Adjusting My Daughter’s ADHD Medication

As promised, here’s the latest on our quest for the best medication to treat Natalie’s ADHD.

Natalie and I met with her pediatrician, Dr. Halbur a week and a half ago for an official six week review of how Nat’s switchover from Ritalin to Focalin XR is going. I say official, because, due to several ear aches, a bad cough, and a nasty rash, Nat and I have had several unexpected opportunities to check in with Dr. Halbur along the way. We made a couple of adjustments already—going almost immediately from a 10 mg dose of Focalin XR to 15 mg, and later adding a 3:00 or 3:30 pm dose of Ritalin LA in order to cover the 13 hours Natalie is awake on a typical day.

Natalie’s teachers haven’t had a chance to really judge how the Focalin is working for Natalie at school. Holidays (and pre-holiday excitement) combined with weather-related late starts, early outs and days off (geez, no wonder things have been tough) have combined to keep them from a steady, predictable school routine. Without a certain amount of consistency, Natalie’s teachers can’t judge the medications efficacy fairly. Their early reports were of a silly, giddy Natalie. I don’t think that will be the final verdict. I’m still hopeful that Nat will be able to focus more consistently throughout the school day; our original goal for this medication change.

At home, I see no real change in Nat’s behavior from when she took short acting Ritalin, with a couple of exceptions. Her handwriting improved dramatically—telling me she can slow down and focus better on this particular task. And as I reported after Thanksgiving, she can tolerate riding in the car much better. So, although the Focalin hasn’t worked miracles, it’s wrought some positive changes.

We haven’t seen a decrease in irritability or anxiety, or some weird OCD-type symptoms, like Nat’s preoccupation with certain thoughts. Thus, our next big experiment. Dr. Halbur prescribed a small dose of Prozac.

Nat reported a little sleepiness during the first few days of taking it, but other than that, no complaints. The first big test of its ability to temper her anxiety came too soon for it to help, I think. Nat acted out like crazy the night before she was to start Tae Kwon Do lessons for the first time.(Then it was canceled due to the weather!) The combination of excitement and fear affected her just as powerfully as usual, with no sign of the Prozac taking the edge off. It was early in her treatment, so, again, I’m remaining hopeful.

If, given time, the Prozac doesn’t help, Dr. Halbur says we’ll try Risperdal instead. It’s known to help with the autistic-like symptoms that sometimes accompany ADHD, Dr. Halbur says, like Nat’s repetitive thoughts.

Right now, I think spring may turn out to be the best medicine! But in the meantime, I’ll try just about anything.
by Kay Marner