Looking for Information About ADHD and Meds

Our 8 year old has recently been diagnosed with ADHD (hyperactivity and impulsivity subtype) and we are researching the use of medication.  We were wondering if folks who have been on long term ADHD medication could share about their experience.  Have you been able to stay with the same medication for a long period of time (years, from what age)?  Have you had to change your dose over the years?   Any thoughts on serious side effects like addiction, depression, bipolar etc?

[Moderator note] There is a lot of past advice about this here: Medication for ADHD in Elementary School 

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My child was diagnosed at age 6 with ADHD combination type, and started medication right away, and it was the best thing we ever did.  Overnight, he went from being the kid who had to leave the class constantly, to being rewarded for meeting his daily goals.  He is now 13.  One of the many great things about ADHD medication is that you know whether it is working or not right away, the same day.  If it makes him feel bad in any way, we stop and try something else.  I cannot think of a single downside for a kid with diagnosed ADHD. He has had some appetite loss (but not much) and now takes a very low dose of melatonin at bedtime. Medications that others told us worked wonders for their kids, made mine feel bad, so we did 1 day and that was it.  Once you find something that works (and, the first one we tried did work, so often not onerous), you stick with it till symptoms come back showing either that he's outgrowing the dose or try a different drug.  We have changed doses and medications multiple times, from Medidate, to Adderall, to Vyvanse to Ritalin.  Most of these have been for about 2 yrs at a time, of varying doses, and have tried a few others (Concerta, Focalin, some others) that didn't work or made him feel bad.  One thing our psychiatrist has pointed out to us is that if you have a kid with a fast metabolism, they will likely need a higher dose than you might anticipate (though you always start with a lower dose and work up), or a second dose in the afternoon, because the medicine will move through their system faster than someone with a slower metabolism.  We saw more depressive effects from not being able to control symptoms than from the medicine.  Good luck.  Don't worry (too much).  It's not as overwhelming as it seems as first.

Our kid started ritalin extended release at age 7 with prozac for anxiety. They kept up with that until age 9 when we raised the prozac and lowered the ritalin because the higher ritalin was likely contributing to anxiety. That worked well, then finally at age 12 we switched to focalin XR keeping the prozac and that's where we still are at age 16. At age 13 we started leaving off the stimulant on weekends unless there was an event to go to.

My son was diagnosed ADHD (presenting combined) in 1st grade, we did CBT, executive functioning training, tutors, etc. and none of it was as effective for us as medication. We were leary of the idea of putting him on medication so young. We wanted him to learn coping skills that would translate into adulthood that were not medication based. HOWEVER, he struggled so much and his therapist finally sat us down and asked us this very very poignant question, "Are you sure that you believe that something that can help your son (and the vast majority of children like him) isn't worth trying? Are you ready to rule it out before even thinking about it or doing research?" It was a gut wrenching question and really hit home with my husband and I. 

We started medication in January of 2018 and it's the best thing we've ever done for him. It did take a few tries to find the right medication and dosage for him (about 3 months) but after that we have had very few issues. He is currently 8 and takes 20 mg of time related ritalin each morning. Some of the positives have been that his social life has improved (he has more friends because he has more impulse control), he has so much more confidence and is generally able to be successful in the gen ed classroom (he does have an IEP and gets some accommodations but mostly for executive functioning). We originally only gave it on school days but near the end of second grade he asked if he could take it all the time as, "my friends like to play with me more when I am under control" so we took that as a sign he is seeing positive results from it. Some things that we have had to adjust are his eating schedule, it is definitely an appetite suppressant so we fill him up with a big breakfast, he eats a smaller lunch at school and then a big dinner (since the meds are out of his system by dinner), we also really stay aware of his sleep as he had trouble falling asleep in the first few months but once we figured out that he needed to take his dose earlier that was less of an issue. We do meet with his developmental pediatrician quarterly, where they track his weight, height and make sure we are all still doing well but we haven't had any trouble or dosage changes since the beginning. 

We were warned that once he hits puberty we will likely need to re-evaluate his medication but our hope is that by that time in his life we are able to go back to using some cognitive behavioral therapy to help him (although I am fully aware this may not happen). Another thing to remember is that ADHD meds move through their system quickly, they won't build a tolerance to it so if you try something once and it doesn't work, there is no long term lingering effect. 

I applaud you for doing your research and checking it out. I know that we were so hesitant about starting and I think if we would have been more open to it in the beginning of his diagnosis we could have saved him a ton of agony and not needed to re-build his confidence as much as we did. 

Best of luck!!! 

Our high-school daughter has been on Adderal XR since the start of second grade and it has helped a lot, socially as well as academically.  We haven't changed medications, though as she has gotten bigger the dosage has proportionately increased.  She is naturally plump, so the weight-loss aspect of stimulants has not been a problem, though for a naturally thin child it can be.

            As for addiction, bipolar, etc.: our kid wants Adderal for school but prefers not taking it on weekends.  The meds have a damping-down effect on kids with ADHD, sometimes called the zombie effect by parents accustomed to kids bouncing off walls.  I've heard it described as feeling chemically forced to pay attention to boring things, not a lot of fun.

            Kids whose ADHD is left untreated may be at greater risk for addiction because of limited impulse control and the urge to self-medicate..  They are at greater risk for poor educational outcomes, in turn adding to risks of psychological problems.  The most effective treatment combines medical and non-medical modalities (e.g., behavioral modification, targeted tutoring).  An excellent resource for information on treating ADHD is Attention Research Update, http://www.helpforadd.com, which summarizes current ADHD research in clear terms.