Gifted Issues Discussion homepage Forums Twice Exceptional We started the meds...

No, but I have a friend that works at Cooperative Education Services here that knows some advocates, so I might ask her for some help.

Went to the psychologist today... He wants to try to up the meds to 30mg and try another med that's short acting since the Vyvanse seems to be wearing off early. I'm not sold on that one, but I'll try the 30mg... He said that the Vyvanse probably wears off around the time we get home and that's probably why he's so whiny around that time.

I also talked to my friend at CES and she gave me some good advice. So I sent an email to his teacher and will go from there.

KD, I hope it works out well!

DeeDee

KD,
Just wanted to check in and see how the medication is going. Did the increased dose of Vyvanse work?

I did want to mention also that we were giving my son a lower dose of Concerta for a while and felt that it worked pretty well. His focus was good, but it just didn't last long enough. Then, when it would wear off, right about the time we got home from school, he'd be a mess for a couple of hours. Very irritable, grumpy, and highly emotional. What helped was to give him a short acting low dose booster in the afternoon before the rebound effect reared it's ugly head. It did work fairly well, but the focus wasn't as good after school during homework time.

Now that we've increased his dose, we do not need the booster. The morning dose lasts long enough, and we really don't see the rebound stuff anymore. Around the 10 hour mark I make sure we are involved in a non-stressful activity. Usually I read to him. Then, he eats dinner, has a shower, we read some more, and then he goes to bed. I guess my point is, I wish we'd increased the dose of the extended release med (Concerta) sooner. I thought we were on the right dose, but evidently not.

I don't think it's a bad idea to try to increased dose sooner than later. You probably have already done that at this point. As you now know, you can usually tell pretty quickly, and you already have a basis for comparison with the lower dose. If the emotional stuff gets worse with the increased dose, maybe a methylphenidate drug like Concerta or Ritalin will be better.
That was our experience, but it is different for everyone.

Keep us posted, and good luck. Thinking of you guys.

Thanks for checking in. I haven't done the increased dose yet just due to scheduling difficulties. I need to give his psychologist a form that his teacher filled out (that looks like a "normal" kid). So I'm not sure what he'll suggest after. He had also suggested the booster, but wanted to check a higher dose first. The only "issue" I have is, at $40 a prescription for a 30-day dose, I feel like it's a waste not to finish it. KWIM? I know that's petty, but, it's $80 in a matter of a few weeks. I wish we could just get a trial to test it and see where it goes.

Thanks again for everyone's input!

Vyvanse is advertised to last 14 hours, but most parents tell me it does not last that long. If given prior to school, the effectiveness has often worn off by the time children begin homework.

Several clients reported symptoms of severe depression after taking Vyvanse, which included suicide ideation.

Most of the psychiatrists that I work with do not feel Vyvanse is better than Adderall. However, they often prescribe Vyvanse to teens because it can not be abused. Snorting Vyvanse will not result in a feeling of being high. Unfortunately, Adderall is sometimes abused by teens. They crush it and snort it to get high. My college clients who take Adderall have to keep it locked in a safe (to prevent theft).

I know what you mean about the cost of the medication. It's crazy expensive! I don't know about the cost of a booster to go along with Vyvanse, but when my son took the methyphenidate (Ritalin) booster, it was super cheap.

I can't tell you how much we spent on meds during the first few months. It was crazy. I have so many leftover medications here it looks like a pharmacy. I hate to throw them away just in case he has to switch back to one of those meds in the future.

Good luck with everything.

We had our follow up with the ped, she prescribed the 30mg of Vyvanse. Luckily, we went through the whole Rx of the 20mg before changing. I refuse to waste those things...

His psychologist suggested the booster, but his ped did not. She said to just give it to him later than we usually do and he would be fine. We give it to him between 6:15-6:45 now, so just do it later and see what happens.

I also asked her about the emotional outbursts and she said that those should get better with the higher dosage. So hopefully she's right about that. Other than that, we haven't had any more of the "side effects" and he hasn't lost any weight and his eating habits haven't changed luckily.

KD, the outbursts could get better OR worse with the higher dosage. Some kids find the stimulant ADHD meds ramp them up. Our kid on Vyvanse was a guy on the edge-- think 3-4 cups of coffee, revved to breaking point. He had many more outbursts than usual, to the point where we had to discontinue it-- the focus wasn't worth the emotional volatility to us at this point. YMMV.

We found the nonstimulant Strattera worked well for attention without giving us extra outbursts.

Personally, I also wouldn't use just a pediatrician to prescribe these drugs-- I'm more comfortable with a specialist who sees hundreds of kids with the same diagnosis mine has, and has lots of experience with each med. Again YMMV.

DeeDee

So far, so good. The outbursts haven't been worse - not necessarily better, but definitely not worse.

I've seen a difference on the higher dosage, and the psychologist said that, as long as we don't have any new problems, we don't have to see him as often anymore.