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Adderall Question

Submitted by an LD OnLine user on

I want to do a trial of Adderall for 2 of the last 3 weeks of school, starting the coming weekend then take my son off for the summer (or sooner if he has troubling side effects). Is this a good idea? Is a trial of this brief a period enough to know if a) it will work or b) any minor side effects will lessen (Am I right in thinking they can work this way?)

We are currently doing a combination of PACE/Neuronet Therapy. Some of his difficulties with the Neuronet I think relate to attention. I recall from
the website that results might be skewed if the child is on stimulant medication, but we are stuck on those attention-related tasks, and I would like to “know” if the stuff works before September. (We have also done Interactive Metronome.)

Thanks.

Jan L.

P.S. My son has APD, NLD (inattentive)—it is hard to root out the root cause and what will work.

Submitted by Anonymous on Tue, 06/08/2004 - 3:22 AM

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My son is on Adderall…You will know right away if it works or not…He isn’t on it on the weekends or during the summer unless he has a huge project he needs to focus on to finish.. When he goes on it after being off it for a while he gets a headache….but that is usually gone by the next day… He doesn’t like the fact that Adderall makes him more “serious”… :) Gee Whiz… :? that can be a good thing especially when he can stay on task and not be distracted by computers, guitars and girls… :lol:

Submitted by Roxie on Tue, 06/08/2004 - 3:48 PM

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No, it’s not enough time. It is only enough time if you get lucky and find the right dose and the right med on the first try. If a Dr is prescribing properly, he/she will start at the lowest dose and go from there since stims are dosed on a response basis and not by a weight calcuation. When my dd took Adderall, the only thing she experienced was the side effects. But after her first adjustment with Ritalin we could see positive results, with side effects in tow.
I want to be honest and straight foward here, side effects, including minor ones (to me thats the headache, stomache, appetite loss, difficulty falling asleep) can last up to 6 months, but usually fade within 3 months. However, in some kids, those minor side effects don’t end up as minor. My dd experienced significant appetite loss for years, we eventually ended up putting her on a med with an appetite stimulant quality b/c I couldn’t deprive her of the positive effects she was having from the medicaiton, which for her were significant. Before you start your son on any medication, do a lot of research, write down all your questions and concerns about the medications. Ask a lot of questions regarding the Dr’s perspective on meds. Personally, I wouldn’t see a Dr that will prescribe and d/c meds at my whim. I want, and expect, to be listened to, heard, and my opinon considered. I want feedback on my opinion, am I off base? Am I wrong, am I over or under simplifying things. I want a Dr that has a reason for choosing the medicaiton he/she picks and has a rational to the way they dose, and adjust medication. I am able to get this information b/c I ask these quesitons. Case in point. When my dd started Clonidine (6 years ago), she was on Ritalin. I brought up concerns about a suspected Clonidine/Ritalin connection and heart problems. I brought in an article and got straight answers, as well the Dr deciding to do a baseline EKG. When we later added the appetite stim, the Dr d/c’d the Clonidine b/c there wasn’t enough information for him to keep her on all 3 meds regarding safety. I know that you have already done a lot of homework regarding medication, but what ever you do, make sure that you get the answers you need to resolve lingering concerns and questions. Good luck.

Submitted by JulieinSC on Tue, 06/08/2004 - 9:12 PM

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As with most things concerning ADHD, there is no “one size fits all” answer. For my son (ADHD-inattentive) we knew right away that Adderall was NOT the right med. Even at a very low dose, the med made him anxious, emotional, etc. The teacher noticed that something had changed for the worse. After three days we moved him off of Adderall for good.

My son had much better luck on Ritalin. Even at a low dose, we noticed a change (for the better) immediately. It was then a question of getting the right dose, which took a little trial and error.

Good luck!

Submitted by KarenN on Wed, 06/09/2004 - 5:07 PM

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According to our trusted psychiatrist , a weekend med trial will let you know if stimulant meds help with the attention. Maintaining the effect through the right dosage and managing any side effects could take longer to understand. We have toyed off and on with a trial, and he strongly suggets doing it over a weekend so you can see the effect.

Submitted by Anonymous on Wed, 06/09/2004 - 6:54 PM

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[quote=”KarenN”]According to our trusted psychiatrist , a weekend med trial will let you know if stimulant meds help with the attention. Maintaining the effect through the right dosage and managing any side effects could take longer to understand. We have toyed off and on with a trial, and he strongly suggets doing it over a weekend so you can see the effect.[/quote]

Hmmm. Many psychiatrists suggest beginning with an extremely small dose of a regular (not time-release) stimulant. With adderall, for example, you would start at 2.5 mg (half of the lowest dose 5 mg tablet). After a few days of observation, you would move up to 5 mg, then 7.5, then 10, etc. Once you start to see positive results (assuming you see them) the goal is then to see what is thebest dose at which those effects are maintained and side effects are not problematic. That can be pretty tricky. Once the correct dose is established then it is possible to give the extended release medication (eg adderall xe) a try.

