Ritalin Questions - No Criticism Needed

Updated on June 18, 2010
K.G. asks from Clairton, PA
25 answers

Hi Moms. Before i start, i want to ask first that if you do not believe in medicating for ADHD that you just not answer this question and keep your opinion to yourself as i am looking for help, not criticism, as so many mother's on here seem to think that everyone wants.

So....if you're still reading...here's where i'm at. After many years of struggling through behavior therapy and psychologists, i've decided to try putting my son, who's been diagnosed with ADHD and PDD-NOS, on medication. I really just want to see if it makes a difference. The doctor started him out on 5 mg or Ritalin. This morning was the first day that he took it and I just have a few questions that the doctor didn't answer (mostly b/c i don't think he believes in medicating for ADHD and only does it bc he has to) so...can anyone tell me:

1. How long does this last in your system. For example, if I give my son this pill at 7 am, will it still be working when i get home at 5 pm or will i never actually get to see the effects of it? Or....does it build up as other pills do enough to last until the next dose? The doctor gave us enough for 14 days and said to call and let him know how it goes but if it only is active while he's in daycare, i won't be able to actually tell him what's happened.

2. Do children ever take more than 1 dose per day?

3. Any pros/cons that you've noticed if your children have tried it?

As you can tell, i'm nervous and feeling a little guilty for trying this but i just want to help him and this is our last resort. Moms, i really appreciate any good feedback!

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S.B.

answers from Philadelphia on

I used to be a HS teacher & I can honestly tell you that I knew quiet a few children who benefited greatly from being on medication. I don't know what medicine they were on, but it definitely made a difference.

I would talk with his daycare teachers & ask them if they've noticed a difference. I would talk to them right away and let them know you are trying medicine & ask them to specifically watch him for the next few days to see if anything changes. Everyday when you pick him up, ask them how his day went & if there were any improvements. Ask them if the morning was better than the afternoon. Ask them if they noticed when his "best", most focused time of day was. Write all of this down as soon as you get home to see if there is a pattern. If every day he has great mornings, but not so great afternoons, then you may need to add a second dose.
Also, you should be able to notice differences over the weekend. Good luck. And you have no reason to feel guilty. You've tried the other options, they didn't work. This might make his life much easier, you should be proud of trying it.

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K.C.

answers from Philadelphia on

Hi, Kelllie,

It's great that you're keeping an open mind and getting your child the help they need. My son (now 12) has ADHD and PDD-NOS, too, diagnosed when he was between 4 and 6yrs old. I wish I could give you specifics on Ritalin, but that was one we never tried. I though there were too many side effects and didn't want that to be our first foray into ADHD meds. Instead we went with Adderall. It made my son into an aggressive zombie. When he wasn't lashing out at everyone, he was almost catatonic. And he stopped eating and sleeping so the doc put him on Remeron, but his anxiety was still there, so the doc wanted to put him on Paxil. At that point, I changed docs. The next psychiatrist put him on Tenex, which was awesome. He explained to us that Tenex is always the first one he tries because it has few, if any, side-effects. Lucky for us, it's the one that works best for our son. A couple of months ago, we were convinced by another doc (we moved, so had to change docs again) to try Strattera. Ever heard the expression "don't fix what's not broken"? My mild, calm, polite son became an aggressive, mean, swearing SOB. So we went right back to Tenex, but used the extended release form, Intuniv, instead. My awesome son is back again. My whole point to this rambling is that there's never any one fix that's gonna work perfectly every time. If you find Ritalin doesn't do it for your son, there are many other meds out there that might. Don't give up just because one or two, or even three, different meds didn't work. And if you find your son shows too many side effects, try another med. Please don't listen to those ignorant people who will try to convince you that you're poisoning your son. You do what's best, don't feel guilty, hang in there, mom!

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M.J.

answers from Sacramento on

You already have some great answers here so I won't duplicate the responses. I just wanted to tell you we started our son on Ritalin when he was four, after he was kicked out of preschool. Ritalin was a life-changer. It made a HUGE, positive difference. We were so thrilled with the results, we wrote the manufacturer letting them know what a wonderful thing they had done creating it. Our son has the same personality and spiritedness, but his behavior is in the normal range. People who meet him for the first time when it's active don't know he has ADHD. Before, our son was subjected to comments like, "What is WRONG with that boy?" right in front of him. Now, people just see how bright and funny he is.

