Just a little nuts

Just a little nuts
A blog about single parenting & autism

Monday, March 9, 2015

Misadventures with Methylphenidate

Little Squirrel started prozac this time last year. She's still on the very low dose and there have been noticeable benefits related to irritability and self esteem.

Before the Prozac....

Since the Prozac...

Because our experience with an antidepressant has gone so well, I finally decided to give ADHD meds a try, for the main reason that LS's academics are slowly going downhill. The kid whose greatest strength was academics is losing ground. The skills and abilities and gifts are there but she just can't focus to save her life, or sit still, or listen, or hold one thought in her head at a time. Every time I fill out one of those behavior questionnaires for ADHD, it's always all 3s. All 3s for all these years. The doctors and counselors never push, but their eyes say enough: they are just itching to give her their pills. But I have always said, not yet. 

Then one day I said, okay let's do it.

The good experience with the prozac softened me up. And of course, research. Hours of it. What I like best about trying the meds is that it's not like the psychopharms that have to build up in your system so it takes awhile to find out if it's helping. With most of the stimulant meds, you'll know right away. 

My greatest concern was the side effect of sleep disturbance. 

"Protect her sleep," was the advice of the very first behavioral consult we ever had when LS was 2 1/2. That is what I've done. Sleep is sacred like a religion around here. LS is a good sleeper finally now and it's all I can count on this life, that she'll be out like a light and she'll stay that way until it's time to get up. 

Yet, despite the threat against sleep, we proceeded.

I got LS involved, and used words like "potion" and "experiment." She has admitted to the trouble focusing and given hints about how really freakin' nuts it is in her head most of the time. She agreed to try the new pill. We planned to take it first thing in the morning on a weekend and see how it goes. 

At first the rx was denied by insurance. They wouldn't pay for the capsule but they would pay for the tablet, of the exact same damn thing. That meant I had drive back up to the doctor's office, get another hard copy rx and then take it back to our pharmacy. This delayed things a few days. Once I finally got the stupid pills, it was after work on the day I am off in time to have 20 (kidless) minutes to do all the grocery shopping for the week. After that I go on autopilot for the rest of the day. We got home and I threw the groceries around, set the pill bottle down with the other meds, gathered LS's piano books and off we went to lesson. 

Later that night before bed time, I set down LS's vitamins and allergy pill like I always do. Or what I thought was the allergy pill...

"That pill tastes weird." LS commented. She had already swallowed it and wandered off. She will take any pill that I set out on the table. So I have to be very careful....

I froze. 

I picked up the new pill bottle and the allergy pill bottle. They both contained round white identical tablets.


I had just given LS Ritalin at bedtime!

Meth before bed???!!!!


I almost panicked then remembered her doctor said he has patients who actually take it for sleep, so they can calm down for sleeping. For real. Unbelievable. But true.

So I took a deep breath and continued the bedtime routine as if nothing was different. 

And it wasn't. 

At least not too different. She seemed to go to sleep quicker than ever. Just a few odd crashing sounds a couple hours later. I peeked in and she was sleeping sideways in the bed, which was different. 

I uneasily went to bed....

...only to be awakened at 3am by a wide awake, jazzed kid. 

"Hi, um, I'm not tired anymore," she burst into my room with the announcement. 

I patiently explained that I understood why she was up, it's the new pill, she can go read or play Minecraft, or do pretty much anything she wants, just do it quietly.

That held her off a couple hours until she came back, at 5:30am, completely dressed for school, and announced she was ready to get up.

Since it was my fault for mixing up her pills, I forfeited my last 45 minutes of sleep and got up with her. 

She was definitely focused, I observed. On Minecraft. Even more intensely than ever. Until it was time to leave for school, she gave me a complete dissertation on it, the speeded up version. 

I debated whether or not to email her teacher an FYI about what to expect for the day, but I decided it was too hard to explain. And embarrassing.

It was my volunteer day though, and I ran into her teacher in the hall and asked how LS was doing and gave a brief explanation, and her teacher was very nice about it, but it was still really embarrassing. Yet, her teacher said LS was doing just fine and that she didn't notice anything at all. 

So far so good.

And it's an 8-10 hour med, so it should be well worn off for bedtime. Except that it wasn't quite. I had to do a little extra coaxing to get her settled to sleep, but thought that could have just been because of the disruption of routine. She slept all night like normal. 

Since I always believe in jumping right back on the horse, instead of waiting for the weekend, I decided to give the med another try, but this time in the morning, as directed. I told LS to let me know how she felt during the day.

I hoped to catch another easy break like with the prozac. 

Sadly, it was not to be.

LS immediately reported that the new pill did help her focus but also made her feel tired and sad and miss me all day. Her social group teacher also said there were more tears than normal. 

If that was the only side effect, I would have encouraged LS to try the new pill one more time, just to be sure.

But that wasn't the only side effect.

Our sacred sleep was threatened! That night she had trouble going to sleep again. So much for the effects wearing off before bed, as described. Then she got up at 3am again! 

The experiment was canceled after that. No more of that "potion" for sure. It took a few days to get the good sleep pattern re-established. Even though the science claims the side effects wear off over time, we didn't see any noticeable benefits worth giving up our sleep for who knows how long and risking our health and sanity! 

*Methylphenidate is the main active ingredient in Ritalin, Metadate, Concerta and other brand name ADHD meds. Ritalin has a bad reputation and people think they are getting something better with other newer brands, but it's all the same thing.