Concentration - Meds or other advice please

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After 5 days on Ritalin, it took me 3 to feel "normal" again. Interestingly Ritalin's bioavailabilty increases with time. Also, what's forgotten is the issue of dependence on stimulants. That's a big thing, too.

Here, a GP can give Vyvanse. We don't have a ped here in town so my kids see the GP. Vyvanse doesn't cause the sleep problems with my son. Ritalin did with my older son, but ritalin is a bit "harsher". Ritalin is methylphenidate and not amphetamine but the effects are smiliar. Vyvanse is amphetamine but it's a prodrug, which rather than just being time released, is converted to the amphetamine in the liver. It's slow to kick in and the comedown from it is gentle and not noticable. There is no sudden "tiredness" etc from it. He's been on the lowest dose (20mg) for a while now and no need to titrate up because he's pretty much fully physically grown. No big growing spurts so they need to up the dose, and he's also not built tolerance to it much.

As for the ADHD assessment, what they do here is give the parents a questionaire and one for the teacher. That's it. Of course there are specialists and all, and they probably do a whole lot more especially if the kids got it bad, but for milder cases they just have you fill out a form. We didn't even do that with this son. Around here, they pretty much believe that it's fairly obvious when the kids got it so they treat it based on what the parent tells them.

I'd truly try the Vyvanse. It's so much better than any of the others IMO. I give it to Jay at about 530 in the morning and he goes right back to sleep. Back when he was going to school, I'd get him up at 630, right when the first part of it is starting to kick in. That not only helped keep him from flying all over the place in the mornings, but it helped him wake up some without ten cups of coffee or a Monster. By the time school started it was working good, and it worked consistantly all day up until about 8 or 9 at night. It slowly wore off and he had no trouble going to bed on his own at 10 or 11, his usual time. Sometimes he went to bed before then.

Now I give it to him when I wake up, usually about 8am and he goes back to sleep and sometimes sleeps until noon or so. It's not so strong that it wakes him up, which you can bet something like adderall or ritalin would do. He goes to bed now about 12 or 1, because thats his usual time, but he's been tired and gone to bed even before the meds wear off. So it doesnt keep him up, and he's VERY sensitive to the feel of any med.

He can feel any kind of psychoactive side effect of just about anything, even if nobody else does. He can take a 25mg Tramadol and feel like he's high as a kite, and those don't even do anything to you, he's that sensitive. He also can't stand that feeling so getting him to take anything is like pulling teeth. The doc wanted to try Adderall first, before Vyvanse (because Vyvanse is more expensive and at that time Medicaid required a trial of Adderall first) so he got some 10mg time release ones. For the first couple of hours things were ok. We tried it on a weekend back when he was still in school. He cleaned his room like I asked and played video games and said it helped and he was ok, and then I guess the "buzz" must have really kicked in because he thought he was going to die. He was shaking a little which is normal, and insisted that I take him to my mothers (a retired nurse) so she could take his blood pressure and all that. He was fine! But no, he would never take another adderall he said. He was convinced that they were too strong and something was wrong etc. The next day, to prove to him they were fine, I took one. I did not feel a thing. It's even a lower dose than a friend of mine my age has to take for narcolepsy. I'm not ADHD or anything, but I didn't feel any kind of intense concentration about things, or shakiness or rapid heartbeat or anything. I told him that they were not the wrong pills, it's the right dose and the smallest amount. He still wouldn't take them again, so we went back and got the Vyvanse. He has felt nothing at all from it, and it works great. If a kid that sensitive to meds can take it without anything, I feel very safe with saying that it's a pretty mild drug, and seeing how well it works with him, it's a very good drug.