My son has been on Adderall XR 10 mg since the beginning of December. He has always seemed to come off it at night really hard, but the last month or so, he gets very angry. I mean screaming, flailing, kicking, hitting, etc. One little thing will set him off and then it will take until he falls asleep for the fit to be over. We have a dr's appointment this afternoon for his physical and I will ask his dr about it then, but I was curious if this has happened to any other kids and if you switched their meds, what worked better for them? (please nothing about natural supplements and diets, etc. Been there, tried that.)
Thanks for the info everyone! I probably should add that my son has an additional anxiety disorder and sometimes when he gets overwhelmed, this is his natural response, so I wanted to determine if this was just him or a side effect of the meds. The dr. agrees that he is coming off the meds too hard in the evening and gets overwhelmed by the emotions, stimuli, etc that surface all at one time. Since Adderall XR works great for him during the day, he is having him try an additional 5 mg of plain Adderall at 4pm so it is a more gradual let down. Tonight was the first night trying it and even though we couldn't get my son to fall asleep until 9:15, he did not have an episode. For those who want to know, if this doesn't work, the dr wants to switch him to Vyvanse, but for insurance reasons, he would have to take Concerta for a month first. Gotta love HMO's! I have heard of melatonin for adults, but not kids, so we are going to ask about that when I call in to update the dr next week. Thanks again!
Some types of ADHD do not mix well with stimulants (over-focused type ADHD). The stimulant my daughter was on made her much more irritable, emotional and prone to melt-downs (we had plenty before the meds so seeing her even worse was terrible--even though it did seem to help her focus some). We are taking a break from meds now because she is young (4.5 yrs) but we will try a non-stimulant med next time.
If I had to take a guess... I would think Amalthea is on the money (anger is a common reaction to the wrong med while ON it... but he sounds like he's fine while on it, it's while he's coming off that he's flailing).
A thing too, bedtime sucks for we adhd'ers. The world quiets down and our minds speed up. While school might be the "time" it's used for most... it's "bedtime" that most of us absolutely lose it (not on meds). Our minds start spinning out of control, and our bodies want NOTHING more than to make up for the quiet and move move move. So if his meds have worn off by bedtime it sounds like he might actually be facing the double problem of a non-medicated adhd bedtime (hell), and the uberawareness left by wearing off/ worn off meds.
The 2 most common tricks to solve this problem are
1) Making sure he's solidly in a dose at bedtime, instead of wearing or worn off of a dose
2) A different med, like non-addictive benedryl given about an hour before bedtime.
Having been in the pharmaceutical industry for almost a decade, I'm going to point you in the direction of the website for Adderall XR for a list of reported and common side effects:
http://www.adderallxr.com/
http://www.adderallxr.com/pdf/AXR_FPI.pdf
I'm not quite sure what Mimi's message states about contraindications with other chemicals. According to the information approved by the FDA, a dose reaches its peak concentration in 7 hours and is excreted in approximately 14 hours. There are many factors that affect its absorption, etc. All drug interactions are listed in the two links I referred above.
There are several options for medications available besides Adderall XR. I'd ask the pediatrician to write them down so you can research on the internet. I'd always advise going directly to the website of the manufacturer and trying to read the full prescribing information as it is the most complete (albeit very scientific)
You can also take that information to any pharmacist and ask them to give you a synopsis - they're acutely trained on the pharmacology of products and may be able to give you not only clinical information but testimonials of other patients for whom they've dispensed the product.
Hoping all goes well with your appointment this afternoon.
our doctor had us try melatonin (available at any drugstore over the counter) about a half hour before bedtime to calm our son down. it works great.
I would definitely talk to the doctor.
That said, my husband had a problem while finding the right Adderall dose where in the middle of messing with the dosages there was a stage where the meds made him much more aware of his problems, limitations, frustrations and pattern and yet did extremely little to correct them.
His family is prone to anger problems, and this middle stage was just so humiliating and frustrating to him that he went through pretty bad rages with himself and everything around him until the doc let us up he prescription.
It might be that coming off the meds is crashing him so hard that he's hitting a similar sort of frustration wall where he just emotionally can't handle how incredibly difficult and painful things are becoming off the meds and how much the exhaustion is kicking in.
Sometimes changing the exact timing of taking the meds can help some with that. Maybe he could start it a little later in the morning since most of us are less tired in the mornings, and thus get an extra half hour or hour at night before he crashes which would help him get past a stressful period for him before he's without the help.
Sometimes it also might help to start some soothing rituals if he is at all amenable to that, shortly before the meds are supposed to start falling off for him. Rubbing his back or other things which stimulate positive brain chemistry might help him ease between these two times with less hard crash.
Why is he on it? Sounds like a really bad side effect. I would try something else or nothing.
We have only been on two different medications Concerta and Vyvanse. We were first on Concerta and then we were on the upper limits of the medication and after a while if did not seem to work as well as it did the first time. So we changed to Vyvanse we saw a personality change we was very angry and was unable to sleep well. We took a break over the summer not taking anything and when school started again we went back on Concerta it is working great now. Hope that every thing works out for you.
My son tried Adderall XR 10 mg too, but it is a stimulant (like Ritalin) and he did not tolerate it well (loss of appetite, hard time settling down, could not fall asleep). He now takes Strattera, and does much better. Still not controlling impulsive behavior, but far better than Adderall. Good luck!!
My son is having great success on Concerta (lower levels). The downside is lack of appetite and it takes him about 15 minutes to fall asleep (vs. unmedicated 30 secs to 2 min.--no joke, but if I ran on high for 13 hours a day I might be that tired too!)
If this was my child I would look for something that lands him softer in the evening.
Let us know how it goes with the doctor.
S.
He may need a higher dosage or a supplemental dosage in the afternoon.
my daughter takes Focalin XR for add.. and has not had those type of side affects and we really like the meds.
HI S.,
Adderall, like any other pharmaceutical, will build up in his system. It will also contraindicate with other synthetic chemicals (household cleaners, preservatives in foods, etc.) he comes in contact with. Removing some of them may help.
M.
