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    #68835 - 02/13/10 03:26 PM ADHD-Vyvanse vs. Concerta
    JenSMP Offline
    Member

    Registered: 09/06/09
    Posts: 425
    Our son (6 years old) was supposed to start Concerta-18 mg tomorrow to treat ADHD. Our insurance will not cover Concerta until we try Vyvanse. I didn't realize an insurance company could override a doctor's order! Luckily the doctor sent a Rx for both (in case ds couldn't swallow a pill-Vyvanse can be broken open and dissolved in water). So it looks like we're starting out on Vyvanse instead. Our doctor didn't seem to have a preference between these two medications.

    Anyone else have children on either of these medications? If so, what has been your experience. Do you have any advice for us during the "observation" stage of starting meds? Thanks!

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    #68837 - 02/13/10 04:00 PM Re: ADHD-Vyvanse vs. Concerta [Re: JenSMP]
    renie1 Offline
    Member

    Registered: 05/04/09
    Posts: 229
    i'm sure others will chime in but i have some experience as an adult with Vyvanese. I decided to try out going on meds for my own ADD to see how it would feel if we made the decision for my son. Vyvanese was the best (i also tried adderal and another i forget the name of). I felt very organized and had no more trouble with concentration, but did not feel like i was on "speed", like adderal. The problem for me was that my insurance would not cover it and it was very very expensive. We ended up putting off doing meds for my DS.
    irene

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    #68858 - 02/14/10 05:57 AM Re: ADHD-Vyvanse vs. Concerta [Re: ]
    keet Offline
    Member

    Registered: 01/26/08
    Posts: 215
    We tried Concerta with ds, but when they increased the dose his stomach started to hurt. He's been on Vyvanse for a couple of weeks and is not experiencing the same pain.

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    #68860 - 02/14/10 07:46 AM Re: ADHD-Vyvanse vs. Concerta [Re: keet]
    melmichigan Offline
    Member

    Registered: 09/05/08
    Posts: 679
    With all the amphetamines you need to watch for the emotional reaction. I've been told that if they are emotional the dose isn't correct, but in our experience the higher doses just brought on more side effects. Weight loss due to loss of appetite and trouble sleeping are the others. We have opted to leave both off meds for now. One DD was an emotional wreck and the other quit gaining weight no matter what we tried, when she fell 20 lbs behind her twin we took her off meds.

    I hope you find a drug that works for your DS, it can be a trying time to find the "right" one. It is trial and error really depending on your specific child.


    Edited by melmichigan (02/14/10 07:48 AM)
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    #68868 - 02/14/10 09:47 AM Re: ADHD-Vyvanse vs. Concerta [Re: melmichigan]
    JenSMP Offline
    Member

    Registered: 09/06/09
    Posts: 425
    Today we started the Vyvanse. About an hour after taking it, we noticed he seemed more subdued and relaxed but no personality change or anything like that. Then he became very clingy and affectionate, very very syrupy sweet. Then about 3 hours after taking the medication, he had a MAJOR meltdown/tantrum over having to turn off his DSi. It was an extreme over reaction. He even kicked his door repeatedly and make his leg bleed. It took quite a while to calm him down and he complained that his head never works right, that his conscience should be telling him the right thing to do but his tells him to keep behaving badly. Once I got him calmed down, he thanked me for making him feel better and has been very clingy ever since. Now he's just moody and irritable and cries very easily. Everything is bothering him. We finally had to tell him to not talk if he was going to complain. It's almost like he's imagining things to complain about. Overall, he's definitely calmer but I'm not noticing that he's any more focused, and he's certainly NOT happier. He's very needy.

    I know it's just the first day. Is this normal though? Does he need a higher dose, or is this an indication that it's the wrong medication? The doctor said the medication should start working on the first day but to observe for 3-7 days at the current dosage before increasing the dose. I can't imagine him going to school on Tuesday like this.

    I've been to some ADHD forums, but they scare the hell out of me, to tell you the truth. You get such mixed information. I will continue to check them out, but I have come to really trust the information and advice I get on this site. I know anything I hear here is going to be well-thought out and provided based on the experience of other very caring, dedicated parents.

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    #68869 - 02/14/10 10:30 AM Re: ADHD-Vyvanse vs. Concerta [Re: JenSMP]
    melmichigan Offline
    Member

    Registered: 09/05/08
    Posts: 679
    This is similar to the reaction my older DD had, for her it only became worse as we increased the dosage. But again, I caution that every child reacts differently. I imagine the doctor would tell you to stick it out for a few more days. For us it came to a point where my DD had to be physically restrained during her outbreaks. She said the medicine made her calmer overall, aside from the emotional outbursts. The problem was that they didn't really help with her concentration and although she could sit and work longer she actual did worse on achievement tests with the meds. As annoying as it may sound it's like she needs the movement to help her do well.

    My younger DD didn't have the outburst and overall did well, she just could/would not eat, no matter what we tried. She was even on Pediasure supplements to no avail. Two different children, two different reactions. It is so individual. <<<hugs>>>

    Has your doctor mentioned working with a behavior therapist while on meds to learn new coping behaviors, the ultimate goal being to then be able to take them off the meds and have then better able to function? We worked on behaviors with my younger DD while she was on meds and she is actually doing pretty well off meds.


