15yo ADHD On Medikinet struggling

[sighbynight]

My 15yo daughter in on 30mg Medikinet XL. She worked her way up from 10mg, starting a year ago. It has had an incredible effect on her academics - she just couldn’t focus before - but since she started in Y11 she’s been struggling with aggressive feelings and intrusive thoughts (not self-harmy ones. Most strong urges to scream in class or throw things at teachers. Hasn’t followed though thankfully). The rebound at the end of the day is pretty terrible - increasingly angry. I think she’s close to school refusal.
School are being helpful, but it’s a fee paying, highly academic school. It’s not really a core area of expertise for them. What are people’s thoughts on medication changes? My daughter is dismissive (of everything!) and says it will either be too difficult or won’t make a difference. I just need to get her to her GCSEs then she can move on to a different educational setting. Although this is a source a load of anxiety too. That’s for another time though.

if anyone has any experience, I’d love to hear it.

Disclaimer: I’m not a healthcare professional.

Based on the experience of an acquaintance of mine
First, I’d suggest you talk to her doctor about the side effects of her medication and see if it’s possible to switch to something that doesn’t cause rebound — or at least causes it less severely.

Second, and this might be hard to hear, consider slowing down the pace of her learning so she doesn’t feel pressured or stressed to keep up. She doesn’t just need to sit her GCSEs; she needs the right grades too. So, if she ends up sitting her GCSEs a year or two later than planned, so be it. As long as she avoids burnout and gets the best grades she can, you’ll have fewer worries in the long run.

Also, given her current situation, a change of education setting after her GCSE’s probably won’t make much difference. So, unless your DD’s doctor can recommend a better medication, a slow and methodical approach to her studies might be in both of your best interests.

I'm sorry to hear this. Does she have frequent medication reviews? Adhd often doesn't travel alone- ocd and intrusive thoughts can occur with/without medication. But you'd need her psychiatrist or professional at the review to unpick it. Ask them to refer you if they can't? I was warned that medication can unmask co-existing conditions eg asd, ocd etc. Eg adhd symptoms are at the forefront but when the meds calm them down, other things may emerge. Ocd is not uncommon with adhd and I'd move fast if you can. The stress of gcse year won't be helping. Just had this conversation about my child at their review last week. Wish you the best.

Medikinet is methylphenidate??
My DD became more anxious and agitated on this. She seemed to have less side effects on Elvanse (lisdexamphetamine) though for various reasons has come off that too.

She also tried non stimulant medication, and did 6 months on atomoxetine. I thought this might have been helping, but she insisted it qasnt and demanded to stop.

She is currently taking an SSRI, snd we may revisit ADHD medication in the future.

I think trying a change could be the next step. Or, maybe she needs a dose increase or a top up to stop the crash after school?
I havea friend who takes a low ish dose of slow release, then tops up at lunch time and if she has a late meeting with 5mg quick release. She says sometimes under-medicated can also be an issue

Elvanse was also great for my DD16. Go for a medical review. We also only use it on school/college days.