We loved Ritalin, but since it only lasted a few hours and then was out of his system, it wasn't ideal for the school day. Our son ultimately ended up on Concerta, a long-acting form of Ritalin. He takes it at 7 am and it lasts until around 3:30/4:00. We also do a small booster dosage of Ritalin after school if he has activities afterward to get him through. Otherwise, he's back to bouncing off the walls and being completely unmanageable.

It's hard to make the leap and try medication -- esp. with all of the uninformed naysayers out there -- but it can be such a very good thing for kids with this condition. It may take some trial and error to find the right dosage and medication for your son in particular, but don't give up. When you find the right combination, it's fantastic.
P.S. Our son won the school's Responsibility Award last year in 1st grade. I attribute it all to the medication enabling him to control his body and make smart decisions. He was definitely not on an award-winning path before we tried Ritalin.

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S.B.

answers from Redding on

Dear K.,
I don't know about Ritalin, but my friend had her child on Concerta.
She had tried everything from diet changes to you name it.
I don't remember the exact dosages, but I do know that her son was a completely different kid on that medication. IN A GOOD WAY.
She didn't just rely on the medication as a cure all, she worked with him daily about focusing and staying on task, etc. His teachers worked closely with her. He was doing so well that they decided to try to wean him off of it over the summer when he was 11, I think, and he no longer takes it anymore. She would have kept him on it if necessary. But he's doing just fine. He's 13 now. He still gets a little forgetful, but all kids do that.

I know that many people feel strongly against medicating children, but in my friend's case, it was very helpful and she doesn't regret it a bit.

Like I said, I don't know about Ritalin, and kids and meds are different, but Concerta is a medication I'm familiar with and saw positive changes with my own eyes. I've known this kid since he was a baby.

I think you should follow up with your doctor about the changes you might be able to expect and stay in close contact with his daycare so they can keep you informed of what they observe.

I wish you the very best!

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R.J.

answers from Seattle on

1. Depends on his metabolism & neurochem... but unless it's long release... no you will likely NOT see the results on days you work. So do make sure to give it to him on weekends as well, at least in the beginning.

2. Yup. You can work that out with your doctor. Ideally, if you could take a long weekend or a week off and observe him and his reactions to it... you'll be able to see very clearly how long the med is in his system and any residual side effects. As others have said, it doesn't build up, but a key thing to know is that after short acting meds wear off the original "symptoms" tend to be worse. AND the first few days to a week while our bodies adjust... the meds show up stronger. After we adjust, our reactions to the meds TEND to mellow out a bit. Hence, why even if you hate a med, you USUALLY try to stay on it for at least a few weeks. Depends on why you hate it though ;) Anything that makes me throw up is gone a lot faster than something that makes me twitchy.

3. This is a highly personal one. Personal = chemically speaking, because all of our neurochem reacts differently. I mean, adhd, so stimulants calm us down across the board (as opposed to 'normal' people) but how we react to each stimulant is different for every person. I often think of meds as picking your side effect :). Not meant in a bad way, some side effects are great (like for me on strattera, my body consciousness/self consciousness d.i.s.a.p.p.e.a.r.e.d. Yay!!! I'm so hyperaware of my body, that a kind of natural anorexia follows... but with straterra, *poof*, it was just my body. Also I could lay down and go to sleep when I wanted -something that has NEVER been true. I also couldn't tell the temperature of water beyond cold/warm/hot... ALL of these are side effects. Some good, some bad, some indifferent.) For ME, Ritalin made me nauseous when happy, and made me throw up if I got excited. So I had to NOT be happy or excited. Not a good fit for me. Adderal made me very focused, but while I could clean and stay organized, and I kept all my emotions... it took away my personality/creativity. Ugh. Bor-ring. Straterra was a reeeeally good fit in all ways but one (I can't write while on it, because I can't hold more than one or two thoughts in my head at a time... while I can usually hold 5 or 6). Anyhow... it's why there isn't just ONE adhd med. There are a ton of them, and they all react slightly differently with each of us.

There's no need to feel guilty. I'm not personally on meds, but not out of some moral question. LOL. DEFINATLY not out of some moral question. Merely because I haven't found on that lets me keep the gifts while nixing the downsides. If I ever did... I'd be on it like white on rice. Big Hugs.

