Success in Drastic Med Dose Reduction

[jfla]

This summer we've been able to reduce the Ritalin LA dose by almost 50%. A combination of one cap of LA (instead of two) and a tad of short acting Ritalin seems to do the trick. A med break might have been helpful too, though we don't know for sure.

Briefly, for the last six years:
-a short acting dose was Ritalin 16.25 or 17.5 mg (that's using 3 1/4 or 3 1/2 of 5mg tabs)
-a long acting dose of Ritalin LA was two capsules of 30mg each

Go figure why they don't seem to be equivalent. The LA dose was the dose that seemed to be effective...to get through school and homework he needed two doses. Do the math, that's a lot of Ritalin...way over the max recommended.

He is sensitive to recognizing the subtle differences and the effectiveness of slight changes in short acting Ritalin, but not the LA.

His previous doctor seemed to think that for some reason his body was not absorbing all of the LA...suggested he was probably peeing much of it out. Blood and liver tests were okay.

After seeing the new doc he tried one LA 30 mg and said it was like taking water.

At my suggestion during this summer he reluctantly tried doses lower than the normal dose of LA 60. Altho he couldn't really tell much difference he wanted to take the normal dose.

New doc ordered EKG, echocardiogram, blood, liver and kidney tests. They all came back normal.

Jump ahead to:
one week med break during family vacation,
two weeks on one dose a day for the summer job,
then two week med break during another family vacation.

Again he tried just one Ritalin LA 30. This time it seemed to work fine; good enough for driving, but not enough to do math or physics. So I convinced him to try just one Ritalin LA 30 + 2.5mg Ritalin. That would equal the Ritalin of a short acting dose.

Success! He says this is the dose for effectively doing homework or focusing in class.

Whether it is the med break or his body changing or a combination of both, lets hope he can continue this drastically lower dose after school starts.

[charliegirl]

WooHoo! I hope the lower dose continues working for him. Thats wonderful!

[lcdc1]

Cool, I bet he is happy too, to be taking less meds!

[bugsmom]

I'm always happy to hear that someone can successfully go to a lower dose! That is awesome.

Let us know how it goes.

[puzzled]

EEK, when Chase was on ritalin LA, he also took two 30mg capsules daily. After a summer med break, we tried to lower it to one...and he said it did not work. He did not elaborate though....

Even though the ritalin LA worked the best for Chase, we had to reluctantly switch to Dexedrine, which works but not as well (financial reasons). I do have some ritalin LA leftover...and some quick release ritalin...I wonder? Maybe we could try this method? If the dose was halved, the cost would be manageable I think.....

Have to bring it up at Chase's next appointment, but I think the ped may shoot me if I want to switch him again, LOL.

Perhaps....we could try it on our own and test it out before the appointment. He has had both meds before, so no danger of bad reactions....and he is very self aware as far as meds go....and it is the beginning of the year, so less pressure right now if it fails as far as challenging school work, the first weeks are usually lots of review.

[jj]

Wonderful. I'm also keeping my fingers crossed this continues to be the perfect dose.

[lisacap]

I tried the same thing with Christian this summer, no med break though, don't think any of us could handle it, but where his summer was so laid back this year, I cut his med's in half myself, didn't tell the doctor, because in the event I needed to have them I would..so instead of 2, 36 mlgs of concerta with a 20 mgl of ritalin each day to jump start it, I started giving him 1 , 36 of concerta and 1/2 of the ritalin and he has been so much better. His summer work is written pretty messy, but he did write his 3 book reports and knew what they were all about and stay edfocused with his writing on the paper, just can't read a word of it. School starts on the 3rd, so this week starting Monday, I am going to do just the 36 of concerta and the 20 of regular ritalin, make him rewrite his reports and see how he does...if all goes well, he is going to start school on this dose...I think sometimes, the more we give them, the worse they are, so hopefully it works out for all of them with school just around the corner.

[puzzled]

I talked to Chase and he is all for trying the combo, so we will. His next appointment is for September 8th I believe. that will give us time to see how it goes....he is usually pretty good at telling me how he feels on a med/dose.

[jfla]

so interesting to read about your experiences, lisacap and puzzled.

I can't help but wonder what influenced the change in my son's response to the LA --med break, age related to the way he metabolizes the LA. He's almost 20.

Before trying the combination of LA and short acting, I wanted to check exactly how much short acting ritalin he needed to start his day. Knowing that I could come up with the same amount of mg in an LA + short acting combo.

His old doc thought that since he used 16.25 or 17.5 as an extra evening dose, that same dose might not be enough in the morning. We tried 17.5 one morning and J thought it might have been a bit too much.

Oh yeah, J mentioned that he thought that he was experiencing rebound effects for some time at the beginning of the summer. So I guess it took awhile for that to settle down too.

I gotta go ;D

I'm glad the combination worked and hope it does for you.

[jill]

cool