Poll: What type of med does your child take?

[camismom]

Mine is on Ritalin LA but I am seriously considering adding back in the Strattera to get her thru this supercharged, hormonally induced hyperness and over-dramatic phase she's going thru. Seems the book I read recently that says ADHD gets worse in girls when they hit puberty is proving to be true!

[crillmom]

my son takes regular ritilan 10 mg. three times a day

[oliviasmommy]

Olivia just switched to Concerta 27mg from Adderall XR 15mg.

[Linda]

Paul is 16 and knock on wood....but he is off meds.It was his choice this school year and so far so good!

[camismom]

I'm knocking Linda... I'm knocking!

[rosyred45]

I'm knocking too Linda ;)Glad to hear he's doing well.

Christy, stop scaring me, that's not funny. Although I did talk to a lady last night that laughed and said, "the addditude doesn't start until they are about 14 :oTara is in trouble, or would that be me

[camismom]

It would be you, believe me. LOL All I can say is thank goodness I only have one!

[JulieinSC]

Mine has been on Metadate CD for 3 years now.

[JeanMarie]

The "other" for us is Metadate CD, 20mg once a day for my ADHD 9 year old son. We just started using Focalin 5mg for occasional use on the weekends, as we do not wish to use the longer acting form when he's not in school. The Focalin works so well that I will be intently watching for the XR formulation to be approved by the FDA.

[Linda]

Hey JeanMarie....Welcome to the board...I think you will find everything you are looking for.The members are wonderful and more than willing to help.

[eaccae]

I checked off "other" because we are going back to Metadate CD this week!

The Metadate CD worked really well - less rebound, it releases more toward the end of the day which is what DS needed - and DS was more balanced on it.

Health insurance stopped coverage. He was on Ritalin LA - but it releases 50-50 and he is actually "too" medicated in the mornings and not enough in the afternoons - rebounds are terrible.

The doctor got approval for the Metadate CD and we are now going back to taht. Here's hoping it works as well switching back!!!

[camismom]

eaccae, How long does that Metadate hold out compared to the Ritalin LA?

Although it did seem to "even her out" Cami didn't do well when she tried the Strat before because she's not a big eater, so she kept a stomach ache.

You say the rebound isn't quite as bad on the Metadate? I like the sound of that. Cami does well during the day on the Ritalin, but at late afternoon and at night when it's worn off.... woo! Watch out, she is hyper that ever!

[Linda]

When Paul was on regular ritalin and it wore off late afternoon it was horrible...like Christy said it was worse than before.

[sportsmom]

Levi is on strattera. 25mg in the morning and 25mg at supper. He is doing very good on it----I would love for him to have a break but unfornataly that is not possible with strattera---we notice rebounds when he does not take it.

[eaccae]

The Metadate CD lasted not much longer than the Ritalin LA but because there weren't the rebound issues - it didn't matter as much. I still may have to give a 5mg ritalin booster when he gets home - at least on Hockey days - we're going to see how he does when he switches back and go from there.

I copied this from a post by zachsmom on millermom's board:

Here's how certain stimulants release per my ds' dr.

Concerta - 18% initially/80% over course of day and lasts (10-12 hrs)

Metadate CD - 30%/70% (8 hrs)

Ritalin LA - 50%/50% (8-9 hrs)

Perhaps this is helpful for some of you whose children need a stronger boost in the morning.

I copied this from a post on millermom's board - it gives the break down of how some of the extended releases work/differ:

Over the past few years there have been additions to the list of medications for ADHD. All but one are the same basic medications we have always used but using different release mechanisms that extend the time they are effective. The one new medication is Focalin, released by the company that produces Ritalin. This article is meant to be an overview. The reader should read the literature from the pharmaceutical company to learn the specific details.

The pharmaceutical companies that make these new, longer-lasting products advertise that they last all day or that they cover the whole school day. This might not be a correct statement for your child.

There are three basic stimulant medications used for ADHD: methylphenidate (Ritalin), dextroamphetamine (Dexedrine), and dextroamphetamine plus levoamphetamine (Adderall). Very recently a modification of methylphenidate was released, Focalin.

To summarize these additions:

METHYLPHENIDATE
Brand Name: Ritalin, Ritalin SR 20

Longer-acting forms: Metadate ER, Metadate CD, Concerta

DEXTRO-AMPHETAMINE
Brand Name: Dexedrine

Longer-acting form: Dexedrine Spansule

DEXTRO-AMPHETAMINE-LEVO-AMPHETAMINE
Brand Name: Adderall

Longer-acting form: Adderall XR

DEXTRO-METHYLPHENIDATE
Brand Name: Focalin

METHYLPHENIDATE
This product has been available since 1954. The brand name is Ritalin. Each tablet last about four hours and comes in a 5 mg, 10 mg and 20 mg size.