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K.C.

answers from Cleveland on

1.First of all I am not judging you we also had a diffucult time coming to our descion to put our son on Ritalin. Now he is taken Folacin. He is doing 95% better in school. His confidence in his own ability are now wonderful. Sometimes you have to try different type of medicine similar to Ritalin and different dosage to get the effective treatment for your child.
2.. he just takes one dosages a day..but not on the weekends or vacation time
3. He has always been polite and well mannered that has never been an issue. What was the issue he was consistently the last child ALWAYS to go on to the next task in the classroom setting since kindergarten. Last year I can't tell you how many times we were driving back to school because he forget his homework again. This whole school year he forgot his homework ..ONCE the whole year big improvement. He always understood the material but now he is consistently getting A on all his subjects.
Its a tough job being a parent. Its just frustrating in the morning getting him the door. Ugh. Hang in there.

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B.D.

answers from Lancaster on

Although I don't personally have a child that requires this medication I do have a nephew and close friend.
The doctor should have told you how often to give this medication - if it says twice a day, then give every twelve hours - every child's dosage can be different. With that being said, I can DEFINATELY tell when these children's dosage is running out of their systems - so the medication must leave fairly quickly.
Although I too have heard the cons - there are many I am sure, I can say that my friend was a young student failing school and went to a straight A student in one marking period. He was finally able to sit still and concentrate - what a difference!
Good Luck to you

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M.R.

answers from Columbus on

Hey K.,

Ritalin is out of they system completey once it is out of the system, it does not build up at all, so once it wears off, it wears off. A 5 mg dose will probably last about 4 hours, but he may metabloize this a little slower or a little faster. You may see something called rebound on a regular dose of ritalin, and you may see some aggitation or anger as it wears out of his system, which is why medications like concerta and ritilin LA are good, they last between 8 and 12 hours, and do not usually result in rebound. All three are methelphenedate, so the are the same medicince, with just different delivery systems.

I would recomend that you consult a board certified child psychiatrist to medicate your son, it does not sound to me like your pediatrician is the right one, espeically if he does not beleive in it, and he may not have enough experience in this area to help your son a much as a really expert prescriber would.

We have two kids on the spectrum, and both also have ADHD, one responds very well to medications, and the other one is a little tricky, so I would highly recomend that you see someone with a lot of experince with these meds, because on 5 mg dose is not going to last him all day, and you have many, many choices out there that will be helpful for the symptoms you see, and will be good tools for him to gain more control over his issues, be more comfortable in general, and make more progress along the way.

Good luck, don't worry about what others may think, and don't let this first expeirence be a deciding factor if it does not go well, you will find a much different experience in a psychiatrists office!

M.

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D.N.

answers from Chicago on

When my nephew was diagnosed ADHD years ago, medication was the route they had to go. he was just out of control. My brother totally looked at every medication out there and refused to put him on Ritalin dce to side effects and other issues. If you ask him about Ritalin today, he goes in to a speech about why and his modd totally changes. My bro can be outspoken but is more than willing to take other peoples point of view. But when it comes to his kids, he looks into every single corner out there before making a decision. One day I asked nim when his son was on Ritalin and he told me "he has NEVER taken that and never will!". Anyway, they put my nephew on Concentra--or something similar sounding. This is the name that comes to mind. It has made a big change in my nephew. Granted there are side effects but my brother believes they are much milder than they would have been on Ritalin. When my nephew started meds, he would take in the morning and be fine for the day but then take again in the afternoon. He is now 13 and there are days my bro does not give his meds and he is doing so much better. Maybe he will be off them in a year or so. I think most of the meds last a few hours at least but you may want to ask about other drugs as well and look into the side effects. This might ease your mind, especially since not everything works the same for every body the same way.

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E.F.

answers from Pittsburgh on

I don't have any experience with my kid, but my best friend's parents are now raising their grandkids (her sister had her parental rights terminated) and putting those kids on some kind of ADHD meds was literally their saving grace. They haven't been kicked out of school since they went on them, grades have gone way up, kids are happier. I think they do have occasional difficulties when they are growing out of their dosage, and have fooled around (with the doctor's guidance) with a little "booster" towards the end of the day. I do know that their grandmother has worked extremely hard at also working on the "natural" stuff with them-- organic food, no artificial colors, dyes, lots of fruits and veggies, glueten-free, casien-free diets etc, no chemicals in the house, etc. I think it all makes a difference.

