Trialing ritalin - the good, the bad and the ugly.....

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I would love some accounts from users or parents regarding ritalin for kids on the spectrum.

We've decided to trial ritalin for DS, who suffers from extreme inattentiveness. We've established that he has an attention span of no more than 3 minutes (unless it's computer games or his special interests). He doesn't have ADHD, rather can be a little fidgety but that would be sensory rather than neurological. Overall, he is generally quite a passive and calm child (with the exception of meltdowns which do happen but pretty infrequently)

He has a receptive language delay and is falling behind at school and struggling with reading and comprehension (he is 7 and in year 1). Anyway....that's the history and so we are on day 6 of ritalin. We started low - a quarter of a tablet so 2.5 mg) in the morning and in the afternoon and after three days have increased the morning dose to half a tablet (5mg). It appears to be having a positive effect on his attention, he is able to engage and focus for longer and is actually asking questions about things he has never shown any interest in. I haven't had the opportunity to observe him at school yet but plan to do so next week.
Then comes the rebound.....this kid becomes a nightmare. It wasn't too bad initally but once we increased the dose, he seems to get ADHD to dangerous levels, where he throws stuff, yells,screams and cries over minuscule things. I am hoping things will improve once his body has had a chance to adjust so I am reserving judgement however if this continues then we will probably need to reconsider.

I am supposed to email the Paediatrician with a status report and revisit in three weeks but I want to wait until I've observed him at school.

I have no first hand knowledge, but if it was working at the lower dose why did the doctor increase the dose?

As I say, no first hand knowledge, but I believe I read that Temple Grandin recommended lower doses. (not that she is a doctor, mind you, but I think it is not unusual for people with ASD to have issues with higher doses.)

Edited for literacy

Last edited by ASDMommyASDKid on 21 Oct 2014, 7:51 am, edited 1 time in total.

Ritalin had the same effect on me. I wanted to literally kill people when it wore off. I trialed for six months and then swore off all psych meds. (I'm on a holistic plan now)

It might be your son would react better to a different med altogether.

From what I've read, they titrate stimulant meds by finding the dose at which you start to see significant negative side effects, then dial it back to the dose before that. Seems, I don't know, kind of messed up to me (to dose on the principle that higher must be better, provided it can be tolerated, especially with drugs that we KNOW are addictive, and we KNOW we develop a tolerance to thus necessitating higher doses). But-- I'm a mom with a liberal arts degree. A hick mom with a liberal arts degree. I'm probably stupid.


When are you seeing "ADHD from Hell??" When the meds are supposed to be having maximum effect, or when they're wearing off??

If it's when they're wearing off, again from my reading (I have read quite a bit in the process of considering medicating DS7, but haven't actually lived through medicating a kid yet), it's probably the withdrawal that he's not tolerating. You know hose days when you drink too much coffee in the morning, and then feel grumpy and headachy and so darn unable to concentrate that you feel like kicking someone just because along about 2 or 3 o'clock in the afternoon???

Imagine that, from Hell, on steroids.

This was not our experience, and does not match what I've read from other parents on addforum.com. Good doctors start at the lowest dose, and then slowly increase the dose (usually 1 change per month) until the parent reports back that things seem optimal. Sometimes you overshoot because it isn't always possible to get 100% to "normal", and then back off.



From what I've read, stimulants are NOT addictive when used correctly (yes they can be turned into addictive drugs by those determined to do so, just like Sudafed). I've seen no references to the development of tolerance. I asked once at addforum if anyone or their kid had developed a tolerance, and got no reports of it. I have heard sometimes an increase is needed around puberty.

I'd recommend the video Essential Ideas for Parents by Russell Barkley. It's free on youtube. Or the book Parenting Children with ADHD: 10 Lessons Medicine Can't Teach by Vincinent Monastra. (The latter sees a place for both medicine AND behavioral treatment).

Our experience was with Adderall -- there are two classes of ADHD stimulants, and Ritalin and Adderall are not in the same group. Often if Ritalin doesn't work or has too many side effects, a doctor will recommend trying something from the other group instead.

We never tried a short-acting form, mainly used long-acting. DS started at Adderall 10mg XR. I couldn't see much difference, the teacher said it was a little better. We then added a non-stimulant, Intuniv, and then increased the Adderall to 15mg. At that point, it was clearly effective during the day, but the crash in the early evening was HORRIFIC. The doctor added a 5mg short-acting to take at the end of the day, which smoothed out the crash somewhat, but it was still an issue. When we changed from 15XR + 5 IR to 20XR, the crash disappeared entirely. He does get a little cranky and difficult around 6pm, but a cheese stick seems to cure it. The doctor explained that it was the same total amount of medication, but released over a longer period of time to create a slower taper.

