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3 yr old issues with other children
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<blockquote data-quote="Marguerite" data-source="post: 262248" data-attributes="member: 1991"><p>I don't know how it usually works in the US but here in Australia before they start a kid on the long-acting stimulants, they first test the kid's response to short-acting forms. Concerta is long-acting ritalin.</p><p></p><p>Our experience - difficult child 1 started taking ritalin at age 6 and the change was dramatic and instant. (well, within half an hour). The medications didn't fix things, they just made it easier for him to concentrate in class a little better. We didn't have long-acting forms of it available back then so we had to keep dosing him through the day, which wasn't always easy and when the dose was dropped off (due to the school not chasing him up for medications) we found we had a problem with rebound. </p><p></p><p>The easiest way to decribe rebound - it's as if all the symptoms of impulsivity and hyperactivity that the medications have kept at bay all day, suddenly arrive at once and emerge in one big dose. Then after that hyperactivity extreme wears off, the child can become teary, emotional and down. There are varying degrees of this. Not all kids will get rebound, some only get it on the short-acting stimulants, some get it on one stimulant but not the other, some get it on all stimulants, some get it on none.</p><p></p><p>We switched difficult child 1 to dexamphetamine, from ritalin and found no rebound problems. But because it was only available in short-acting, we had big problems with the school forgetting to medicate difficult child 1. So the doctor found acompoundingpharmacist who makes the medications up into a long-acting form. This compounding is done privately and does cost, but for us it is worth it.</p><p></p><p>difficult child 3 was started on dex at age 3. The positive benefit was immense, immediate and like magic. We were also very apprehensive about starting him on medications at such a young age, but the change wassopositive that we quickly were won over. We have copped a lot of criticism dfrom some people (who should know better) and I have the confidence to stand my ground and say, "You should have known difficult child 3 before he was medicated - you wouldn't argue against it, if you had."</p><p></p><p>At about the same time we switched difficult child 1 from ritalin to dexamphetamine. The ritalin rebound had become almost intolerable, but we found no rebound on dex. (A friend of mine had her son rebounding on dex, but not ritalin).</p><p></p><p>Then we got around the school's failure to medicate difficult child 1 (and easy child 2/difficult child 2, but this stage) by giving them the long-acting form. Again, wonderful improvement.</p><p></p><p>The thing with stimulants as treatment - if they're going to work, you will know it fast. Within hours. The first day. If they don't work, then the medications wash out of their system by the end of that day.</p><p></p><p>The long-acting forms, such as Concerta - they may take a few days to fully wash out of the child's system, but I would say no more than three days. You may also notice a bit of build-up over two or three days as the child stabilises on the medications. Rebound is less likely on long-acting medications, but if it is there you will notice it in the evening as medications wear off. Or maybe by next morning, before the medications are given/before they kick in.</p><p></p><p>Temple Grandin discusses medications and what she calls the "Wow! factor". She says that if you give a kid medications and you notice a really obvious improvement, like "Wow! What a fabulous improvement!" then clearly, the medications are worth pursuing. But if you dose the child and notice little or no difference, then it's time to discuss this with the precribing doctor and ask for some justification for continuing the medications.</p><p></p><p>Basically - if it works, then go for it. If it doesn't - don't waste your efforts.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 262248, member: 1991"] I don't know how it usually works in the US but here in Australia before they start a kid on the long-acting stimulants, they first test the kid's response to short-acting forms. Concerta is long-acting ritalin. Our experience - difficult child 1 started taking ritalin at age 6 and the change was dramatic and instant. (well, within half an hour). The medications didn't fix things, they just made it easier for him to concentrate in class a little better. We didn't have long-acting forms of it available back then so we had to keep dosing him through the day, which wasn't always easy and when the dose was dropped off (due to the school not chasing him up for medications) we found we had a problem with rebound. The easiest way to decribe rebound - it's as if all the symptoms of impulsivity and hyperactivity that the medications have kept at bay all day, suddenly arrive at once and emerge in one big dose. Then after that hyperactivity extreme wears off, the child can become teary, emotional and down. There are varying degrees of this. Not all kids will get rebound, some only get it on the short-acting stimulants, some get it on one stimulant but not the other, some get it on all stimulants, some get it on none. We switched difficult child 1 to dexamphetamine, from ritalin and found no rebound problems. But because it was only available in short-acting, we had big problems with the school forgetting to medicate difficult child 1. So the doctor found acompoundingpharmacist who makes the medications up into a long-acting form. This compounding is done privately and does cost, but for us it is worth it. difficult child 3 was started on dex at age 3. The positive benefit was immense, immediate and like magic. We were also very apprehensive about starting him on medications at such a young age, but the change wassopositive that we quickly were won over. We have copped a lot of criticism dfrom some people (who should know better) and I have the confidence to stand my ground and say, "You should have known difficult child 3 before he was medicated - you wouldn't argue against it, if you had." At about the same time we switched difficult child 1 from ritalin to dexamphetamine. The ritalin rebound had become almost intolerable, but we found no rebound on dex. (A friend of mine had her son rebounding on dex, but not ritalin). Then we got around the school's failure to medicate difficult child 1 (and easy child 2/difficult child 2, but this stage) by giving them the long-acting form. Again, wonderful improvement. The thing with stimulants as treatment - if they're going to work, you will know it fast. Within hours. The first day. If they don't work, then the medications wash out of their system by the end of that day. The long-acting forms, such as Concerta - they may take a few days to fully wash out of the child's system, but I would say no more than three days. You may also notice a bit of build-up over two or three days as the child stabilises on the medications. Rebound is less likely on long-acting medications, but if it is there you will notice it in the evening as medications wear off. Or maybe by next morning, before the medications are given/before they kick in. Temple Grandin discusses medications and what she calls the "Wow! factor". She says that if you give a kid medications and you notice a really obvious improvement, like "Wow! What a fabulous improvement!" then clearly, the medications are worth pursuing. But if you dose the child and notice little or no difference, then it's time to discuss this with the precribing doctor and ask for some justification for continuing the medications. Basically - if it works, then go for it. If it doesn't - don't waste your efforts. Marg [/QUOTE]
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