The longer-acting form has also been available, Ritalin-SR20. (SR means sustained release; 20 means that the total amount of methylphenidate is 20 mg.) The mechanism of action releases 10 mg initially and 10 mg four hours later. Note that "SR20" does not mean that the person gets 20 mg over eight hours. The surface of the SR product can not be crushed, chewed, or cut. If the surface is broken, all of the medication will be released at once. The release process has been inconsistent. Sometimes it last six hours and sometimes each release lasts thee hours, resulting in down times between hours three and four of each release.

Metadate is a longer-acting methylphenidate. It comes in two forms, Metadate ER and Metadate CD. Metadate ER is designed to last eight hours. It comes in a 10 mg and a 20 mg strength. The Metadate ER 10 mg releases the equivalent of 5 mg initially and 5 mg four hours later. The Metadate ER 20 mg releases the equivalent of 10 mg immediately and 10 mg four hours later. (Again, do not be confused by the number, thinking that this is the level released.) The surface of the tablet can not be broken. If it is, all of the medication is released immediately.

Metadate CD is the newest form of this brand and lasts eight hours. It is a capsule with multiple beads inside. 6 mg are released initially and 14 mg are released over the remainder of time.Unlike the Metadate ER, the capsule can be opened and the beads sprinkled over food and taken in this way.

Concerta is a long acting form of methylphenidate that uses a unique and different release mechanism. It slowly releases the medication in an even flow over 10 to 12 hours. The full length of action may vary with each person. The conversion model between methylphenidate and Concerta is as follows:

If the person has been taking methylphenidate The equivalent Concerta is

5 mg three times a day Concerta 18

10 mg three times a day Concerta 36

15 mg three times a day Concerta 54

20 mg three times a day two Concerta 36*

*A 72 mg form will be coming out soon

Concerta must be used as a whole capsule. If the surface is broken by chewing or cutting it in half, the release mechanism will not work.

DEXTRO-AMPHETAMINE
This product has been available in the tablet form since the 1950s. The brand name, Dexedrine, comes in a 5 mg tablet only. Thus, the individual would take multiple tablets to equal the dose desired. The generic form, Dextrostat, comes in a 10 mg strength.

The longer-acting form is Dexedrine Spansule. It comes in a 5 mg, 10 mg, and 15 mg strength. If the individual needs a 20 mg strength, two 10 mg spansules are used. The spansule is a capsule with small beads inside and releases a steady strength of the dose over eight hours. It, too, can be opened and sprinkled over food.

DEXTRO-AMPHETAMINE and LEVO-AMPHETAMINE
The trade name is Adderall. There are no generic forms at this time. The shorter-acting tables come in 5 mg, 10 mg, 20 mg, and 30 mg strengths. Each is scored so that by breaking it in half, the physician can set an individual dose from 2.5 mg to 20 mg. (The 30 mg is to provide the flexibility of a 15 mg dose; it is not recommended that 30 mg be used for an individual dose.) The ads state that one dose will last through the school day. In reality, each tablet lasts for an average of five hours.

The new, longer-acting form is Adderall XR. It comes in a 10 mg, 20 mg, and 30 mg capsule. Fifty percent of the beads release immediately and 50 percent are released slowly over about 8 hours. Thus, the Adderall XR 10 releases 5 mg immediately and 5 mg over the remaining time. The XR 20 releases 10 immediately and 10 over time. And, the XT 30 releases 15 mg immediately and 15 mg over time. Again, do not misunderstand the amount in the name as the amount released at any one time. Like the other capsules with beads, it can be opened and sprinkled over food.

FOCALIN
Focalin is a new product. It is a refined form of Ritalin. The pharmaceutical company studied the two forms of methylphenidate, dextro-methylphenidate and levo-methylphenidate, and found that the dextro form was significantly more potent than the levo form. Focalin is dextro-methylphenidate. Each tablet is described as being twice as effective as Ritalin. Thus, half the dose that was used with Ritalin is needed. It comes in a 2.5 mg, 5 mg, and 10 mg strength. This is equivalent to the 5 mg, 10 mg, and 20 mg Ritalin tablets. Each tablet lasts about four hours.

BE AN INFORMED CONSUMER.
Labels and strengths can be misleading. The length of action advertised may be exaggerated and you must learn how long it last for each individual. The numbers in the name of the product can be misleading, suggesting that this is the amount released throughout the time of effectiveness.

It is difficult to know which medication is best for which individual. Also, although there are common side effects, some individuals have these side effects with one product and not with another. It takes trial and experience to find the best medication, dose, and timing.

When using a longer-acting form of a medication, be sure to learn how long it lasts. It may be necessary to add a short-acting tablet to cover the end of the day. For example, if a student takes a Concerta tablet at 7:00 A.M., it might wear off between 5:00 and 7:00 P.M. If homework is done until 9;00 or 10:00 P.M., a short acting methylphenidate might be needed to cover the end of the day. If the eight hour longer-acting tables are used, they might wear off at about 3:00 or 4:00 P.M. and a shorter acting tablet might be needed to cover homework.