Since most kids doing a slow introduction meds trial will not show positive effects at the lowest doses (although they may show side effects) it is unlikely that a weekend trial would give you enough information to know whether the medication is likely to be helpful. Perhaps your doctor does things differently, however.

Submitted by Roxie on Wed, 06/09/2004 - 7:00 PM

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Karen, with all due respect to your psychiatrist, I would like to know what his response would be if asked about the cases where 5mgs of Ritalin TID is like water to a child that needs 20mgs TID, or the equivalent of another med? The positive effects of that lower dose for my dd were hard to detect, weekend or at school, we began to see a difference at 10mgs, a difference that could be attributed to the medication. Had we gone with the 5mgs as our ‘test’ for the effeciency of stims, we would have stopped at Adderall actually, and certainly the first trial of Ritalin. I certainly know that a med trial over a weekend may produce anticipated/wanted results, but I don’t see how it can be a thumbs up or down without considering the possibility of medication adjustments or even that outside factors that may influence ADHD symtoms, if present.

Submitted by KarenN on Wed, 06/09/2004 - 7:28 PM

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well obviously his advice was in the context of my child who we aren’t sure is really ADD, and has some anxiety and tics. So we’d want to start really really low and go from there. See if we can get a positive result with the least amount of medication. Not that we’ve done it….

Submitted by Roxie on Wed, 06/09/2004 - 8:14 PM

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Now that you’ve done it what? Did you get the results you were looking for? Or are you still on the journey trying to find the right treatment plan for yur son? Having comorbid disorders make it all so much more of a challenge. I don’t envy you at all, I hope all is going well.

Submitted by mommyloons on Wed, 06/09/2004 - 8:24 PM

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My Son just increased his dose of adderal from 5mg to 10mg. The differences was noted instantly. I also think any side effects will come out almost instantly after starting usage. We took him off the medication last summer because we just wanted him to be on it in a learning situation. This year the child psycologist we see said we should keep him on it so he can be less implusive in social situations. This is just my opinion and I am very big on following your own gut. With my son and our situation this seemed to always work. Good Luck on what you decide.

Submitted by KarenN on Wed, 06/09/2004 - 9:36 PM

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oops, clarification. NOT that we’ve done it. We haven’t done a meds trial. Everytime we get close we get a reprieve - a better school report or something like that. But if the situation requires we definitely would try it, and may need to in the future as the demands of middle school kick in.

Submitted by Anonymous on Fri, 06/11/2004 - 12:26 PM

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will a 3 week trial work? I think the best answer is- it depends… Not much of an answer but these things are so individual. Our child is inattentive ADD with language LD’s.

In our case the answer was YES. We started with ritalin and could see a response within hours. It took several months for side effects to come on. We halted. Several months later, we tried Adderall and 2 years on, no side effects. We use a very small dose.

meds trials are not as uncommon as some posters would have you believe. It can be very difficult to obtain a definitve diagnosis, difficult to find a doctor who is not predisposed to a particular diagnosis, difficult to tease out what is ADD and what is LD, etc. A trial of meds has been around for many years.

My child was struggling. I obtained excellent tutoring and she began to read. We discovered visual tracking problems and did VT successfully. We had afterschool private tutoring form a great spec ed teacher. But it wasn’t enough. She needed the meds, both academically and socially.

The stimulant meds have been around for decades. They are taken up very rapidly and they are eliminated from the body rapidly. There are lots of scary stories out there and scary people who will accuse you of nasty things for medding your child. This is a very personal decision-you are on a board with parents who have given a great deal of thought to the meds question. In our case, we knew we had investigated and remediated as much as we could and our child still needed help. In our case (we were lucky) the meds worked quickly and successfully. We knew by day 2 the meds were working and spent a week or so adjusting the dose.

There is another med now available, Stratterra, that is a non-stimulant. It takes 6 weeks or more to do a trial as it kicks in slowly. Do a search on this board for Stratterra. Its a more complicated process than the stimulants.

As to the people who will jump on your case for considering medding your child- Make an informed decision but remember only you know your child and his needs.

Good luck to you and your child

Submitted by JanL on Mon, 06/14/2004 - 2:41 AM

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I appreciate the advice. I’ve decided to wait until Sept. to do a trial of low-dose SR Adderall. (Strattera is not yet available in Canada.)

My instincts say try it but not now. I especially appreciate the points that this stuff has been around for a long time, that no one makes these decisions lightly, that there is lots of variation in effects, and that this medication can help.

Submitted by KarenN on Mon, 06/14/2004 - 12:27 PM

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JanL, Based on our most recent school report (just received 2 days ago) it seems my son is still inattentive in certain school periods. (and this is in a special school where they are willing to help…)

I’m leaning towards a meds trial in august just so we can see if it has the desired effect at all! Then wait until the school year starts, adjustments are over with new teachers and the inevitable september jitters…) before embarking on anything more formal.

Our doctor also prefers the stimulants that have been around for decades over straterra as a first choice for all the reasons discussed.

I’ll certainly let you all know what we do and the outcome!

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