Ritalin

[Kate]

Hi everyone,

I usually post on child neurology as I have a daughter with epilepsy but thought this might be more relevant to this board. I wondered if anyone has any experience with using Ritalin for ADHD?

Laura, age 7, has Dravet syndrome which is severe epilepsy with secondary autism, ADHD and severe learning difficulties. Her behaviour needs calming and I am at the point of wanting to try medications. Our neuro wants to try Ritalin. I know of other Dravet kids on Risperdal but none on Ritalin. From what I read online, Risperdal and Ritalin are quite different types of medication and I'm not sure yet why our neuro favours Ritalin rather than Risperdal. We see him tomorrow to collect a prescription so I can ask then but maybe others here know the answer?

Laura's behaviour manifests in extreme busy activity, lots of climbing, throwing, screaming, kicking, biting, refusal behaviour and inability to function in a classroom setting. At home she cannot sit still at all, will run out of the house, across the road given the chance and has no understnding of danger or safety. I basically want to calm her down and then I wonder if maybe she will be able to concentrate enough to learn. Developmentally she is very delayed.

Many thanks, Kate.

[peglem]

I have no experience with ritalin, except seeing some of my students on it. But my daughter is on risperdal. Here's what I think, from my own research- sorry, I don't have any links for it:( Ritalin helps with focussing unorganized thinking- like when your mind can't stick with one thought long enough to fully process it. Risperdal helps with an unorganized body- unwanted movements or poor motor planning- its a dopamine suppressor. But, I recall from somewhere that risperdal may induce seizure activity (my daughter doesn't have seizures). But, I would check that to make sure. I was thinking that might be why the doc wanted to try ritalin instead.

I have to add- because its kinda my thing: My daughter, even with the risperdal gets the behaviors you say your daughter has when she has a strep infection- and those behaviors are the only way I know she has one because immune response is absent! Strep can cause autoimmune reactions that affect movement and OCD.

I would definately question the doc until you understand completely his rational for the medication-he may be making some assumptions that need correcting.

[Kate]

Thanks for your input. I've done some more reading and discussed with her neuro and I can see why he felt Ritalin was a good match.

She's been on it for about 8 days now and it is helping quite a bit. The first day was awful and we realised that he'd started her on too high a dose (for her) and so we gave her a quarter dose the following day and things were much better. As it is very short acting we sometimes give her two 1/4 doses a day, depending on whether we are out of the house in the afternoon. It has affected her eating and also to some extent her sleep but both are manageable by adjusting the timing of the doses. A number of family members have noiced a positive change in her over Christmas. So it is so far so good.

I will let you know if anything changes but things are much calmer in our house and she has started to take an interest in some toys for the first time which is great to see.

[lisa6wks]

Hi Kate,
I am glad to see that the Ritalin is working for your daughter. As you have already discovered, the nice thing about Ritalin is that either it works or it doesn't and and you pretty much know right away. Hopefully the fact that Laura is now able to focus a little bitter she will be a little more available for learning as well. My understanding is that is also helps with short term memory. My daughter was on it for a couple of years until she decided she didn't need it any more.

Lisa

[PMM]

I'm glad that the ritalin is working for your daughter. My son's ADHD was controlled fairly well with ritalin. He took it for two years before he was switched to adderall. I found the adderall did work better for him but more importantly, the drop off was more gradual since it's more than one stimulant and their drop off rates are different. I remember with ritalin that within 20 min of when the pill was done working my son frequently had melt downs.

A friend didn't believe me when I said we have to get going before his meds wear off until he saw it for his own eyes. My son went from behaving to non stop... I looked at my friend and said seeing is believing. It doesn't affect all kids this way but if you are seeing that that aspect is a problem there are other meds that don't have the same drop off rate, adderall being one.

Pat

[blackbelt1997]

I have ADHD. At first I was on Ritalin to see if it'd work. I switched to Concerta after being on the Ritalin for a few months because I sometimes forgot to take the 2nd dose of the Ritalin, it wore off a few hours after taking it and it was too soon to take the next dose, and I had a noticeable rebound period after the drug wore off. I only have to take Concerta once a day and I don't have a significant rebound period.
I think the literature that comes with my medication says something about not taking it if one has had a seizure. I guess though doctors must weigh everyone's individual situations to find the right medication.

[Kate]

Hi again,

Laura continues to benefit from the Ritalin but we are having significant problems with her appetite and she is losing weight at quite a rate. Thankfully she has a bit of spare but we need to address this soon. We are due back with her neuro in about 4 weeks and so I will ask about both Concerta and Adderall - I'm not sure if either is available here in the UK.

We do see some rebound in the afternoon after the morning dose has worn off but with needing her to eat in the evening, having a second dose isn't an option. Does anyone know if either Concerta or Adderall have similar problems with appetite suppression?

Many thanks for everyone's input. I really appreciate it. As Laura cannot speak we have to guess a lot about how it affects her and so it is very valuable to hear other people's experiences.

[blackbelt1997]

Kate,
I have had some weight loss while on Concerta, but I am also working on my Master's degree so I'm not eating my usual sometimes when the medication wears off.

[PMM]

I saw more apetite supression with ritalin than with adderall with my son. On the other hand most boys eat more that girls anyway so my experience may not be average. Also since he took adderall most times only once a day (he took forever to metabolize it) it was wearing off between 4-5pm so he'd eat a big dinner. So if there was a light meal it would have been lunch.

Pat

[rainbow_kid]

Ritalin is good and i have had positive changes. It has helped me alot. I been on it since april 2004. before that med. I was on adderall and think it is very addicting and did no good for me.

