My son has ADHD attentive and took Focalin from the ages of 13 to 21. He truly was able to focus and understand things at school much better. His grades shot up and although not a superstar, still graduated with a B+ from high school. We never asked for more time on tests or other accommodations. (When he started in 7th grade, his grades shut up within 10 days from C,D, one F to A, mostly B’s and a C. Those synapses definitely weren’t working properly.)
He hated being on them and took himself off at university. Because they made him feel dull and lifeless, quiet. He’s a happy cheerful person. I love being around him. He also has very low anxiety. I found out that his symptoms are a real thing with stimulants. it’s called Emotional Blunting
He just got a new job and expressed how nervous and anxious he is as he “doesn’t learn things easily “. I was glad he is self aware and admitted that about himself and to me. I broached the subject of meds again and he was receptive . I suggested starting at a much lower dosage He hasn’t been to the doctor in years. His has since retired and died. So he needs to find a new one.
Today I started researching meds and think he may be a great candidate for a non-stimulant ADHD med, Strettera. It does NOT cause emotional blunting and helps with anxiety. It’s not a controlled substance, so no danger of dependency. The emotional blunting was what he hated the most.
I don’t have experience or advice but also think it’s a good idea to research and explore new options - he and his body have matured since the last intervention and also there are new treatments available - here’s hoping he can find an intervention he is comfortable with and that helps his productivity at work.
Also by posting, bumping up so it doesn’t get lost in case someone here has advice!
Something to consider, but make 100% certain that he does this in conjunction with a specialist, maybe a psychiatrist? Make sure and tell him to give honest answers to the doctor’s questions. There can be serious consequences to taking the wrong medications. Some people will tell the doctor what they need to hear in order to get the medication they want- don’t do that. Some doctors don’t look at the side effects and conflicts with other medications. I have a loved one who was on different medications with severe conflicts, and taking Adderall when she has severe anxiety and panic attacks (no!!!). These medications can be wonderful, and they can also screw up your entire life, so make sure he sees and is followed up by a specialist!
My adhd 28 year old has been on focalin since the 6th grade, it was a game changer. He does need to see a physician every 3 months. My oldest was on a non stimulant medication in elementary school, didn’t help. Her adhd never really affected her grades, but I know she takes a stimulant now, at 30 (she works full time as a cpa, and as a musician).
It’s worth looking at other options if you son did not like the way he felt on stimulants. However, most of the people I’ve worked with (I’m a psychologist) who have tried Strattera (or similar) have not found it useful for inattention. If your son does try stimulant medication again, he could try a lower dose, not take on weekends, and possibly only take it on work days where he knows he’ll be learning new or complicated tasks. Best of luck to him.
My son took Strattera but that was way back in grade school. He switched to it from Adderall because that was causing a lot of side effects ( nausea, no appetite, and tics). It was prescribed by a pediatric neurologist. He stopped taking it by HS and is unmedicated as an adult.
When was the last physical, OP? I have a neighbor whose “ADHD” (never properly medicated) turned out to be an atypical presentation of Hashimoto. Two months on the appropriate meds and the symptoms cleared! No more brain fog, distraction, inability to focus!
I’d have your son try to get into a psychiatrist and see what they recommend.
My son took Strattera in middle school for a short while. It made him surly. I think we tried every medication and he didn’t like any of them. He felt they took away his personality and creativity. The first few years of college I would go every month to his psychiatrist to pick up the written prescription and fill it and mail it to him. Joke was on me when he had a box full of full pill bottles when we moved him out of his dorm.
My daughter also took a variety of meds in HS. She also didn’t like how they made her feel. For her they caused a lot of anxiety. In college she made the decision to stop. Earlier this year she decided to go back to school and went back on medication. Her psychiatrist decided what one he was willing to prescribe and it wasn’t the one she thought she wanted. She ended up stopping as she was having a problem with increased heart rate.
That’s good to know about Strattera. Thanks for chiming in.