    Edited by melmichigan (02/14/10 10:34 AM)
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    #68871 - 02/14/10 11:10 AM Re: ADHD-Vyvanse vs. Concerta [Re: melmichigan]
    JenSMP Offline
    Member

    Registered: 09/06/09
    Posts: 425
    Yes, we are also working on controlling the outbursts. The thing is, the outbursts are the least of our concerns. They are inappropriate to say the least, but they are not frequent. It's the inattention (even more than the hyperactivity, although he has both) that is so debilitating for our son. Even when he's allowed to move around during a lesson or while doing schoolwork, he's not able to focus long enough to complete tasks. He can't even eat a meal without being up at least 15 times with frequent reminders to come back to the table and eat. When he takes a shower or gets dressed, he simply cannot follow through without reminders, even with visual cues, charts, etc. It's affecting his self esteem, and he wonders what is wrong with him. I wish we could manage without the meds, but we've tried all the behavior mod techniques and home/school interventions. They help, but at this point it's not enough. His inattention is getting worse instead of better. We've had the same problems for years, and feel that the medication is a necessary next step. My goal, and our doctor's goal, is to eventually come off the meds. In the meantime, he needs to learn coping strategies.

    He's much more emotional that usual, however on this medication. I can't help but attribute it to the Vyvanse. Hopefully it'll pass, but if not, we'll have to try something else. On a positive note, he ate lunch without any problem. He hasn't complained of appetite loss or stomach aches at all.

    The strange thing about the meltdown today is that he seemed fearful and sad rather than angry and frustrated like usual. Again, I know it's the first day. I need to just see what happens over the next couple of days, but I've been so nervous about this. I just prayed and prayed that it would go smoothly.

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    #68877 - 02/14/10 01:56 PM Re: ADHD-Vyvanse vs. Concerta [Re: JenSMP]
    JenSMP Offline
    Member

    Registered: 09/06/09
    Posts: 425
    The day has gotten much better. DS seems happier than this morning, calm, less energetic (asked to come home when we were on a walk-usually could go walking for hours), and still a little more emotional (gets sad and irritated easily). I have read that for some, these emotional side effects fade or disappear after the first few days or even weeks. I hope that's the case for my little guy. So far, he's not having any physical side effects other than a very slight dry mouth and loss of appetite. He's still eating when I give him food, but he doesn't ask for any snacks like usual.

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    #68879 - 02/14/10 03:41 PM Re: ADHD-Vyvanse vs. Concerta [Re: JenSMP]
    melmichigan Offline
    Member

    Registered: 09/05/08
    Posts: 679
    A friend of our has a DD who is doing great on meds. She just sets out an appropriate portion and encourages her DD to eat it. She has lost weight but not to the extreme of my DD, so giving them food and even drinks when you know they need it is a great way to combat the loss of appetite. smile The emotional side effects can and does fade for many kids, although it can take a little while, even a few weeks.

    Please don't feel the need to explain your reasoning. I definately think that there are kids that needs meds and would never feel that I could put myself in your shoes. I really wish they could have worked better for my kids, especially my older DD. I am also very grateful that our physician had our DD's working with behavior strategies while on meds, from everything I understand it isn't very common. It's more common that the med is the end of treatment, see me again when you need a refill. Therapy definately made a difference with my younger DD. The doctor has also left it open to possible small runs on meds for my younger DD when she really needs to work on specific behavior, which we may need to consider at some point in her future. Again <<<hugs>>>


    Edited by melmichigan (02/14/10 03:41 PM)
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    #68881 - 02/14/10 04:24 PM Re: ADHD-Vyvanse vs. Concerta [Re: melmichigan]
    JenSMP Offline
    Member

    Registered: 09/06/09
    Posts: 425
    Thanks Melissa. I'm feeling more encouraged now as the day has progressed. I definitely notice differences in my ds, both good and bad. We'll see where we are in a few days. It's always a tough decision to start medication, and the mixed results people experience make that decision even more difficult. He seems to be coming off the Vyvanse now (wearing off), and he's not irritable at all. He's just a little manic and unfocused (and still not hungry for dinner at 7:30 pm).

    I am going to keep the behavior therapy in mind. We haven't done that. We just use very consistent behavior modification techniques at home. Some we've come up with on our own. I'm a speech pathologist, and my husband has a psychology background, although he doesn't work in the field anymore. I feel like we have pretty good insight, but we're certainly no experts. Our developmental behavioral pediatrician has given us some great interventions for home and for school as well. She's very familiar with Montessori, so that's been good. So many of the interventions are meant for a traditional classroom, and they do not apply for our personal situation. We are very lucky to have a school and teacher who is willing to try anything, even traditional classroom strategies if necessary. Hopefully this classroom will continue to be good for ds. He will be there for two more years after this one if all goes well.

    I am going to look into the behavior therapy though. DS really needs some coping strategies for dealing with his frustration, anger, and disappointment. We currently have about 4 meltdowns a week at home, and sometimes they are pretty severe. At school, he doesn't have major tantrums, but he cries very easily. They describe him as highly emotional. Luckily the meltdowns and crying fits don't last long, but still, crying over every little thing in the classroom isn't productive and isn't winning him any friends.

    Thanks again for the support. I really appreciate it.

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