I came across a very interesting tidbit at my monthly CHADD meeting early in June. One of the parents had noticed over the months that her 9-year-old son was seemingly under-medicated. Her suspicion was that the change had happened when he switched to longer acting formulation of Methylphenidate (Ritalin.) She wasn’t sure if it was that the dosing didn’t translate or if he just wasn’t responding as well.
Despite the doctor’s reluctance, she pushed to have her son put back on three times daily of short acting Methylphenidate. To the great surprise of many, this was much, much more effective. He seems like he is a whole new kid. (Of course the parents are doing a ton of behavioral stuff with him. But now that he’s appropriately medicated, they are really seeing results.)
Pharmacologically, there is no difference in the active ingredient in Ritalin, Methylphenidate (generic name and the actual ingredient,) Metadate, Ritalin LR, SR, ER, Concerta, Daytrana, and even Focalin. But most patients will tell you that they respond better to one or more than others. The conventional wisdom is that the longer lasting more sophisticated delivery systems are more beneficial. Clearly, as in this boy’s case, that is not always true.
I think the take away here is that it is important to think outside the box and not assume anything when it comes to trying stimulants. It really is trial and error. But, when we get it right, it can be life changing. More on meds coming up.