Adjust ADHD meds for a special occasion long day?

November 19, 2021 9:27 PM

This is the first year that my son is on meds for ADHD during Thanksgiving. We're going to be in a group, and stay up late, each of which is usually a challenge. For those with experience: do you ever adjust or add to meds when you know a long, trying, special occasion day like this is coming up? If so, how?
posted by nadise to Health & Fitness (6 answers total)

It really depends on a lot of things. What he's taking (especially if it's extended release or not), how old he is, whether or not he usually takes it every day or just for school, how long he's been on it, how well he's adjusted to it, whether or not taking it later in the day might prevent him from sleeping well - or at all - that night...

Plus, what his major symptoms are. Is he more inattentive, more hyperactive, etc.

When my son was taking an extended released version, he didn't always take it on non-school days. It didn't keep him up at night if we had him take it later in the day, say 10am or noon, rather than 7am-ish. My son was combined-type, both inattentive and hyperactive, but it was primarily the inattentive in-school that we really struggled with managing, along with some moderate impulse issues that tended to show up in the sort of very-low supervision that public school is.

A family gathering - which in our case, included about a dozen other kids ranging from a few years younger to a few years older - tended to have a lot of energy, a lot of playing, and probably, a great deal of running around in the yard, even in the winter. Plus a plethora of adults that would actually notice any issues, and other kids (including three siblings) that would just tend to help keep him on track.

After we got familiar with how the medication affected him, and were much better at the consistency and patterns and just "managing" his day to day, we generally didn't bother, because we found it wasn't necessary in the non-school settings. Once I took him out of public school to homeschool - he staying in longer than the other kids for [reasons] - we found it wasn't nearly as necessary, and he really didn't care for the way the medication made him feel. It was a tool that we used when we needed it, and in some ways, was a lifesaver , but for us, it allowed him to gain the coping skills and learn to manage his own behaviors, internally and externally, so that he was eventually more comfortable without it, and knew he could rely on himself. I suspect that the non-medicated days may have helped him learn to tell the difference between the ways he felt, and with recognition, he was able to learn to adapt his actions.

All that to say, this is what worked FOR US. Your situation may be entirely different. I'd been very anti-medication prior to trying it, and what made me decide we needed to was my son's own statements of "feeling crazy" and "not like myself" and being worried and scared, as a kindergartener, because he knew he was having thoughts that were simply followed by action, without ever even considering whether it was a good idea or not. So when he reached a point where he asked to not be on the medication, it seemed he'd gained enough coping skills, so we tried it.
posted by stormyteal at 10:38 PM on November 19, 2021 [2 favorites]

ADHD meds are stimulants. They can be dangerous when taken not as prescribed. This is a question for your child's psychiatrist, not strangers on the internet.
posted by shadygrove at 12:22 AM on November 20, 2021 [19 favorites]

Agree that it's a good idea to check with your child's med prescriber. However, I will share my daughter's strategy for how she occasionally adjusts her son's medication - he's now 8 and has taken ADHD meds for 2 years. It took a long time to get the dosages and timings right so he didn't "come down" abruptly in the very early evening as he's grown and added weight, so be prepared for adjustments over time. Now he takes a long acting med in the morning and a short-acting booster at lunch. If it's going to be a long, stimulating day she might let him sleep in in the morning, thus taking his morning med at a later hour than usual, and then take his short acting after, rather than before lunch. This usually works out well, and he is able to sleep normally and participate in activities after dinner. She has found out what "wiggle room" she has in adjusting the timing of doses according to the family's activities, and the pediatrician who prescribes his meds is fine with minor adjustments. Routine schedule interruptions can be a challenge, so working with the doctor and achieving a common goal is important and together you can try different strategies to achieve the best solution for your son and your family.
posted by citygirl at 7:40 AM on November 20, 2021 [1 favorite]

Response by poster: @shadygrove I'm not asking for medical advice on the internet. That's why I left out details of what my son is taking. I'm asking for personal experience; anecdotes I can learn from rather than emulate. It just helps to hear a plurality of experiences rather than just one voice (his doctor's).

Sounds like some people have had success with shifting timing and adding boosters. Thanks for those who shared their experience!
posted by nadise at 9:48 AM on November 20, 2021 [2 favorites]

My friend is an elementary teacher and parent to a few kids under 8. I recently asked her this question for another friend whose 8 year old is on ADHD meds - the mom was considering taking him off the meds for non-school days. My teacher friend’s suggestion was, in general, to keep the dosage consistent all the time to help the child feel regulated.
posted by nouvelle-personne at 11:32 AM on November 20, 2021 [2 favorites]

I know lots of people suggest not taking meds out of school and we do often do that too BUT it is not unreasonable to have and use meds to help social actions and reactions to other people. For my kid ADHD often leads to pushing kids and other people's boundaries in a way that is upsetting. Also emotional regulation is less than steller without the thought time gained by meds. So it can be a useful too especially depending on the social mix of kids (older and younger, quieter or not, and how well they interact in return)
posted by aetg at 5:52 AM on November 21, 2021 [2 favorites]