Calvin knew - medication continued

- trileptal 750mg twice daily
- tenex 2mg at bedtime
- fluoxetine (Prozac) 15 mg  in the morning
- risperidone 1.5mg at bedtime
- vyvanse 40mg in the morning
- dextroamphetimine 7.5mg at 3pm

We held stead with Calvin's medications for several months, but we still were seeing lots of break through tantrums. Calvin started telling us that he needed more medicine. More of the "blue capsule" (vyvanse) because it wasn't strong enough. We also noticed that his worst behavior was in the afternoon. I thought that it was just because the afternoon is when I have all the 4 kids together so of course it's the most stressful for him. But, it also occurred to us that it might be that the medication from morning is wearing off by then.  We told Calvin he couldn't make excuses for hitting, breaking, tearing, etc. blaming medicine and had to make good choices himself, but he insisted that he needed to take another capsule when he got home from school. So we told him we'd ask the psychiatrist when we saw him next.


We reported to the psychiatrist that we were still having violent tantrums, many of them occurring in the afternoon (or even in the morning before meds were on board).  we also told him that Calvin expressed the desire to take more medication in the afternoon like the vyvanse he was taking in the morning.  The dr. said we could try a booster in the afternoon, a quick acting medicine similar to the slow release medicine in vyvanse. But he also thought we'd get more bang for our buck by increasing the rispridol.  

We tried both, one at at a time of course, actually increasing rispiradol first as the doctor suggested, but it was the addition of the booster pill that made the biggest difference. Dextroamphetamine, given daily at 3pm has been a game changer for us.  I thought it was neat that Calvin had identified which medication needed to be added. Not sure if it was a lucky guess or he is actually that in tune with how he feels. Either way we're happy for him.

Now, he is by no means cured, but it is good to have made a little progress from a year ago. If we hadn't Calvin would probably not be living with us anymore, as he would have been to aggressive, unsafe and harmful. As it is we have bought ourselves a little more time with him in our home, difficult as it may be I still feel it is nice to have the family together.


PS. It is common that the ADHD medications wear off by mid afternoon.  For most ADHD kids it's not a huge deal since by then they are home from school, but where it so significantly changes Calivn's behavior it is a big deal for him.