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J.M.

answers from Philadelphia on

Mom, I wish you the best in the world and for your child. Yes , I do have a child with ADHD and a mood disorder. She has been on this medication for many years plus 2 others. From what i'm told it's pretty much in their system when they take it, My daughter takes this once a day in the am but again ther are two others that she takes. Just be patient and give it time. I know how hard it is and how frustrating it can be ! If there are behavior problems please make an effort to read " 10 Days to a less Defiant Child" It Has dramatically helped my daughters behavior and it has taught me a great deal in overcoming my daughter's behavior.Best of luck to you . I hope this info helps.

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J.M.

answers from Boston on

First of all, don't feel guilty. Would you feel guilty giving your child Tylenol if he had a fever? Sure, maybe he could manage without it, but he'd feel miserable. Now imagine that he had that fever every single day.

Anyway, moving on. I don't have a medicated kid, but I'm a teacher, so I see lots of medicated kids.

1. You need to check with your doctor. There's extended release tablets and not. Also, depending on the dose, it's going to impact your son differently. But no, it's not like an antidepressant - you have to take it every day or it doesn't work.

1a. Do check in with the daycare teachers to see if it's making a difference in a group setting. The change should be noticeable enough that you don't have to be his mom to see it.

2. Sometimes people take more than one dose per day, but again, it depends on the strength of the dose. Also, doctors would likely be inclined to give younger children only one dose, as it's just one less thing to remember.

3. One thing that a lot of parents worry about is that the kids' appetite decreases. A lot. Ritalin is a stimulant, and stimulants are appetite suppressors. Once he gets used to it, his appetite will likely come back, but it does take a little while.

Finally, this probably won't be perfect. Medicating is trial and error a little bit, finding the right drug, the right dose, etc. But I do want to commend you for doing what you think is best by your kid, even if you have personal reservations about it. You can always take him off the drugs, but sometimes if people wait too long to treat, kids have all kinds of other baggage that it's really hard to catch up on (making friends, getting behind in school, etc.)

Good luck.

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S.C.

answers from Fort Wayne on

I don't know for sure. I can tell you that my nephew takes Ritalin and it's a time release medication. It will last in his system for up to 12 hours (i think).

Don't feel guilty about giving your son a medication to help him. It sounds like you've thought it out very carefully and have arrived at the best decision for your son.

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J.C.

answers from Anchorage on

Sometimes medication can be a life saver. The only thing I thought when I read your post was that maybe you should see about finding another doctor, one that is more in tune and supportive of the direction you have needed to take with your son.

M..

answers from Miami on

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D.W.

answers from Indianapolis on

Because of how long Ritalin has been on the market, there are likely MANY different generic versions available through various pharmacies as well as the original brand.

There are very likely extended release versions as well as shorter acting versions - all with the same active ingredient, but all will act a little differently.

Having worked in the pharmaceutical industry for over a decade, I'd strongly encourage you to speak with a pharmacist and see what different options are available of ritalin-based medications. Generic does not always equal brand, so even if the desired response is not initially there, I'd advise trying a different manufacturer or delivery system (capsule vs. tablet, etc).

I don't believe that my 14 year old niece was given enough of a chance to deal with her ADHD behaviorally, but she's been on medications for several years, and she prefers how she feels on them now vs. days when she skips them.

So, don't feel guilty. You've done your best, and it may be time for a different kind of intervention. Nothing is permanent. But, hopefully, your son will feel better. If not ritalin, there are many options, many doses and many developmental changes that your son will go through over the next few years that will ultimately help you all deal as best as possible with this diagnosis.

Good luck!

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D.B.

answers from Minneapolis on

I'm much like you, in that after years of trying other methods, we had to medicate our ADD son. It was either that or he'd still be in kindergarten (or expelled) 3 years later. Finding the 'right' medicine for him was tricky, especially since my son has had growth delay issues since he was 2 and we couldn't afford him to not eat.

