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Post by mom23boyz on Jan 31, 2009 0:31:35 GMT -5
Well my ds had his appointment with the head psych today. He thinks my ds easily develops tolerance to stim medication. Since we max out each med we try and its still not enough. I told him we did great with Concerta for about 6 months and then when we up'ed the dose to 54 mg it still was not enough and every other drug lasts about 3 months then not working as well. The doctor says this is a tolerance build up. He says the receptors in my sons brain are too saturated with the max doses of ritalin and he needs a drug "holiday". He said we could either go without drugs for 10 days,( that's not gonna happen he wouldnt be able to go to school or anywhere!!) or we could use Vyvanse for 15 days to undo the ritalin saturation then back to the Concerta for 3 months, then back to Vyvanse 2 weeks, then back to Concerta 3 months so he doesnt build up the tolerance. Has anyone else ever heard of this reasoning? He said if we keep going up on doses it will just keep happening. But we had bad reactions to Adderall XR so I am hoping the Vyvanse doesn't do this since it's only 2 weeks at a time. I told him I tried that a few months ago. When the Adderall XR started making ds crazy, I took him off and put him on Concerta 54 mg to get him through until his appt, and it was not enough. The dr says if its still not enough, we can add some other medication to help with the impulsivity. I am wondering would this be like an antidepressant? And does anyone have experience with this sort of cocktail?  ? Thanks for any info!! |
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Post by charliegirl on Jan 31, 2009 3:37:31 GMT -5
Have you tried not giving meds on weekends and holidays? Many parents only give their children meds when they need the benefits for school or activities they need to have more focus and control for. That is often enough to keep them from developing a tolerance for the meds.
Many people do best with med cocktails but the amounts and types of meds are totally dependent on each individual. Your dr will be the best person to determine which ones will work best for your ds.
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Post by bugsmom on Jan 31, 2009 15:25:59 GMT -5
mom23...my heart goes out to you. It's got to be so frustrating when something actually works, and then he builds up these tolorences. Hugs to you.
CG is right that your doctor would be the best to discuss all of this. Many children do take different meds that are not traditionlly used for adhd. It sounds as if your doctor is trying his best to find out will be good for your son. That doesn't neccessarily involve an anti-depressent, but it could. Another option for the impulsivity, could be Tenex, which is a blood-pressure medicine. My son has taken it for over a year and it is somewhat helpful with the hyperness and impulsivity. I know others have had better luck with it, but like your son, my son's hyperactivity is off the charts.
It can be so hard to take a drug "holiday" when their disability effects every aspect of their life. Just know you'll get through this and we're here for you.
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Post by lisacap on Jan 31, 2009 16:15:25 GMT -5
Christian has also maxed out every drug he has taken, what seems to be a miracle the first few weeks or months turns back into a nightmare....It took a while, but if you look it up the maximum amount of concerta they can take is 72mlg. Christian takes 2 "36" mlg every morning. They also give me one perscription for it, written as 2 daily, so you only have one copay. He has been on it for almost 2 yrs like this now. When behavior starts to change, or he is in trouble alot in school, I add a 20 mlg ritalin booster in the morning, it kicks in quicker and gets him through the day. On the weekends I cut it down, ( I don't tell the doctor, in the event I need to do both so I have them) I give him 1 '36' and the 20 mlg of ritalin. It keeps him calm enough all day, and when Monday comes around I go back up to the 72 to get him through school. They say it is a lot, but nothing else works for him, and with this mixture he has been doing very well...hope that helps..he is also 13 so I don't want to try any of the new patch things, he will rip them off the minute he leaves the house. But we have tried every ADHD med out there, and always end up back on the Concerta. Don't know if this helps you any, but it is something to think about. Try lowering it on the weekends and upping it during school. If we have major plans on the weekend, like tonight we have a party, I give him the whole kit and kaboodle....
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Post by mom23boyz on Feb 1, 2009 14:30:34 GMT -5
Thanks all for the advice. It is back to school tomorrow, I hope they are not calling me by 11 am telling me to come and get him!! Well in regards to not medicating on weekends and holidays, our family would be in shambles, my ds would be in constant trouble and we wouldn't be able to leave the house!! I do give him lower doses of Focalin on the weekends than I use for school, but I believe the dr is right about the tolerance.
Lisa thanks for the info. I knew 72 is the max, and his dr had mentioned that it would be as high as we could go, but he wants to try this Vyvanse 2 week and then 54 mg Concerta first to see if we can stay at a lower dose I guess. Because when I asked what if the 54 is not enough? He said we could try adding something with it? I dont know what that is, but I figured we would just go up to the 72 mg dose and then if that didn't work add something else, but I dont have my med license, lol. I will keep you all posted, please pray for us this week during school, the school is breathing down my neck wanting another meeting, to see what their options are, and I flat out told them, he is going through med changes again, and I will not put him in the special education room!! Thanks for the hope!!!
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Post by puzzled on Feb 1, 2009 20:41:42 GMT -5
My son takes his meds only on school days, but he is not hyperactive at all, just a bit talkative.
He takes Tenex (guanfacine is the generic) which helps with impulsivivity, aggression and I believe a small bit with focus as well. It is an older blood pressure medicine and is on the $4 list at Walmart. Chase takes 1mg each morning, and 2mg in the evening....it did make his sleepy the first few days...and I think a teeny bit dizzy/nauseous...and he is sometimes a bit sleepy on days he doesn't take his stim, but if he has something he needs to do, I give him a fast acting ritalin to pull him through.
You may ask your doctor about this med, Chase has been on it for about 3 years now, no side effects to speak of except perhaps a slight weight gain, which he needed badly.
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I was about to conquer the world but then I got distracted by something shiny.
