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Navigation to the Medication Journey

 

Now you’ve decided that it is time to let your child try it. 

 

The process of trying medication is a journey. For many, it can take one or two medications and trying different dosages from the lowest dose to get it to the right dose for your child. This is very individual because how every child metabolises and responds to the same medication can be different from others. 

 

However, for some, finding one medication does not work or make your child's behaviour worse (such as aggression and irritability), or in other cases, they experience severe side effects such as significant weight loss or become very emotional, extremely anxious or sad or low mood.

 

Therefore, before your child starts taking medication, it’s important to understand that finding the right medication, dosage, and schedule for your child can take time.

 

Why it’s important

 

You will need to work closely with your child’s doctor, as your child may need to try different types of medication or combinations of medications to find what works best for them. When your child starts taking ADHD medication, there are a few things you can expect throughout the first few weeks:

 

Choice, Dosing and schedule: Your paediatrician may adjust the dosage over time to get the best results and minimise possible side effects, depending on what medication chosen. It’s important to follow these instructions carefully, as taking too much or too little medication can affect its effectiveness. The medication schedule may also be adjusted based on the desired outcome.

 

For example, depending on your goal, whether you would like to help your child's symptoms primarily during school hours or after school hours, such as doing homework/ assignments and/or engaging in sports activities, you are encouraged to discuss with your doctor.

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Response rate: Most children with ADHD alone demonstrated 80-90% response rate, whereas others who have both ADHD and Autism Spectrum Disorder, however, dropped to 60%. 

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Side effects: Like all medications, ADHD medications can cause side effects. Common side effects include decreased appetite, trouble sleeping, and stomach upset. These side effects are usually mild and go away after a few days or a couple of weeks. If your child experiences more severe side effects, such as chest pain or difficulty breathing, contact your doctor immediately.

 

Improvement: In many cases, ADHD medication can lead to significant improvements in your child’s symptoms within days to weeks. You may notice that your child is better able to focus, pay attention, and control their impulses. If you don’t notice a change, then perhaps the medication or dosage needs to be reviewed.

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Long term: Clinical studies showed that children taking stimulant medications such as Ritalin and Dexamphetamine can improve their academic ability and Executive Function long term, which can be trained. Please refer to Executive Function Strategies and other non-medication strategies on ADHD Info. Therefore, once your child shows improvement in attention and behaviours, it is now the best time to improve their organisational skills to improve their adult capability and their full potential. 

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If the dose needs of the medication is low, you may also consider having a trial off medication after discussion with the doctor. 

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Comorbidities: It’s important to note that between 50% and 67% of kids with ADHD also have another co-occurring condition. ADHD symptoms may sometimes mask or obscure the presence of co-occurring conditions, making it more challenging to identify them. Starting medication should reduce the majority of the ADHD symptoms - hyperactivity and impulsivity or inability to focus, but if your child is still struggling, you might want to consider the possibility that they have another underlying condition, such as Autism Specturm Disorder, Dylexia (Learning disorder), Anxiety disorder or untreated Major depression.

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Regular follow-up with doctor: Your doctor will likely want to schedule regular check-ins to monitor your child’s progress and adjust the medication as needed. If you notice any significant changes in your child’s behaviour or mood, it’s important to contact your doctor. In some cases, a change in medication or dosage may be necessary. You should also contact your doctor immediately if your child experiences any of the following:

• Chest pain or difficulty breathing

• Severe headaches or blurred vision

• Fainting or seizures

• Allergic reaction, such as rash or hives

 

 

Tips and strategies

 

Booking follow-up appointments ahead of time to see a paediatrician is important, as it can take weeks or months because of waitlists. Please plan ahead and book regular review appointments at least every 6 months. This will allow you to discuss and address your concerns early.

 

Talk to your child about the medication – Talking to your child about medication in an age-appropriate way can have many benefits, including teaching them about self-care, self-advocacy, and self-acceptance. 

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Check that your child can swallow the medication – some medications need to be swallowed whole, which is no easy feat for a child. A good way to prepare your child and teach them this skill is to practise swallowing a tic tac. Other medications can be crushed, and kids are happy to take them mixed into yoghurt, in a spoonful of honey, or with another sweet food. Don’t forget to ask your doctor how your child needs to take their medication to ensure you administer it correctly. 

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Monitor your child – Keep track of how your child is responding to the medication using the Vanderbilt ADHD Scale, as well as getting regular feedback from the class teacher. While ADHD medication can be safe and effective, it’s important to keep an eye out for any changes in your child’s behaviour or mood. Here are a few things to look out for

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• Changes in appetite or weight: ADHD medication can cause decreased appetite, which can lead to weight loss. If your child is losing weight rapidly or refusing to eat, it’s important to talk to your doctor about it.

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• Mood changes – While medication can improve ADHD symptoms, it can also affect your child’s mood and behaviour. Some children may become more irritable or emotional when taking medication, while others may become more withdrawn. If you notice any significant changes in your child’s behaviour, speak to your doctor immediately.

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• Sleep Problems – ADHD medication can cause trouble sleeping. However, sleep disorder, particularly having trouble falling asleep, is very common in children with ADHD. If your child is having trouble falling asleep or staying asleep, their doctor might need to review the medication, dosage, and schedule.

 

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• Tics – In rare cases, ADHD medication can cause tics or involuntary movements. If your child develops tics, book an appointment to speak with your doctor.

 

• Food and drink – stimulant medication can be an appetite suppressant.

  • Ensuring your child eats high-protein diet before taking their medication can help with stomach aches and weight loss.

  • Drinking regularly is also important to avoid headaches at the end of the day. Having a healthy and protein-rich snack after school may help ease “hanger” symptoms and medication rebound.

  • Avoid food (Citrus) containing ascorbic acid or vitamin C an hour before and after you give your child ADHD medication, as they interfere with how the medication is metabolised.