Thursday, February 04, 2016

ADHD Meds.: Complaints & Solutions

ADHD Medications:  Typical Complaints & Solutions

Not eating - Allow healthy snacks; during summer break they often make-up for lost growth; eat by the  clock vs. hungry; if still OK on growth chart, don't worry.
Mid-late morning behavior problems - Adjust dose timing - at-home + mid-morn. doses; change to longer lasting medication.
After school behavior problems - Was noon dose given?; Change to long-lasting form.
Very irritable mid-late afternoon - Same as just above.

After 4-6 weeks meds. not working as well – Called “acclimation phenomenon”; increase dose

Trouble falling asleep - Make dosage time earlier, or, amount smaller.

Still can’t get up, wake-up mornings - Give pre-awakening dose; re-review sleep problems for possible solutions.

More withdrawn, crying, angry - Lower dose or change medication.

Too zoned-out; very tired - Same as just above.
Headaches; stomach pain - Try Tylenol and/or Pepto-Bismol, wait 1 week; maybe just initial reaction (not uncommon).

Refuses to take it - Do more education; discuss their resistance: Stigma?; How it makes them feel?; Trouble swallowing pills?; Feel it's "controlling" them?
Nothing happened after 1 month! - Should have increased dose after 1-2 weeks!

Uncertain what to expect? - Get education from doctor, Internet.
Helped some problems, not others - Depends on which symptoms it helped and which it didn't; Discuss with doctor; Consider different medication or second medication.  Re-check diagnosis.

Medication effects don't last long enough - Dose maybe too low; Consider longer lasting form; most meds. last from 6 to 12 hrs.; individual metabolism varies & effects med. duration.
Feel too "revved-up", or shaky - Dose too high; Wrong med.?

Skin itches a lot - Dose too high; Wrong med.; try lotion or Vit. E capsules; stimulants can cause skin dryness.
Everything is much worse - Wrong med.; re-check diagnosis; most ADHD people have at least one co-occurring condition.

Can't swallow pills! - Try new liquid form or patch; if capsule, try sprinkling over food.
Pharmacist says ADHD meds. are all the same, or, all forms of Ritalin (methylphenidate) are the same - Absolutely FALSE!  Different ADHD people tend to respond best to different meds., and, to different formulations of the same med., e.g., Concerta vs. Ritalin LA.

Don’t have insurance; can’t afford meds. – Look on drug manufacturer web site for “Patient Assistance Program” (PAP), or, call their 800#.  PAP’s provide meds. at low cost depending on income.
I’m afraid about what others say about side-effects – All substances, whether prescribed meds. or “supplements” have side-effects.  The vast majority of truly problem side-effects from ADHD meds. occur due to incomplete or mis-diagnosis, and lack of prescriber knowledge about ADHD and how ADHD meds. work.  If your prescriber is a specialist in ADHD or very knowledgeable about ADHD and how ADHD meds. work, you should be able to avoid most if not all side-effects.

I’m concerned about long-term effects of ADHD Meds. – Ritalin has been on the market since 1954.  Amphetamines have been used to treat ADHD about as long or longer.  Although more well-done studies on long-term effects are needed, no significant problems have been documented to date.  The very negative life-costs of not taking ADHD meds. has been well documented, e.g., higher rates of divorce, unemployment, injury, lower income.

1.       Going to see an “ADHD Specialist.”  Not just any old “doctor” or mental health professional will do.

2.       Thorough diagnosis; including co-occurring conditions.

3.       Monitoring responses.

4.       Patience.

5.       Sticking with a “Specialist.”

6.       Always consider diagnosis review/update.

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