ADD medication tips

<p>My D is in her 2nd yr of college. ADD meds are not new for her. The issue this term is now to manage them with new schedule. Due to course availability she has two days of the week with classes in the am, mid day, and class again from 4:30-7:30. The classes are large lecture courses and if she skips the meds she doesn't retain a thing. The problem is that she can't seem to get to sleep if she takes meds late in the day.
Any suggestions as to how your students have handled this issue.
I will also call her neurologist for his suggestions.
She is on Adderall. She does not want a med change. It took a lot of time to find a med that worked.</p>

<p>I am very concerned about the same issue. Would love to hear your neurologist’s suggestions. D is currently a HS jr and also on Adderall. Even with a small afternoon dose (in addition to XR in the a.m.), she has insomnia problems. This will enable her to study from 4 to 8ish, which often isn’t enough time. We can’t figure out what she’ll do in college, when so much of the studying and activities seem to happen from 8 p.m. to midnight or later.</p>

<p>I am not familiar with Adderall dosages as my son takes Vyvanse and is a college sophomore. He has both 20 and 30 mg prescriptions and adjusts what he takes depending on his schedule. He can take a 20 in the morning and then another 20 for evening class/study. Other days, he will take just a single 30 if his day is not running late. </p>

<p>Is there a similar type of adjustment that might work for Adderall?</p>

<p>My son takes his meds with his shower in the morning. I had the bottle stuck in with his tooth paste and tooth brush…you know, his morning stuff he takes to the bathroom. It doesn’t matter if his classes are later or not. She cannot sleep at night because the meds have not worn off. So, it would be fine for her to take them in the morning even when classes are later. If that does not work, you might want to seek out a med change.</p>

<p>One of mine took a dose of shorter acting ritalin (4 hours) later in the day to help with evening homework and still allow him to sleep. Or maybe the opposite - take the short acting early in the morning and then the longer at noonish, which should be completely gone by midnight (12 hours max). I would consult the doctor as there should be a way she can combine the meds to cover her classes (and homework) but still let her sleep.</p>

<p>Drinking orange juice can help. Orange juice’s acidity will decrease absorption in the gut soon after taking the adderall, but it also increases excretion later on, when the adderall is in the circulatory system. So it basically ends the adderall’s effects sooner. So once work is finished, try a glass of juice. This is what some psychiatrists suggest, so not my idea, comes from a professional!</p>

<p>Otherwise, I would try to keep the meds’ timing to the morning, and accommodate the ADHD in classes, in other ways. Is the student registered with a disabilities office? Some schools will accommodate this situation, offering, say, an exam in the morning, or providing notes from the class (a volunteer can be selected and the notes left to be picked up anonymously, the professor can supply them, or a friend in class), or giving first priority for morning sections. </p>

<p>Another idea might be to use a Smart Pen, to record lectures (google this if you haven’t seen one). There are other strategies. Then, when the student has a free morning while the adderall is strong, she can review the lecture or notes.( I once took a real estate class with a migraine. I put my body in the class for the required number of hours and then studied on my own later.)</p>

<p>Are any of the classes online? Or rather, are any of the lectures for the class posted online?</p>

<p>The only other possibility is to take something to help with sleep. People say Klonopin works to help with sleep while adderall is still on board. That would mean taking that med for those two nights. Is your daughter the kind who would find it hard to resist taking it at other times? Twice a week would not created dependency. Also, Benadryl is pretty gentle and helps with sleep. I recommend getting the children’s chewable, which are half doses, and often work well enough and avoid the 25 mg full dose. Some people have paradoxical reactions to Benadryl, though.</p>

<p>I guess having relaxing rituals like meditation or self-Reiki might help too. Lying in bed and doing Reiki can induce sleep even when a person is really anxious. Reiki attunements generally take one day: you just have to find a workshop and pay for it. I have a child with severe ADHD who basically cannot take meds at all due to another condition, and yoga and Reiki have both helped her quite a bit.</p>

<p>p.s. from an online site re adderall:</p>

<p>Also, vitamin C and and a goodly amount of acidic drinks (orange juice, cranberry juice, real lemonade etc) will help excretion</p>

