
Suggest Treatment For ADHD In A Child

Question: Ok, my daughter is now 9. She was diagnosed with ADHD at 4 years old. She has always been extremely hyper, like can't stop talking, moving, and getting in others faces or personal space. She also had a very hard time focusing on anything that didn't interest her for more than a few minutes. She also had a hard time with impulse control. She was put on focalin at 4 and improved a huge amount. She always has been highly intelligent reading on her own at 3 years old and very creative. However, now that she is on focalin 10 mg in am and 10 and 1/2 of 5 mg so around 12-13 mg in afternoon, she is quite moody when I pick her up at school around 3:30. And barely eats lunch. She has always been very small even before melds, but now is up to about 50 pounds and maybe 48-50 inches tall aprox. She takes guafacine around 5:00 1/1/2 mg to help her focus, not be so obstinate, and eat and sleeps better. We have tried 1 mg of gufacine in am with just 1 10 mg of focalin as her ADHD specialist suggested, it helps in am, but can't give in afternoon or she gets way too sleepy and lethargic. Any suggestions? We need her to be more balanced and not on such an emotional rollarcoster. She does best in am on the 2 together focalin and gufacine, which I believe in intunive. She is just finishing 3rd grade at a small private school where they have recess 2-3 times a day and smaller classroom size. She is happier, but still struggles at 11:30 lunch a little socially as even though she takes med prior to lunch, it hasn't always kicked in time to be back to normal for lunch. We really want to help her as she has so much potential to do well in school and with friends. Please write and tell me how to manage her melds better or what to do to make her more emotionally stable. She hardly ever plays with other children after school except her brother who is 20 months older than her, I don't want her to give up as she is smart and can be a good friend, but struggles with people.
Brief Answer:
give focalin after lunch, use extended release preparation
Detailed Answer:
Hello,
Many children like your daughter suffer from loss of appetite due to focalin. In such children I recommend giving focalin after lunch. It will help in reducing anorexia and child would take enough lunch. Child should also have enough breakfast. Shifting to extended release (XR) preparation will help in reducing dose frequency; sustain drug level in system and more effective control of the symptoms. Need to maintain her growth chart also.
Please discuss my recommendations to her treating doctor and change treatment plan.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
give focalin after lunch, use extended release preparation
Detailed Answer:
Hello,
Many children like your daughter suffer from loss of appetite due to focalin. In such children I recommend giving focalin after lunch. It will help in reducing anorexia and child would take enough lunch. Child should also have enough breakfast. Shifting to extended release (XR) preparation will help in reducing dose frequency; sustain drug level in system and more effective control of the symptoms. Need to maintain her growth chart also.
Please discuss my recommendations to her treating doctor and change treatment plan.
Hope I have answered your query, I will be happy to help further.
Regards,
Dr.Chintan Solanki.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar

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