Whether he is taking Adderall XR and losing too much weight or who is too aggressive, is too sleepy while taking Strattera, or simply not getting good enough control with Concerta, it is not unusual to need to adjust a child's ADHD medicine from time to time.
Although parents are often tempted to give up on a medicine when their child is having problems with it, since any ADHD medicine can cause side effects, it is often better to adjust the dose before switching to a new medicine. This can be especially helpful for children having side effects from stimulants, with often include aggression, appetite suppression, and insomnia. In many of these situations, decreasing the dosage can eliminate the side effect. Unfortunately, it may also cause the dosage to be so low that it doesn't control your child's ADHD symptoms anymore.
Other times, a change to a different medicine can make a world of difference. Although most stimulants have similar side effects, they do seem to affect children differently. So, Adderall XR might cause one child to be very aggressive and moody, while another might do great and not have any side effects at all.
Other common scenarios that doctors and parents often encounter in treating children with ADHD include:
Strattera Causing SleepinessExcessive sleepiness is one of the more common side effects of the non-stimulant Strattera. Since many children with ADHD also often have problems going to sleep at night, you can often use this side effect to your advantage by giving your child the Strattera in the evening. If your child is still sleepy the next morning, splitting the dose and giving half in the morning and half in the evening may work.
Concerta Isn't Working In The MorningAlthough Concerta is a long acting form of Ritalin that does usually last for 10 to 12 hours, it only gives about 22 percent of the dose in the morning. This is in contrast to other long acting ADHD medicines, such as Adderall XR, Ritalin LA, and Focalin XR, which give half the dose in the morning and another half later in the day.
If your child's Concerta isn't working in the morning, it may be that he needs a higher dose, which would also increase his morning dose. A higher dose would also increase his afternoon dose though, which he may not need if he had been otherwise doing well. In this situation, a different ADHD might work better.
Concerta and Adderall XR Are Lasting Too LongSince most long acting ADHD medicines, like Concerta and Adderall XR, last for about 12 hours, they usually wear off at about dinner time and far before bedtime. Some kids do seem to be very sensitive to the medicines though and they seem to last far longer for 12 hours. For these kids, a short acting stimulant or a shorter-acting long acting stimulant, like Ritalin LA, might work better.
Nothing Is WorkingAlthough many kids do great with the first ADHD they are put on, others do better with the second or third medication they try. Unfortunately, some kids still have problems even after having tried all of the traditional ADHD medications, in which case it may help to:
- get a second opinion from a child psychologist and/or child psychologist to confirm that your child really does have ADHD
- consider that your child needs to see a psychologist, in addition to taking medication
- ask your doctor about combination therapy to treat co-morbid disorders, like depression or bipolar disorder
- do additional testing to look for learning disabilities and dyslexia