<p>Waiting on the call back from the MD. I will share what they suggest.
She hates all the meds. If she can get away with it she doesn’t take them. Many days she doesn’t take them even when she knows she should. The grades reflex that strategy.
Compmom- I will share with her the orange juice suggestion. Also looking into reiki.
You also present some great tips. She is registered with the disabilities office. She gets extra time on exams and a quiet testing location. She also is entitled to a note taker. The school provided her with a smartpen. She didn’t use it last year but I have suggested she try it this quarter. Last year she had all her classes in the am. Her roommate had all the same classes and shared her notes. This quarter the late classes could not be avoided.
She has tried vyvance but it caused problems with her blood pressure and gave her severe anxiety.</p>

<p>Adderall has the reputation of being a bit uneven from day to day in terms of when it starts to wear off (perhaps related to the citrus thing-- dunno). </p>

<p>What mom2and said in post #5 is the typical strategy-- to take a short acting “booster” med (metadate, dexedrine, ritalin, focalin) as the longer acting one is wearing off.</p>

<p>Does anyone’s child suffer from dry mouth when taking adderal? My S often skips his dose because of the "bad breath."he drinks lots of water, brushes often, chews gum…nothing helps. He has tried other meds but adderal is the only one that seems affective for him. His grades suffer when he doesn’t use them.</p>

<p>Playing phone tag with the Dr.
I had a nice talk with my D last night. I am trying to help her brainstorm ideas as to how to best make this work. One thing we figured out is that she needs to schedule good healthy filling meals around the med schedule. Eating a good meal prior to taking. The meds take away her appetite. When she doesn’t eat enough she gets irritable. That doesn’t help the coming off med side effects.
Like Limewire’s S she has found adderall works best for her with the least amount of side effects. She prefers the short acting. The time released made her more anxious.
Limewire my D doesn’t have the dry mouth but my S did. He made the decision in college that he was not willing to take any meds. He felt they took away his creativity. His grades did suffer and he lost a merit scholarship. He made the choice to take out loans to cover the difference versus going back on medication to bring his gpa back up.</p>

<p>My daughter, the one who cannot take meds for her ADHD due to another condition, did actually try adderall, at college, and it did help her in the very short term with work. She tried taking it ONLY when she had a big paper due, or exam, that kind of thing. The payback was awful after the med effects stopped, so she was fatigued and depressed the next day.</p>

<p>Like the son above, she decided that taking meds wasn’t worth it, and made the decision to leave college. I hasten to say that I think this has been a good thing, because her attitude is typical of what I think is called a “strengths based” approach. She has accepted that her focus/reading issues make her previous aspiration to study philosophy, difficult. She is immersed in a performing art and studying hands on holistic health modalities and is actually much happier.</p>

<p>Some will decide to fit life to their ADHD rather than fit their ADHD to life, via meds.</p>

<p>I hope noone takes this as a negative post, because it is not meant that way, not at all :)</p>

<p>^ Yes! For my S I don’t think meds are worth it. I like the idea of fitting life to ADD. I’m not belittling those (with ADD)whose passion is academic… If they need meds, they should by all means take them.</p>

<p>I would also recommend a short acting small dose for the late class days. Ritalin, Adderall and others come as non-time-released. Maybe a small dose (5mg or maybe 10mg). She’ll have to see what time is optimal for her to take it and still be able to fall asleep. I will warn you that in some markets, the short acting meds are prone to shortages and hard to find. (I’m a pediatrician and treat lots of kids/teens with ADD). Some young adults find a benefit with that other stimulant we love, caffeine. Again, she might have to tinker with the timing. Good luck!</p>

<p>Limewine, I am glad you added that about kids whose passion is academics.</p>

<p>I have another daughter with multiple health issues, who loves academics, and she/we/her MD’s do absolutely anything to keep her in that environment.</p>

<p>The daughter with ADHD cannot take meds because of the other condition, so she really had no choice but to fit her ADHD to life, so to speak. I just wanted folks to know that even in that situation, a positive outcome is possible.</p>

<p>Basically, every kid and every situation is different.</p>

<p>My comment was most likely not that helpful to the original poster, whose daughter is committed to academics at the moment, but I was hoping it could add some hope for others reading the thread.</p>

