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Children's Diagnosis & Treatment This forums is for parents to discuss issues related to diagnosis and treament of children with AD/HD

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Old 10-17-18, 07:44 PM
maple17 maple17 is offline
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Going from Vyvanse to Ritalin

I'm not sure if I posted about my son (10.5), who was also diagnosed with ADHD late last year. Because his sister has done so well on Vyvanse (huge improvement in grades and school all around, increased emotional regulation), we decided to go with that med for him as well.

The results have been less than stellar for him. He didn't have any side effects whatsoever except for the weight loss and we're still battling to try and get him to gain weight. The most recent weigh in, he's gained 300g in 3 months and only grew 0.5cm. This is at an age when his peers are starting to see huge gains in height.

We had reduced the Vyvanse dose down to 20mg (from 30mg) to see if it would help, but it hasn't much. I went through some of this with his sister and it was only with intensive focused supplementation (pediasure and the like) that she finally turned a corner. She has no weight issues now and her appetite is fine on it.

The paed reckons that Vyvanse is not worth it for him in that he's not really making any gains in focus or executive functioning. He's not got any behavioural issues in class, it's just hard to focus, follow through with tasks, and he's chatty when he should be listening. He's very bright as many ADHDers are and scored in the top percentiles on his WISC, but his lack of focus affects his schoolwork. So, the paed wants us to switch to the methylphenidate side and start with Ritalin to see if if makes a difference.

Given that both are stimulants, will trialling Ritalin really make that much of a difference or is it perhaps likely that he just doesn't respond to stimulants positively at all?
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Old 10-18-18, 02:04 AM
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Re: Going from Vyvanse to Ritalin

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Originally Posted by maple17 View Post
Given that both are stimulants, will trialling Ritalin really make that much of a difference or is it perhaps likely that he just doesn't respond to stimulants positively at all?
Ritalin (methylphenidate) is a different type of stimulant than Vyvanse (amphetamine), and they have slightly different mechanisms of action in the brain. Generally, it makes sense to try each of the two types. Though, assuming your two kids inherited the same set of ADHD genes, it's a bit weird that only one of the kids responds well to Vyvanse. Oh well, I guess every kid is different!

With stimulants, if it's the right dose and the right type of medication, you'll see the therapeutic effects right away. If there are negative side effects, they sometimes decrease after a few days (but not always). Issues with weight/height gain are due to appetite suppression. Is he eating well? Does he tend to have an easier time eating in the morning (before Vyvanse) and late at night (after Vyvanse has worn off)?
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Old 10-18-18, 04:03 AM
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Re: Going from Vyvanse to Ritalin

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Originally Posted by CharlesH View Post
Ritalin (methylphenidate) is a different type of stimulant than Vyvanse (amphetamine), and they have slightly different mechanisms of action in the brain. Generally, it makes sense to try each of the two types. Though, assuming your two kids inherited the same set of ADHD genes, it's a bit weird that only one of the kids responds well to Vyvanse. Oh well, I guess every kid is different!

With stimulants, if it's the right dose and the right type of medication, you'll see the therapeutic effects right away. If there are negative side effects, they sometimes decrease after a few days (but not always). Issues with weight/height gain are due to appetite suppression. Is he eating well? Does he tend to have an easier time eating in the morning (before Vyvanse) and late at night (after Vyvanse has worn off)?

Yeah, it's weird how genetics works. Same set of parents, but they have different diagnoses (one is ASD/ADHD and the other ADHD/suspected SPD). Different blood types too.

Maybe our expectations were too high as our daughter went from barely passing and doodling in the margins while tutors tried in vain to help her to colour coding her school binders and finishing assignments weeks ahead of time. From C student to As and Bs. Our son seems pretty much the same as before the Vyvanse to be honest. The teacher didn't have many issues with him before and doesn't now, but we still struggle with him to do assignments, focus on his work, proofread, remember more than one task at a time. All of that is the same. We see an OT and he rolls his eyes at that.

It seems like his appetite is lower, even outside of the med's influence (and part of it TBH is his food aversions as well). He picks through breakfast (I make him drink a pediasure/sustagen in addition to the cereal). He picks at lunch and often brings back items, saying he wasn't hungry. Then he snacks from about 4pm on and we try and stuff a huge dinner, dessert, sustagen and snacks into him before bed. We saw the same with his sister, but her appetite came back.

It's like for the returns (not much), this particular med doesn't seem to be helping much. I guess I didn't know lack of therapeutic effect was a possibility. I thought people switched due to bad side effects.
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Old 10-18-18, 04:48 AM
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Re: Going from Vyvanse to Ritalin

I think some of it can be due to the fact boys and girls are different. I am not saying this is a guarantee just that I personally noticed a difference in my kids with the two different classes of medications.
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Old 10-18-18, 05:30 AM
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Re: Going from Vyvanse to Ritalin

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I think some of it can be due to the fact boys and girls are different. I am not saying this is a guarantee just that I personally noticed a difference in my kids with the two different classes of medications.

Maybe that's part of it. Their ADHD is different as well. She had more emotional regulation and impulsivity issues while his EF is more of a challenge and he's the more typical highly active, in motion, and obviously distracted. When he had his WISC done originally (unmedicated), the pyschologist noted him rocking his chair, swinging his legs, counting air vents in the room, and narrating his way through the test.
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