Special Needs Education

» chemig - sheila1970, re:sleep problems

We are having problems with the medication getting into his system in the morning. (Yesterday I had to apply the patch at 5:00 a.m. so that he could focus for the beginning of the school day). Thankfully, we have had no problems at night. We started him on the patch on a weekend, so we could experiment a bit with application and removal time. He has been on the patch less than a week, but we have not had a single problem with falling asleep, even 2 hours after patch removal. We are also not experiencing significant rebounding between patch removal and bedtime. We started out with Focalin XR (I'm curious as to how you get consistent dosing dividing the regular release and extended release granules evenly). We started my son last year on a low dose of Focalin XR then, after playing with dosing after a growth spurt, our developmental pediatrician added a booster dose this fall. When we were still not getting results for the expected time period, our regular pediatrician changed him to 2 doses of regular Focalin. But, he is such a quick metabolizer that the morning dosage was not getting him through to his lunchtime dose. He was becoming VERY overactive and unfocused in school, so we switched to Daytrana. So far the lag time before his symptoms lessen is the only drawback. I did notice this morning that it is starting to get into his system faster--after breakfast this morning he was able to sit and focus building with Magnetix while waiting for the bus (almost 2 hours after application). So, as you say, each child is going to be different. But, if you are having trouble adjusting him on Focalin XR, it could be because of the two different components in each capsule. If he isn't getting enough of the smaller ones in his first dose, you wouldn't see an effect on his behavior/attention right away, and if he is getting his boosters while the extended release components are being released, especially late in the day, the could interfere with sleep. From the way our pediatrician explained the pharmacology of Focalin XR to me, half of dose in each capsule is "quick acting" , designed to be released into the bloodstream right away, and the other have is designed to start entering the bloodstream gradually as the first wave is dissipating, so that you can get up to 12 hours of effect. So, if a child is switched from Focalin to Focalin XR, the dosage is doubled from their Focalin dosage, or if they switch from XR to regular, the does is 1/2. Good luck, though, I hope you find a solution that works for you. My son used to be inperpetual motion--I would get tired and dizzy just watching him!

-- posted by chemig