I did read that perhaps a low dose stimulant that’s just a 12 hour capsule might be the best in his situation. Focus at work and then feel like himself the rest of the time and in weekends.
One more vote for seeing a psychiatrist who is sophisticated in ADHD management in adults. Commonly the SNRI’s are the class of meds used to treat ADHD inattentive type. There are other treatment options if “traditional” stimulant ADHD meds are contraindicated in patients for whatever reason. For example, in some kids, and sometimes in adults, Clonidine or Guanfacine is prescribed (though it would NOT be the right approach for your son’s sx). I am simply giving as an example/pointing out that there may be other alternatives.
Strattera is a hit or miss medication. A lot of people get no benefit from it. You have to take it every day, and it takes a number of weeks to find out whether you are going to be one of the responders or not. In contrast, with stimulants such as Focalin (dexmethylphenidate), response rates are higher, and you know within a couple of days whether they will work. The other nice thing about stimulants is that you can take them on an as needed basis, and if desired not take them on weekends, vacations, or less demanding work days. You can also take preparations that last a half day and then wear off by the evening if being emotionally blunted is affecting your social life.
So for a young person who responded well to stimulants before, going on a stimulant again is perhaps a safer bet during this new job situation.
Stimulants are a controlled substance, but have very low risk if used as prescribed. These meds are not particularly complicated. A psychiatrist could prescribe them, but so could a family physician, internist, NP etc. Have him call his regular doctor’s office and ask the nurse whether his doctor prescribes these meds for those with a documented history of ADHD. Most will, but if yours doesn’t then ask whom they recommend. Your son will need proof that he has been formally diagnosed with ADHD in the past, so have him start working on getting a release of information to obtain his old records.
For a healthy young man previously diagnosed with ADHD, this is straightforward, and very unlikely to be something else such as a thyroid problem.
Actually these 12 hour time-release preparations are probably not what your son will want. 12 hour preparations are most useful for children who need to be given a pill early in the morning before going to school and who need it to last all school day and for a few hours after school so they can do homework. Most adults prefer a non-time-release preparation that lasts say 4 hours. This allows more flexibility.
All great info to you all. His previous doctor who prescribed them is in the same system as a new one who will be seeing him. Wouldn’t they be a he to see he’d been prescribed them in the past.
Good info about 4 hours vs 12. He’s always had a hard time getting to sleep and I remember it made it worse the him. They were a 24 hr release. I’m really wanting him to not face that flat feeling again, or I know he’ll go off of them.
Yes, if he is in the same system they will be able to see his old records. This will make everything a lot easier. He won’t need to do a release of information form.
So it sounds like he was on Focalin XR (time release Focalin.) It is supposed to last 12-15 hours, but in some people it lasts longer, to the point that it interferes with falling asleep. Since this was your son’s experience, he will want to try an immediate release preparation instead.
The other nice thing about immediate release preparations is that you can split the pill. It just gives you more flexibility, especially flexibility to go low. As an example, a common time release stimulant is Concerta. It is time-release methylphenidate, the lowest dose is 18mg. But some people do just fine on immediate release methylphenidate 5mg in the morning and another 5 mg at lunch. Or even just 5mg in the morning if the second half of their work day is less intense. So they can do well on a much smaller total number of milligrams, feel like themselves socially after work, and fall asleep normally. The immediate release is a lot cheaper too.
(In “the olden days” the time release stimulants didn’t exist, and school children would have to go get their afternoon dose from the school nurse. Embarrassing for the kid, and inconvenient for the busy nurse–but in some ways a better plan medically, especially in those kids who have trouble sleeping on the XR versions.)
Yes, he was on Focalin XR, I think 15 mg. If he does decide to do a stimulant vs a non-stimulant, he could do the same thing with regular focalin, too. I think he will have to do a day with whatever he takes,
In my opinion…you need to see the psychiatrist or whoever will be choosing, prescribing and monitoring this medication. Monitoring would include both efficacy, and side effects, as well as possible changes in dosage amounts. This monitoring is probably the most important component of dealing with just about every medication.
I hope you find the right combination for your person.