It might help to keep a log of the time of medication and the time meltdowns occur, and show it to the doctor. If it indicates that he is crashing when the medicine is wearing off, there may be another formulation that will work better for him.

We accidentally had a "no-meds" day at school last spring. I broke my foot, and DH was directing the morning routine. He got the pill box out but forgot to actually give DS his meds. DS is in a special ed school for kids with AS, the most supportive environment possible, and that day the teacher said she couldn't figure out what was up because he was CONSTANTLY running over to the mini-trampoline to take a break.

We briefly tried Ritalin and Aderral when our DS was around 6 or7 but it just made him more hyper and aggressive - Vyvanse even more horrifically so - so we switched to Abilify. It was supposed to help with "irritability" but even at 10mg it was no more effective at that than at 4 which is where he is now. OTOH his receptive verbal abilities and attention span actually improved.

I hear you about the "crash" though. Our son is that way as well. He goes into a feedback loop of despair. We added clonodine which seems to have helped calm him down and eventually want to go to bed. Oddly enough, from what I've read clonodine is used to treat Tourette's but our neurologist dismissed that in our son.

i also used ritalin for a while, and still to incidentally.
aside from the benefits i recieve from it (mainly improved attentiveness), there are some definite and strong downsides, which makes me only reach for it on emergencies.

for one; it greatly inproved my perception, in all forms (vision, hearing, touch, temperature, pressure...), which can be so distracting the net-result of the meds are negative, i need a specially prepared area to benefit.

also, in the starting and ending of the active time, i feel all kinds of effects, just after taking one and before it actually works; i fet greatly increased heart rythm and blood pressure, which never really felt safe and also happened when i was taking it regularly.
during the turn-down phase (after it stopped working), i will feel dizzy and lose my balance (which is bad to begin with). aside from headaches from the changing perceptive abilities.
after this part, i will be fully drained of energy and unable to do the simplest mental tasks without sleep or taking another tablet, worse then the aftermath of energy drinks (but simular).

now, these are personal effects, your DS might not get any of this, but for me it was a reason to stop regularly taking ritalin and simular meds, and only take some if i really need extended focus.

p.s. the final trigger for this desicion was a 'bad trip', at one point i had a tablet stay active for 3 days straight, i was unable to sleep or even relax, having maxed-out sensory issues constantly troughout.

I would like to resurrect this post and ask the original poster for an update if you are still on the forum. I'm waiting on our scrip in the mail to arrive tomorrow for concerta which is along those lines of ritalin. My son is 11 in the 5th grade and is extremely inattentive. His mind is 12 places at once and his distractibility is so invasive to his learning. I see it and honestly to me it seems like he's on drugs when he's not because he's just so distracted. However, I'm very conservative with medicine. I'm very nervous. I'm not interested in making him easier for everyone else, I'm only interested in helping him do his best in school. He is at the age where he can police himself and I think he will either feel better or worse and now he is able to let me know. Since Ritalin and cconcerta are in the same family, I'm wondering how your experience has been? Have you had to change things etc..?

So. I'm not op, but we just started my almost 5 year old daughter on the daytrana patch (it's a stimulant, similar to Ritalin). She is not on the spectrum (my 7 yo is, which is why I'm on these forums) but this child is so hyper and impulsive I'm not sure we'd be able to tell if she has aspergers or not. She is off the charts. So step one is to curb the hyperactivity and impulsivity. So far the Daytrana helps. However I will say she crashes very hard at the end of the day and like op in the evening when it's worn off... she is like 10x her usual in unmedicated self. A real hot mess. But during the day, it does help. Key thing is, and it really took biting the bullet and doing it for me to understand, it's that if a child truly has dhd the meds will help in some areas.

We tried Ritalin, Concerta, and welbutrin (spelling) - each at 3 different doses over a period of 6 months for our daughter. She had not gotten a diagnosis of Aspergers at the time. She turned into a demon child.

She was a little bit better with attention, but her behaviors became violent and she could no longer control her emotions. She had to be removed from her 1st grade class and was kicked off the school bus because of behaviors.

We eventually took her off all medications and it took another 6 months for her to return to her 'normal' self.

I would strongly urge any parent who tries medication (it works really well for some) and their child behaviors change, take them off the medication immediately.

Good Luck and God Bless