[Salsa]

I took Ritalin as a kid, and I have epilepsy as well. I was also dx'd with ADHD as an adult and tried taking Ritalin at that time, but it seemed to lower my seizure threshold and so I was taken off of it-- mostly by request on my quart but, as I recall, the doctor was just as much in agreement.

I tried Straterra. I don't recall it causing seizures but made me almost anorexic. That is, I lost my appetite and lost a ton of weight. I enjoyed the weight loss but also knew that my new eating habits weren't healthy and so I also requested that the doctor take me off of it.

I guess what I'm saying is that I've had different experience at different times in my life (worked fine when I was a kid) so you almost have to go by trial and error because it's going to be different for everyone.

Sandy

[Lyn]

Hi there
Nice to meet you. My son (13 yo AS, ADHD, ODD) started taking Ritalin when he was 9. It worked really well in terms of improving his focus, and organisational skills as well as curbing oppositional defiance disorder.

Unfortunately, his failure to gain weight, and the fights we had trying to get him to eat and to sleep made it pretty much untenable. So, we tried (unsuccessfully) Strattera then we switched to Risperdal, then it was Luvox, failing that it was Epilim. Problem was, none of them worked to ease rage and oppositional behaviour.

Ultimately, we tried Concerta and Risperdal. It does seem to be working reasonably well, although sometimes he needs a top up dose of Ritalin 10 in the afternoon. I know this sounds like I am one of those mothers who relies on medication to make life easier, but frankly I feared for my safety and the safety of my daughter without it.

I guess I have been raving on about me and that is not what you were looking for, but I just want to say that sometimes, trial and error is the only way to do it.

BTW while Ritalin will suppress the appetite, Risperdal will increase it out of control, my boy increased 20 Kg (45 lb) in a matter of a few months. Now he is on both it seems to balance out.

Cheers

Lyn

[Kate]

Thanks for sharing your experiences with this. Laura remains on 10mg Ritalin a.m. Her weight loss is steadying (a bit) but so it seems is the effectiveness of the medication and the rebound in the late afternon now seems worse than at first. So Ritalin does not seem as effective as it was in the first month or two and I am wondering if this is a common experience. I know from our vast experience of anti-convulsant mediactions that this often happens with those meds, so I wonder if it also happens with meds like Ritalin. I think that I will ask her neuro to try Concerta when we see him next month. We have Laura's annual review at school in June and I am wondering what they will report - she made very little progress in the first two years. I think she has been able to focus better but I know they are concerned because she rarely eats at all during school hours. I will post an update in a month or so. Meanwhile thanks to everyone for adding to this thread - the responses have been very helpful.

[Lyn]

There is very definitely a honeymoon phase with all of these meds - risperdal included. The dosages might have to be increased for your daughter. I think that when the dosage is correct, the effects are more constant (ie, they don't develop the tolerance for it anymore) - but I am not sure - I would hate to think I would be increasing my son's dose every five minutes after a couple of years.

Lyn

[Kate]

We switched to Concerta last month. For the first two weeks Laura was really affected by it, hardly eating and very lethargic, but now she seems to have got used to it. Her eating is better although not great but it hasn't been for a few years because of her epilepsy meds.

Behaviourally I would say she is better but not great. I think her brain is just working round the meds. It may be that we need a higher dose. Lyn, I'm interested to read that your son had good results on Ritalin with Risperidone. I've not come across anyone using both meds. You are right it is a lot of trial and error. It's such a shame that some meds seem to be great at the start but then quickly lose their effectiveness.

[Lyn]

Hi Kate
My son's appetite doesn't seem to be too badly diminished by concerta (unless of course he doesn't want what we are having and is looking for an excuse :rolleyes: )

I am sure that this risperdal boosts it though, He is still on both meds because we were at a stage where we were facing violence, or even self-harm. Matt's paediatrician suggested it as almost a last resort. Fortunately it has paid off.

I find Concerta is OK, but not great - but then again I am dealing with a hormonal 14 year old - and they are not reknowned for non-moody, helpful behaviour at the best of times;) .

Hope all goes well for you

Cheers

[Kate]

It's been a year since Laura started on Ritalin and I would say it has made a big difference to her ADHD.

She switched to Concerta (extended release Ritalin) in May and this helped even-out the medication for her. We did see a huge dip in her appetite and put in a g-tube in July. This was something that was on the cards for her anyway although the Ritalin accelerated the need for it. (The g-tube has made a huge difference to her health and means we can get her epilepsy meds down without a fight and keep her fed and hydrated during illnesses and after seizures.)

Her school annual report showed that she has made much more progress this year and her behaviour plan is no longer needed as she is much more willing to move between rooms in the school and accept the class curriculum.

Thankfully we haven't had problems with sleeping that some people see with Ritalin and aside from the appetite problems, we have only had good results.

[michael178]

ritalin is an old, old drug (you can tell it's old because of it's cheapness), so it has been tested through public usage for years, yet it is the constant subject of controversy. I first took it in college, and had positive results, and continue to take it, now I take it to clear up my brainfog, and it works well for that. It has an addiction side, of course, but the addiction starts immediately after the drug leaves your body and last for one half of the time of the effectivenesses of the drug. A 4 hour pill means 2 hours of immediate addiction withdrawal, that sort of thing.
One of the nice but little mentioned affects of the drug is it helps kids socially, to get along with other children.

[rainbow_kid]

I take risperdal,ritalin,zoloft and i have gained a lot of weight and weigh 188 pounds which is too much and in 2004 i was weighing 133 .