Day 5 of ADHD Meds...

[SeekingBalance]

Well, we did it and took the leap into ADHD meds.

My 7 year old son was officially diagnosed in mid May. I sought to treat this medically because he's had a horrendous time in grade one and the biggest fallout was to his self-esteem. We learned at his evaluation that he is both gifted and ADHD combined type...  so I've got this bright kid who knows intellectually what he's supposed to do, but can't put the brakes on his impulsivity. Anyway, he's getting CBT twice a month and going to a  "social skills" daycamp for 2 weeks in the summer and then a weekly program starting in the fall.

My doctor initially prescribed Concerta - but he couldn't swallow the pills, and the more frustrated he became, of course the more unwilling he was to even try it.

He's now on 20 mg of Vyvanse - which we sprinkle on his breakfast and then make sure he eats it very promptly. His teacher reported that he had a bit more focus/perseverance with desk work. I've not noticed much at this point in time (problems aren't as pronounced at home) but he is having trouble getting to sleep and staying asleep.

Does anyone have experience with this side effect of a stimulant med? Will it go away, or is it more likely to continue? I'm going to keep with this for now, but obviously he can't continue to have a lack of sleep over the long run.

Megan

[SpottedFoxx]

I take adderal for ADHD.  When I first started on the med (and when my dosage changes), I have sleep disturbances.  It did go away for me.  I've heard epson salt baths help with this side effect as does melatonin.  You may want to check with your doctor about the melatonin.

[kbins]

My DS#1 is on 15mg of Adderall XR. He started on Focalin but had emotional crashes (sobbing, sad) around 4-6 pm every night. Anyhow, yes, if I don't get him the meds before 7am, he can be up to 9 or 10pm and says he's not sleepy. Before meds, he was asleep before 8:30 each night and slept soundly til 6 or 7am. He is completely unaware of what the meds are for - thinks they are allergy meds - this was to remove any placebo effect or excuse-making during the school year. (We plan to tell him of the ADHD diagnosis in a couple of weeks before summer camp.) He is also gifted but was so very much not realizing his potential due to the distractability/impulsivity. He would miss questions on assignments or tests because he skipped them or read the instructions too quickly. We noticed an immediate, profound difference on him with meds. He actually made all A's this quarter, and scored near perfect on the exit exam for grade this year (missed 2 questions).

Can you drop the dose back 5mg to see if it helps with sleep?

ETA: We also sprinkle, DS cannot swallow anything even as large as an M&M. He has a sensitive gag reflex.

[karne]

I'm not that much farther along this path than you, OP!  Is the dose your ds is currently taking a beginning dose to be increased as needed?  I know that the first dosage we tried was great for a few weeks (started low), but then needed to be adjusted, and even then it's possible that we may need adjustment or changing of meds.  I gather that this is very common, and that some kids respond well to certain meds at certain dosages, and it's trial and error to get there.

Regarding the sleep issues-we had them here prior to meds, and had been very successful in using a low dose of melatonin.  That, along with a good bedtime routine, works about 75-80% of the time.  However, if insomnia continues to be a side effect, we'll probably look at a med change because it's not OK to be up on school nights.  I have found this, and decreased appetite to be the more difficult issues with medication.

I will say that my child's quality of school life has improved fairly dramatically.  I hope that your ds has a similar experience.

[34me]

My dd started on Concerta and at 17 has been on Vyvanse for a couple years.  She had some issues at first but now sleeps better than I do.

[columbusmomma]

My DS started on vyvanse when he was 7. He had some sleep issues too initially. They went away in about 1-2 weeks. Same with the trouble falling asleep. My pediatrician did say he could have 1.5mg of melatonin if the sleep issue persisted for a long time. Something interesting I read recently was that sometimes(and I wouldn't think it is your DS'case since he is just starting the med)people have trouble falling asleep b/c the med wears off and then the hyperactivity of their ADHD kicks back in. At times taking a smaller dose of stimulatnt medication actually helps them fall asleep. Interesting! I would think this side effect will wear off for your DS after he's taken the med.for a bit.

[SeekingBalance]

Thanks to all of you for your input. He's now had a week's worth. The last two days we took the meds at 7am and he fell asleep before 9pm. Phew. So that was helpful. And last night he had a much more restful, peaceful sleep - also good. We're going to keep at it another week and then reassess dosage, benefits, etc. I'm grateful to have a place to ask these questions!

Megan

[karne]

Good luck!  Hope the week goes well.

