medication increase

[columbusmomma]

I have a question about increasing the dosage of DS' medication. He takes vyvanse for adhd. He's been taking the lowest dose, 20mg for almost a year now. We do the occasional holiday from taking it. We recently increased the dosage to 30mg as he said the 20mg wasn't working anymore. The teachers also noted problems in the classroom. So he is older now, hasn't gained much wt, has gotten a little taller, but the dr. did explain the only reason for increasing isn't just getting bigger and needing more. I shouldn've asked more questions, and I'm not findout out much info online, but I'm totally curious as to why sometimes a higher dose is needed for this specific type of med? TIA!

[Essie]

I don't have an answer, but how old is he? isn't Vyvanse the same drug (almost) as Adderall? I ask b/c the dose of V seems high to me. What's going on in the classroom? do you like his teachers? do they "get" him? My son has Asperger's and is ADHD ish at times so I know how it is!

[Learning_Mum]

I think your body just adjusts to the medication and therefore needs more of it to be effective. That's what I've found with my AD anyway.

[Essie]

Did you get any answers OP?

[columbusmomma]

Thanks for the replies! I didn't know if this type of medication could be built up in the body and therefore become in effective, and yes it is similar to adderal, it is a stimulant medication for adhd/add. DS is 8, he is doing better in the classroom with this recent increase. 30mg used to be the lowest dose but now 20mg is available as the lowest dose. That's what he originally started on. He used that dose for a year.

[Essie]

Originally Posted by columbusmomma

Thanks for the replies! I didn't know if this type of medication could be built up in the body and therefore become in effective, and yes it is similar to adderal, it is a stimulant medication for adhd/add. DS is 8, he is doing better in the classroom with this recent increase. 30mg used to be the lowest dose but now 20mg is available as the lowest dose. That's what he originally started on. He used that dose for a year.

I don't think it does build up as it is short acting even if it's sustained release. I'm not positive, but I think it leaves the system pretty quickly unlike pain meds or anti depressants or the like.

[columbusmomma]

You are right Essie! It is quick acting and does leave the body quickly.
DS and his teachers both expressed concern about working in the classroom. The teachers, who know him well, as he had them last year in 2nd grade, noticed he was having focusing/concentration/etc. issues. DS told me twice that his medicine "wasn't working" anymore. I was trying to figure out why he would need an increase if at one point in time, the 20mg was working great. But then he noted that it wasn't seeming effective anymore. And I'm thinking to myself, will this happen throughout time, he'll just need a dosage change?

[Essie]

Originally Posted by columbusmomma

You are right Essie! It is quick acting and does leave the body quickly.
DS and his teachers both expressed concern about working in the classroom. The teachers, who know him well, as he had them last year in 2nd grade, noticed he was having focusing/concentration/etc. issues. DS told me twice that his medicine "wasn't working" anymore. I was trying to figure out why he would need an increase if at one point in time, the 20mg was working great. But then he noted that it wasn't seeming effective anymore. And I'm thinking to myself, will this happen throughout time, he'll just need a dosage change?

Well, from growing and being bigger his body could handle more, but as you stated he hasn't gotten much bigger. Maybe it's b/c of brain development? I am curious now. Have you contacted the Dr.? btw, I take Adderall XR myself.

About a year ago our child psychiatrist mentioned us trying a stimulant med for DS, as we took him off Risperdal. We never did try. One thing I fear is that it will interfere with sleep, as we have problems getting him to sleep anyway! I've been revisiting the idea b/c he has a really hard time keeping focused. He's doing ok so far in school but I just got a call today from the school that he was in silly/goofy mode. Does your son get that way? What have his challenges been?

