As a family, we have four cases of ADHD, which have taught us a lot about ADHD medications. The first to be diagnosed was our oldest daughter, who was 11 at the time of her diagnosis. Despite her giftedness with an IQ way above 140, she had been struggling with attention issues in school and at home that we couldn’t simply explain with boredom or laziness.
While her diagnostic process was still going on, we realized that our 10-year-old daughter had the same problems, again despite being similarly gifted. There appears to be a myth in the “gifted community” that gifted children don’t have ADHD, but are just either lazy or bored. That certainly delayed the correct diagnosis for our daughters, but we’re happy we finally got there. But that (and the fact that girls are usually diagnosed much later than boys anyway) is a topic for another day.
Going through the process with our daughters, my wife and I noticed that we are actually exhibiting a lot of the same symptoms. We had made adjustments to our lives that made the symptoms somewhat easier to deal with, but both suddenly realized that ADHD would explain a lot of the struggles we had had since our childhood. We found a doctor who specializes in adult ADHD and both got a very clear diagnosis.
Changing ADHD medications
Once diagnosed, our oldest started medication right away. In Germany, the first line ADHD medication for children is always Methylphenidate (sold as Ritalin or Medikinet here, and under many other names around the world). We saw an immediate effect on her ability to concentrate, but it wore off in the early afternoon, and she really struggled with having to eat something substantial before taking the medication.
Alternative options were either a different formulation of Methylphenidate (Concerta) that is supposed to last longer, or a switch to Lisdexamfetamine (Elvanse in Europe, Vyvanse in other countries). We opted for the latter because it can be taken without food, and the improvement was phenomenal. She no longer had the “rebound effect” that is seen with many Methylphenidate products, and is now able to concentrate the whole day, while her sleep does not seem to be affected.
A big difference
My wife was first prescribed Methylphenidate as well, and had the exact same experience. She would lose her focus in the early afternoon, unless she took a second dose around lunchtime, which she would forget more often than not. Again, a switch to Lisdexamfetamine made a huge difference, so when I started in medication a few weeks later, I started on Elvanse right away, which in Europe is approved as a first line ADHD medication for adults. One thing we notice is that some of the concentration-improving effect of Elvanse/Vyvanse seems to last even through a day or two of not taking the medication, such as on weekends.
Our middle daughter has gone through the exact same journey, first having to start on Methylphenidate and then moving on to Lisdexamfetamine, with great success. The changes in her, particularly after the switch from Ritalin to Elvanse, were phenomenal.
We have all been very lucky not to experience any of the potential side effects of either medication, although quite honestly, half of them sound more like what happens if people take the medication even though they don’t actually have ADHD. Loss of appetite is the only thing we see, but we all generally make up for it with a different eating rhythm – and catching up on weekends. We asked our oldest at one point whether she wanted to take her medication on a Saturday when she still needed to study for a test, and she told us “no, I want to eat a lot today, so that’s not an option”.
Lessons learned
This is of course an anecdotal report of four people with somewhat similar genetics, so it should not be misunderstood as a recommendation for or against a particular medication. We actually know other swho didn’t respond well to Lisdexamfetamine and had to switch to something else. However, people with ADHD who struggle with the medication that has been prescribed should talk to their doctor about alternatives. And those struggles don’t just mean side-effects, but also required lifestyle changes, such as the need to have breakfast before taking medication, which was a major problem for us, since we generally eat rather late.
what about you?
Have you had similar experiences? Are you still searching for the perfect dosage of the right ADHD medication? I’d love to hear in the comments what your experience has been.