreaded.

The trouble is that in the last 2 days of giving the LA version, we have just had a subdued child, with none of the positive effects being seen clearly, maybe mildly, but barely noticable at all.

So my question is, does anyone (including the original poster) have experience of this, and what was the solution?
Thank you

In case anyone finds this thread in the future, the last week was horrendous, my son was subdued and very low mood (and complaining of tummy ache and headache occasionally). This was with 20mg LA, Ritalin, today we switched back to the normal 10mg short acting and the positive mood returned and no complaints.

I don't know why there was such a difference (if anyone knows I would love to find out), but we do not intend going back to the long acting.

In case anyone finds this thread in the future, the last week was horrendous, my son was subdued and very low mood (and complaining of tummy ache and headache occasionally). This was with 20mg LA, Ritalin, today we switched back to the normal 10mg short acting and the positive mood returned and no complaints.

I don't know why there was such a difference (if anyone knows I would love to find out), but we do not intend going back to the long acting.

Short release Ritalin doesn't suit ds either, but not in the way you describe - it was more like he was unmedicated so there were no positive effects, and he was more hyper and uncontrolled. We switched back to the immediate release version and this works much better.

He also takes atomoxetine 40mg daily which has a consistent stabilising effect but isn't sufficient on its own. The two together work well.

IMO the only way you can find out what's best for your own child in terms of ADHD medication is trial and error as it's different for everyone.

• sorry I meant slow release doesn't suit him but immediate effect is fine.

When ds1 swapped from short acting to Concerta XL we found that it did not have such a good effect but the school were forgetting to give his lunchtime dose of short acting or saying they couldn't catch him to get him to take it so we stuck with the Concerta. It wore off after about 8 hours with ds too so he takes 10 mg of short acting if he is doing something in the evenings. He is now 17 and rarely needs his evening dose. He goes by how he feels himself.