HTH

[columbusmomma]

Good point about brain develpment. I will ask his doc when we go to his checkup in a few weeks!
Challenges at school in the past have been(and then again recently before his dosage increased): difficulty staying focused on what's happening in class. Not being able to complete the assignment, or rushing throughout. Trouble keeping hands to himself when on the rug with the whole class. Moving about the classroom vs. sitting at the table. Goofing around with the kids(although I know that's not just adhd symptoms but being himself). Prior to meds he was literally in trouble everyday at school for goofing around, not doing work. The teacher called daily!! Once we started the medication I never got a call again about silly behavior, being distracted by other kids,etc. He hasn't been to the "discipline" type room where kids go when they can't be in the room due to whatever issue is going on ever since he started on the vyvanse. When he started medication last year he had trouble falling asleep for the first couple days or so, then no problem. The biggest side of effect is no appetite at lunch but that returns later in the day and I let him snack and eat as much as he wants.

[Essie]

Originally Posted by columbusmomma

Good point about brain develpment. I will ask his doc when we go to his checkup in a few weeks!
Challenges at school in the past have been(and then again recently before his dosage increased): difficulty staying focused on what's happening in class. Not being able to complete the assignment, or rushing throughout. Trouble keeping hands to himself when on the rug with the whole class. Moving about the classroom vs. sitting at the table. Goofing around with the kids(although I know that's not just adhd symptoms but being himself). Prior to meds he was literally in trouble everyday at school for goofing around, not doing work. The teacher called daily!! Once we started the medication I never got a call again about silly behavior, being distracted by other kids,etc. He hasn't been to the "discipline" type room where kids go when they can't be in the room due to whatever issue is going on ever since he started on the vyvanse. When he started medication last year he had trouble falling asleep for the first couple days or so, then no problem. The biggest side of effect is no appetite at lunch but that returns later in the day and I let him snack and eat as much as he wants.

Thanks for sharing that's interesting. If it makes you feel any better I got a call yesterday for the same reason! Honestly though, sometimes do you feel like our kids are held to different standards than other kids? I mean, they called me b/c he was writing "burp" on his FINISHED work. It's not ideal behavior, but would they call a parent of a non adhd or Aspie kid for this?

This makes me re-think the other meds out there. I wonder if they would help my son... My dh is not into it at all so we have a really hard time over all of this.

[columbusmomma]

I do think our kids are held to different standards at times
However, I was getting all of these calls when DS was in kindergarten and 1st grade, prior to the diagnosis(for the most part). Luckily he had a wonderful teacher! She tried lots of classroom intervention type stuff. This he has the same teachers he did last year for 2nd grade as well. They know him well. I take it with a grain of salt when they have "concerns" and I'm feeling more comfortable now when deciding if it is adhd or just regular stuff. And your burp example(ha-ha!) is normal kid stuff! That's a good example of would they call if the child wasn't aspie or adhd!
Vyvanse is the first and only med DS has taken. We are fortunate that we didn't go through a bunch of trial and error meds. We are also fortunate that he is on course with his school work for his grade level. He is exceeding in math so that's cool too

I hear you though about your DH to be reluctant about meds. We were too. It has been a lifesaver though! You could always try and then stop giving if there are probs.

[ABrez]

This may not help much as I'm an adult but I take 50mg of Vyvanse a day. That is the middle of the road dose and I'm going up to 70mg a day soon. I wouldn't say that my dose is being increased because I've grown accustomed to the drug. The doctor has said just being in a different environment with additional stressors can make a person need a higher dose of the drug. For me, that's having a work at home job. Maybe just the faster pace of another grade level could make the drugs not be as effective for your son. 

For what it's worth... to take the meds and have the peace and quiet they bring is amazing. When the drugs stop working it's almost harder than before you had the drugs. Because you know there is another reality. If that makes any sense at all.

Are you in Columbus, Ohio? I'm in Hilliard.

[columbusmomma]

Hi ABrez, yes I'm in Cols,Ohio

Thanks for giving me a personal perspective on vyvanse. It is nice to hear how you feel since DS, being a child hasn't lived with ADHD as long as you have, and has only been coping with it for a few years YKWIM? But he did tell me that it just wasn't working anymore, so that is good that he knows himself. It has been a lifesaver for us, especially when being in school. So far the adjusted dose from 20 to 30 mg. is ok.