Currently he is on Ritalin XR. He has a fast metabolism so a pill we give to him at 7:50 am is worn off by about 3:00 in the afternoon. The teachers have learned not to allow him out of the classroom for the last 1/2 hour of the school day because of this :) Once it's out of the system, it's out. No residual affect. If you need an example of this, just visit us any night of the week during homework hour. You'll understand. For this reason, we've considered giving him a 2nd dose, but need to discuss with the psychologist first,

We have tried several different meds, but found that Aderall made him into a zombie. Also, Strattera, like Kristen commented, turned him into a little aggressive, mean, monster. Oh, it was terrible. Took him about 2 weeks for that stuff to get out of his system. What a long 2 months that was! He actually started the Ritalin XR in a very low dose while on the Strattera, just a touch to get him started before the Strattera kicked in. Now we are left with just the Ritalin XR at a higher dose and are back to the original problem of him being unable to focus after 3:00 pm. I might talk to the doctor about the Tenex that Kristen mentioned because our kids sound quite similar.

The biggest con with the Ritalin was the appetite suppression. We learned to make sure he eats a big breakfast before having his pill, we know he usually doesn't eat any lunch, so we make up by giving him a dinner right after school, another dinner at 6, and usually he'll have a mini-dinner right before bed at 8:00. Once it wears off, the appetite is right back & then some it seems.

All in all, don't feel guilty. For us, the difference was a kid that one week 'didn't know his letters' and the next week 'was reading short stories.' It was truley amazing. ADD, if it is true ADD, is a medical condition due to the composition of the brain. If wonder if the people who bash parents who medicating their children would bash a friend who was taking medication for depression.

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M.B.

answers from Cincinnati on

I'm glad you put the criticism disclaimer on there. Lord knows what some would say. Now, I teach children with special ed and no, I'm not a big fan of medicating kids. HOWEVER, some do need it. For some kids, it can change their whole world for the better. So, I do know some of my students take multiple doses a day while others only take one pill in the mornings. I'm not sure the specifics on Ritalin but I'm sure if you google it's name you'll find more information than you actually want.

Pros and cons can differ from child to child. The best advice I can give is to just keep a close eye on him, talk to his daycare providers and let them know of the change. Ask them to keep mental note of how his days differ now than before the medication. Ask them if he seems 'better' or 'zoned out' or no change.

Medicating children is always very nerve racking but you're trying to do what you thing might help your son. There's no guilt in that. Just keep an eye on him. Daycare tells me he's still quite young. And, just a little tidbit, please don't be offended. I've recently come across some studies talking about red food dye affecting kids in a manner that many of them appear to have ADHD and are in fact diagnosed and medicated for it. It's newer information to me so I just wanted to pass it along. It could make for some interesting reading if you want. Good Luck!

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J.T.

answers from Dallas on

i have a child with high functioning autism, and we tried him on a stimulant when he was about 5.5, the stimulants can sometimes counteract the "irritability" that is marked in many high functioning autistic kiddos. for him, we were not successful, but i will answer you questions the best i can!

1. typically, 8ish hours - this type of med doesn't really "build up" like many other drugs - you can ask your daycare providers about his behavior changes - honestly, i'd NOT tell them you're medicating him so that they will not see changes that aren't really there. then after a week, ask about changes, and then let them know about the meds. ***obviously, for emergency reasons - let the daycare director know about the meds, but i really would not tell his direct caretakers - or test it on a weekend or take a few days off work so you can see for yourself if there are changes.***

2. some kids(esp in higher level school grades) take a mini dose in the afternoon to allow them to concentrate for homework

3. a major drawback(and the one my husband, a pharmacist, was most concerned about) is it is suspected that it can cause a slight stunting in growth

like many things in life and parenting, you have to do a risk/benefit analysis.

hope i was able to help!

N.O.

answers from Dallas on

Don't hesitate to try it for him if you feel it's what you have to do for your child. I neve took it, nor have any of my children but my sister did growing up and it helped her tremendously. I'm not sure about your dosage question, I just know my sis had a lot of issues in school concentrating and understading and ritalin was a life saver for her.....literally! She never had any bad side effects from it and mostly only needed it on school days, where she had the most problelms with the ADD.