<p>I spoke with the neurologist and I have also had several conversations with my D. The quarter just started last week which is why we are just now dealing with this.
The plan for now- my D sat down with her schedule, her phone and me on the other end to brainstorm ideas and to make a plan. We talked about her goals for the quarter, her daily schedule. She also is going to try to sit in the front of the large lecture hall in order to help with distraction.We have come up with a set time schedule for taking the meds on certain days and also how to manage meals while on the medication. We also discussed the importance of eating before taking the meds and also what she can have in her backpack to take between classes or after class to give her body some fuel. Since the side effects are lessened if she can eat something. Unfortunately she has a hard time finding something she can stomach when on the meds. We came up with peanut butter sandwich or Fiber One bars.
After talking with the Dr he has suggested she cut the pills in half for the afternoon dosage.(she only uses short acting, she had been on 20 mg at each dose) He also gave the suggestion based on her schedule that some days she might want to try taking the half pill in the early am and then the 2nd dose at lunch as a full pill and see if that makes it through the late afternoon early evening classes. He is concerned about the not being able to sleep and also the irritablility she feels when coming off the meds. He is hoping that my reducing the last dose to 10mg she can reduce the side effects. If the problem continues they will explore a medication change.
Regarding Jaylynn post- we have had a hard time finding the Adderall. The large chain pharmacies in our town never can get it. I have found a couple of local pharmacies that always have it in stock and I mail them to her or give them to her when she is home for break. Because she doesn’t use it everyday that sometimes works.
My D’s passion is not academics. In a perfect world she would not go to school but train horses all day. But she does see the value in having a college degree. I don’t want her to sell herself short. Sure it sucks that she has to work harder then most of her classmates and friends and usually for a lower grade. (she also has LD) We try to remind her that she is just as smart just that her brain works differently but if there is something she wants to achieve she should not let her disabilities limit her.
In my S’s case for college to be successful without meds he had to find the right type of school for him. He also had to have a major with faculty that were willing to work with him. He started out thinking engineering but ended up in Graphic Design. I don’t think he could have made it without meds through an engineering program. His art program was small and his professors learned to love him. ADD, LD and all. He also loved philosophy. His classes were small. His disabilities make him a terrrible writer. His professors were able to see through discussions that he knew the material and were willing to overlook his written work. This could not have happened at a large school.
For those who still have HS students- I would suggest you talk with your Dr about how to manage meds in college. What will the stradegy be. Will your child want to stay on long acting if their schedule is one class at 8 am and not another till 7 pm. Also start to think about what documentation you might need to get accommodations.</p>

<p>I am gaining new respect for my S’s doctor after reading through this. Before he started college and even before sophomore year S met with his doctor to discuss the medication strategy for the school year given his schedule. I haven’t heard about him having any issues with insomnia. Also in S’s school (a large public) the disabilities office would arrange for seating needs in the lecture hall if needed. This would include sitting in the front. S is also dealing with another diagnosis that allows him to have priority registration which helps him to set up a schedule that works with health issues. I don’t know if ADHD would work for this sort of accommodation but it might be worth asking the question to help in future semesters if managing the meds remains a problem.</p>

<p>Mom60,</p>

<p>You mentioned that your daughter does not like to take mediations and often skips them. Stimulants like Adderall and Ritalin do cause insomnia and anorexia in patients when they start taking these drugs but if taken regularly the patient usually becomes more tolerant of the drugs and the side effects diminish over time. This does not occur if the medications are only taken sporadically. It is possible that if she starts to take her medication on a regular basis, her sleeping and eating patterns will become more normal while still improving her academic performance.</p>

<p>Spectrum- my D does have priority registration. She had a great schedule worked out. A few weeks before school started she decided on a major change. Totally messed with her schedule and she had to. Work with classes that had openings.
LeMaitre- her dr keeps close watch on her weight. I agree that if she took it on a more regular basis she might lessen the side effects. She might also lose less of her belongings.</p>

<p>Hi all, I have read this thread with great interest. Thank you to everyone for your posts. They have been helpful to me. Our son is a h.s. school senior and on Adderall. He takes the extended release version in the morning. I think it lasts 10 hours, so he is effectively without the Adderall by the time he is doing homework at night. We do see him struggling to focus. He will intersperse homework with playing the piano. He says that helps. He is often up to 11:30-12:00 finishing homework. I worry that he is not getting enough sleep (gets up at 6:00). Some evenings he complains that he has trouble getting to sleep. I think that can’t be the Adderall, I think it is more that he is charged from doing homework & piano so late at night. I will check into the Reiki techniques to see if that will help him. I have been reluctant to ask the MD for a short acting prescription to add to the 20 mg of xr Adderall he is already taking…just seems too much especially since he is already having sleep issues. He does seem able to power through the homework ok.<br>
I read with interest the posts about college schedule of classes & how that can upset the apple cart with Adderall. I think a talk with the prescriber is a good idea before he goes off to college.</p>