ADHD and Medication: Finding the Right Dose

by Kristyn Crow | More from this Blogger

03 Jan 2007 10:21 PM

If your child is on stimulant therapy for ADHD, finding the right dose can be difficult. Every child is an individual who will respond physically and mentally to medication in different ways. Even when a dosage has been working well for some time, it will likely need to be adjusted as your child grows and develops. The difference between the correct dose and an incorrect one can make all the difference in your child's outlook.

Finding a dose that will benefit your child requires a triangular partnership between you as the parent, your child's pediatrician, and your child's teacher.

What the Doctor Should Do:

Typically the doctor will begin with a starting dose based on your child's weight and symptom history. This is an educated guess-a place to begin. The doctor will then need to periodically increase or decrease the dose depending upon the input he receives from you. This is called "titration," and it's the same principal used with any other condition requiring medication, such as juvenile diabetes. The doctor will need to know whether improvement has been seen on the current dose, or if any side effects have been observed. A good doctor will ask a lot of questions, and take notes. He or she should approach medication changes cautiously.

What the Teacher Should Do:

Your child's teacher should be in regular contact with you, via phone calls or private meetings while your child's dose is in question. The teacher should be making observations about whether your child is able to focus during class time, whether the quality of work is improving or not, and whether any behavior problems are being observed. The teacher should be especially watchful for side effects such as dizziness, tics, abnormal thinking, nervousness, or a "zoned out" appearance. Anything of concern should be reported to you as soon as possible. More subtle changes could be made known to you in a weekly contact. The teacher should also be making classroom adaptations to help your child have the best possible chance for success.

What You Should Do:

It would be an excellent idea for you to keep a written record of your child's symptoms and your observations. There are many ways you can do this. It's likely that the brand of medication your child is on will have its own website with a tracking sheet for you to use online. (Such as www.concerta.net or www.adderall.com.) If not, you can purchase a small notebook or calendar to write down dates and symptoms observed. If your child has bouts of hyperactivity at certain times of the day, make note of it. If you're seeing mood swings or erratic behavior after a recent dosage switch, jot it down. This information will be critical to helping your child's doctor determine whether the dose needs an adjustment. You know your son or daughter better than anyone else. Be your child's advocate and insist that his or her needs be met.

Kristyn Crow is the author of this blog. Visit her website by clicking here. Some links on this blog may have been generated by outside sources are not necessarily endorsed by Kristyn Crow.

Related Articles:

ADHD: Myths and Parental Guides

ADHD: To Medicate, or not to Medicate--That is the Question

ADHD and the Maddening Missing Meds

Learn more about Kristyn Crow

Kristyn Crow is the mother of seven children, and the author of three children's books. Visit her website at www.kristyncrow.com.

View Full Profile | More from this Blogger

Fatherofeight (2475) 03 Jan 2007 10:55 PM

Very good article. It is very appropriate time wise for us. We start our 2nd grader in a new private school tomorrow after 1 1/2 years of homeschooling. You have given me some thoughts as to what to suggest to his teacher that she do. By the way, I have been blogging on adoption for one month.

Kristyn Crow (2546) 04 Jan 2007 12:52 AM

I'd love to hear how things go at the new private school. Thanks so much for your comments! You're doing a great job blogging--thanks Ed.

Linda Hansen (1796) 04 Jan 2007 05:37 AM

Kristyn, our oldest had a rough time in the beginning with his meds. He was initially given Ritalin and his system couldn't tolerate it, no matter what dose. Adderall didn't work either. We tried different doses of Strattera and he is now where he needs to be with his meds. I agree completely with staying on the same page with your child's teachers, they can be your extra eyes and be a great deal of help when determining if meds are working. Great article with much info, thanks Artcraft

Kristyn Crow (2546) 04 Jan 2007 08:55 AM

My oldest stepdaughter tried Strattera and it made her nauseated every morning. The doctor suggested she take an antacid with it. So she was taking medication to help her take her medication. And still she was queasy and throwing up in the morning. Not a good situation. We stopped the Strattera, and went to Adderall, which has had terrific results for both my stepdaughters, and no nausea. I've heard glowing stories of Strattera and Concerta from other people, but Adderall worked best in our case. I think that's what's tricky here--every child will respond differently to different meds. All we can do is make conservative guesses until we find the right fit.

rsbg (501) 04 Jan 2007 09:10 PM

great article! getting the dosage right is so hard and so frustrating to parents-especially if you have one parent that agrees with the adhd/medication theory and one that does not. it is truly a "trial and error" type thing, which can be very difficult to deal with. and each child is truly different.... my oldest was on adderall for a while, he did great until one day he got in trouble at school. he ended up trying to turn over the principal's desk, tried to knock her computer off the desk, banging his head on a concrete wall-all of this out of a child that HAD NEVER shown a violent outburst in all his life (and never has since), and this was in kindergarten!!!!!