I think it's great you're trying to get him help instead of ignoring his condition. I have a sister who has a son that's almost 7 now and he has obvioulsy shown signs of ADHD for years now, she's refused to seek help for him and now he's suffering bad in school for it.....failling grades, no attention span and always in trouble for acting out. Teachers are even suggesting her to have him evaluated and they've seen how good medicine helps for ADHD but she's still in denial and I feel for my nephew....I hope one day she'll come around for him.

Anyways, don't be scare to try and see if it helps or not, it won't hurt to try.
Good luck to you and your son, I wish you both the best!

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S.A.

answers from Los Angeles on

i have a friend who went through the same thing. She didnt want to give her daughter a second dose later in the day though. So instead she gave her a cup of coffee when she got home to help her get through her homework. i know it sounds really silly, but I have had several people tell me it helped their child. Coffe for us wires us up, but for children with ADD and ADHD it has the opposite affect. I just wanted to tell you that so that if you hadnt tried it already you could give it a go and see if it helps.
I dont think your doing the wrong thing at all. Only you know what your son really goes through day to day so no one has the right to judge you. Just give it sometime and find what fits him best. I hope things work out for you and your son. Give the coffee thing a try if you havent, it might not last as long as the meds do but made it will just enough to get him through the rest of his day, if your concerned about giving him a second dose. I hope this helps.

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J.B.

answers from Atlanta on

If you move forward, please post about the differences in your child. I really think we may be facing this in the future with one of our sons, and I would love to hear feedback from someone who doesn't know us. Sorry I don't have any suggestions or answers for you, but I'm very interested in knowing what happens!

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K.P.

answers from New York on

Okay... first of all, good for you for trying everything before medicating, but then accepting that many neurological conditions are best addressed using a combo of meds and behavioral interventions! I'm a child psychologist, so I don't prescribe, but I am often responsible for monitoring the impact of the meds.

1. Ritalin has two forms- one is XR (time released) and the other often requires more than one dosage during the day (usually around lunch time). Because medicating young children is a somewhat inexact science, doctors will start at the lowest dosage and monitor your son's reaction and behavioral changes. If you are giving one dose per day, you are probably using the XR. You will not be the one seeing the maximum effect of the meds.

2. Yes, see above.

3. Be aware of side effects and watch for them. Be open and honest with the school and the daycare about what he's on and what they should look for. Ritalin is a stimulant and it can often be harsh on the stomach and can reduce hunger. Many families find that small meals throughout the day are more successful than "three square meals".

** I just read some of your responses.... PLEASE KEEP THE EDUCATORS IN THE LOOP! There is no value to keeping the people who see your son all day in the dark. If something (god forbid) happens to your child while in their care, they should know what's in his system. The purpose of the meds is to help your child, don't use it to "test" the teacher. It's dangerous and goes against the whole concept of open communication and working together.

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S.R.

answers from McAllen on

My son has the same diagnosis as yours and I am medicating him, and I have to say I'm really happy about the results, he has been eating a little less, so I have to be more focused on what he eats, also I've noticed in my child's case it stays with him, I would say for about 5 maybe 6 hours, and I have noticed that he is tired when he comes home from school, and naps, a little bit, but hey! he is sleeping!!!.
I am very happy, he is not getting anxious, and although he is still very active, I do get alittle bit more peace and have a little less trouble getting him to sleep.
Hope you find it helpful for your child. Best of luck

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P.M.

answers from Harrisburg on

Our son has never been on ritalin, but has taken concerta and now takes vyvanse. We've found it stays in his system 8-12 hours...depending on what he's doing that day. The more he needs to focus...the shorter time the medicine lasts.

Don't feel guilty. Sometimes it's your only option. I would, however, find another doctor. Before we medicated our son, we found a pediatrician who specializes in ADD/ADHD. They're out there...you just need to look...and you may need to drive further. We did...but it was worth the extra time to make sure he was being treated by the best. Your psychologist should be able to recommend someone.

We've done a blend of the meds + the psychologist. The meds certainly take the edge off of his impulsivity, but our long-term goal is to have him medicine free, so he needs to learn coping strategies to deal with the difficulties he faces with organizational challenges.

Be very blunt with your son. There are so many books out there about ADHD. We constantly talk with our son about the struggles he faces, but we will NEVER let him use his diagnosis as an excuse. Provide him with the tools he needs to succeed. It's hard but necessary for him to function in later life.

Good luck!

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