Med switching question

I just posted my intro, but want to ask a question about switching meds for my son.

He is 11, short for his age (0% - was always short prior to starting meds), and is in 5th grade.

I am concerned about the level of meds he is on, and am also concerned about finding something else prior to middle school - since this is when all the @#$ hit the fan for two of my other kids (though neither of them liked school and my son does).

He is taking BOTH a 36+27 in the am and a 27 in the afternoon. We just raised the morning dose from 54 last week. I could tell that that he was having a lot more trouble focusing in school, as I can easily drop by his class and check on him - plus I teach science enrichment once a week to each class, so his class comes to me and I noticed that he was having more trouble over the last couple weeks. I will say that his class doesn't help. He has been in the MOST DIFFICULT cohort of kids we have had in our school since they were in kindergarten. The teachers can't wait for this group to leave. I really like each kid individually, but as a group they DO NOT STOP TALKING or listen to signals/directions. It is not just his class, but the other 5th grade class as well...so doesn't matter how you mix them up.

As his medication has increased over the years, so has his rebound in the afternoon - like way beyond what he is like with no meds. I know it is probably time for a change. My psychiatrist was very willing to try different meds with my daughter, but we have just continued with Concern for my son because he has been functioning so well...except for the dosage amounts (my issue) and the rebound.

I have heard a lot of people having success with Vyvanse and Intuniv, but know my insurance didn't cover those before (or did but they were non-preferred and expensive) when we tried with my daughter. I am going to check on whether this is still true or not.

Adderal was a HUGE problem with my daughter - it made her seemed possessed and we had to take her off.

Yes, I will discuss with the psychiatrist. The question is more on how and when do I make this transition? Should I do it now, before the end of the school year? What supports should I put in place if he is having trouble with behavior/focus (he will be super goofy and will try to entertain everyone if it isn't working).

Will these other medicines eliminate the rebound problem?

I’m a grandmother to an ADHD child, and do not have enough knowledge to even attempt this. Hopefully others will be if more help.

PixiTrix, I don’t know enough about those meds either.
When my son was in school, we agreed that the teacher would give him a cue when he was behaving in a disruptive way in class. I hope some others can respond to the meds question.

Does your son have specific skills for managing his rebound now? Can he report to you about his ability to focus and his ability to maintain appropriate classroom behavior? I guess I would try to make a plan (if he does change meds) that includes measuring his Ability to do this or that task. If your son knows you’re both able to manage a transition he may feel more in control.

Hello, I'm not sure if I can help but I can tell you my experience. My son was first diagnosed when he was 6(17 now) he started on 37mg Concerta and it was a life save, worked great for years, the only problem I had was that he never wanted to eat and was skinny for years but as he grew we'd adjust meds accordingly. I think he capped on 100mg Concerta, Elementary and Middle school were very ROUGH, but we made it, barely:) Around end of eighth grade, Concerta just did not work at all. We switched to Adderall 25mgXR (we started in dosages of 5mg to see what worked best)and 10mg Adderall salts in the evening as needed in evening for homework if morning dosage has worn off. It has been great for us, he even has his appetite back, he is now a Junior and on the same dosage and I have had maybe 3 calls in 3 years from the school. All kids are different in regards to meds. Adderall didn't work for your daughter but may work for your son. I'd suggest starting in very low dosage 5 or 10 mg. When my son switched meds, I made sure we did it on the weekend so I could monitor him. I don't have experience in the meds you mentioned and wish I could be more helpful.

Since the whole class of children deal with restlessness and in attentiveness does the teachers do more hands on assignments or is it mainly lectures?

My 11 yr old is on Vyvanse and Intuniv and is doing okay with it. The Intuniv really helps with the afternoon rebound (massive meltdown). A generic for Intuniv just hit the market a couple of months ago. We haven't tried it yet because I still have discount cards for the name brand stuff.

Ask your psychiatrist for discount cards from Shire! The are good for 6 prescriptions and limit the amount you have to pay for Intuniv and Vyvanse. The bad news is, not every pharmacy accepts them, but Wal-mart & Sam's do. We lowered our monthly medication costs by almost $125.

I would not wait.

Good luck! :D

This is how I teach - hands on science activities/experiments, and I have to stop and sit and do nothing with them because they just can't manage to do it without being loud, silly, and not following my signals. The principal has come in twice to be a second set of eyes and hands - not to evaluate me, but because she is tracking them also.. We have also split them up where I took the ones that were behaving the previous time and the principal took the ones that weren't (though I don't really like this method). The regular teacher is not the issue (she mixes it up and does not rely on lecture) because the grade level has been the same from kindergarten - whether with a hands-on or less hands-on teacher - doesn't matter. I have worked with the teacher for years and had another daughter in her class...so it is not that.

Fortunately, my son has always been one of the ones behaving until the last few weeks when meds weren't working as well. Even then, he was not a "stand-out" problem.


Kels said:

Since the whole class of children deal with restlessness and in attentiveness does the teachers do more hands on assignments or is it mainly lectures?

I just checked with my Rx coverage/insurance and Vyvanse is still a nonpreferred medication and would cost me $111 for a 30 day supply. That is a lot compared to my $10 copay/$3 generic copay. Intuniv does have a generic now that I can get for $3. I made an appointment with the psychiatrist tomorrow morning. We'll see what he says.

kfwellman said:

My 11 yr old is on Vyvanse and Intuniv and is doing okay with it. The Intuniv really helps with the afternoon rebound (massive meltdown). A generic for Intuniv just hit the market a couple of months ago. We haven't tried it yet because I still have discount cards for the name brand stuff.

Ask your psychiatrist for discount cards from Shire! The are good for 6 prescriptions and limit the amount you have to pay for Intuniv and Vyvanse. The bad news is, not every pharmacy accepts them, but Wal-mart & Sam's do. We lowered our monthly medication costs by almost $125.

I would not wait.

Good luck! :D