[bl987ue]

Our son is on Concerta and had some problems with insomnia as well.  Something that seems to really work for him is to wake him at 6 to take his medicine and then let him drift back off.  His bedtimes are much happier now, plus we have a set bedtime ritual--warm bath, warm milk with honey and vanilla, and a little scalp massage.  He conks right out.

[Evan&Anna's_Mom]

My DD takes Vyvance as well.  I agree that we had some sleep issues at first but they went away within a couple of weeks.  But if she doesn't take her meds before about 8 AM bedtime get increasingly difficult.  Since she wants to sleep in now that it is summer this has become a much bigger issue.  In fact, she slept in past 9 this morning and we decided to skip meds entirely today.  Now, if I can keep from screaming at her until bedtime we'll be in great shape.I have a much harder time with her when she skips!  Too much noise, bouncing and careening off the walls (literally).  We've already been to the park and pool today, about to go for a bike ride.

[SeekingBalance]

Thanks Evan&Anna's Mom.

How old is your daughter? How long has she taken this and how much does she take?

We've now completed 2 weeks. I too think the summer schedule will mess up the timing of the morning meds. I think we need to up the dose a bit. He's tolerating it very well, no side effects other than the initial 4 nights of restless sleep. He's having a small benefit in the classroom, but I think we can do a bit better... will up the dose at the next doctor's appointment.

Megan

[Evan&Anna's_Mom]

My DD is 8.  Was diagnosed just shy of 7 and has been taking vyvanse vor about a year now.  She takes 30 mg.  The improvement in her school performance was amazing and we have only seen sleep issues when we started and when we increased the dose about 6 months ago -- both times for only a week or 2.  Though as I said, the summer is really messing with us at the moment and just last night DH and I decided that it would be better to wake her in the morning to get the meds back on track.  Its such a balancing act!

The other side effect that we do see is a very diminished appetite during the day.  I am OK with this -- she gets a good breakfast before taking the meds and when she is hungry during the day I make sure whatever she eats is calorie dense with at least some nutrition.  She is served lunch and dinner but I don't fuss over how much she eats (or doesn't eat).  When she gets hungry as the meds wear off I generally give her more dinner or something similar.  I had to learn to let go of the not eating and the need to eat just before bedtime which were frustrating at first.  But given the benefits we see with the meds, in the end I realized that was a small price to pay.

We taught DD to take a pill using mini M & Ms.  Regular M & Ms are actually larger than the pill she  needs to take and the wrong shape.  Tic Tacs were too sticky to work well.  She is completely competent at it now and loves that she doesn't have to take any sort of medication in liquid form any more.  So that the dose is more certain, it might be worth continuing to work with your child to be able to swallow the pill.

[bec]

My DD is on a non-stimulant drug for ADHD (Intuniv).  It's a pill she takes.  Because it's non-stimulant, it isn't as critical that we get it to her early enough.  A good friend of mine, though, does have her daughter on a stimulant drug.  She gives it to her daughter at 5am (otherwise she is up all night), and her daughter goes right back to sleep.  Maybe that could be a summer alternative? 

[SeekingBalance]

Evan&Anna's Mom... thanks for your reply! We're about where you were a year ago it seems. I got a detailed note from my son's teacher last night and it does seem that the meds have resulted in improvements at school - mainly with the inattentiveness/focus but less with the impulsiveness. Maybe we'll try 30mg to see if that would help more with all symptoms.

It sounds like the pill your daughter is taking is different in terms of its composition? Ours is a capsule with powder in it... so more long and narrow and not round.

I do agree we should be practicing pill swallowing however, because it would be more accurate than sprinkling on food. That will be our goal over the summer

Thanks, again, to everyone... so helpful and supportive!

Megan

[chaoticzenmom]

I have a friend who tried every form of pill and her child couldn't eat or sleep.  They finally tried the patch and they put it on after breakfast and take it off by 5:00 everyday and it seems to have done the trick.  I cannot remember the name of the patch, sorry. 

[Emmeline II]

Originally Posted by chaoticzenmom 

I have a friend who tried every form of pill and her child couldn't eat or sleep.  They finally tried the patch and they put it on after breakfast and take it off by 5:00 everyday and it seems to have done the trick.  I cannot remember the name of the patch, sorry. 

You may be talking about Daytrana.

[Evan&Anna's_Mom]

Originally Posted by SeekingBalance 
It sounds like the pill your daughter is taking is different in terms of its composition? Ours is a capsule with powder in it... so more long and narrow and not round.

No, same pill.  We just practiced with a round mini m&m because we couldn't find anything like the little capsule to practice with.  Also, the first couple of trial medications were pills rather than capsules.  Good luck!