Finding the Right ADHD Medication Takes Time
One thing I've realised over the past year is that starting ADHD medication isn't the end of the journey. I think I'd assumed that once we'd found a medication that worked, we would have crossed one of the biggest hurdles, and that things would become much more straightforward for Smiler from then onwards. What I hadn't appreciated was that finding the right medication can be a journey in itself.
After nearly ten months on the first ADHD medication that Smiler tried, we, together with his psychiatrist, decided it was time to see whether a different option might suit him better.
At his recent appointment, we explained that Smiler had started asking if he could stop taking his medication altogether. Some of the side effects had become increasingly difficult for him to live with, and from his perspective, the benefits no longer outweighed the negatives.
The biggest issue was his appetite. At 6'2", Smiler has always had a huge appetite, but on the medication he was rarely hungry enough to eat lunch. Even by dinner time, his appetite often hadn't returned enough to properly enjoy his evening meal. If we went out for dinner, he felt completely cheated, sometimes only managing half of his favourite meals.
More worrying, though, was hearing him tell us that the medication sometimes made him feel sad. That's not something any parent wants to hear.
From our perspective, we had noticed the occasional dip in his mood too, but what concerned us most was that he had started skin-picking quite frequently, which can sometimes be associated with anxiety. At the moment, emotional dysregulation remains the biggest challenge for Smiler, and we didn't feel that the medication was helping enough with that to justify the side effects he was experiencing.
Our psychiatrist didn't think stopping medication altogether was the best option. Instead, she suggested that, because it was the summer holidays and Smiler is between exam years, this was actually an ideal time to try a different stimulant while we had the flexibility to adjust the dose if needed.
He's now been taking the new medication for two weeks. It's still far too early to know whether it's the right medication for him, especially as he's only on a relatively low starting dose, but so far we've noticed that the skin-picking seems to have reduced, and generally he seems happier in himself. We'll have to see how things look as we gradually increase the dose over the coming weeks, but we're hopeful this might prove to be a better fit.
If I'm honest, I felt deflated when we realised we needed to change medications. We'd hoped we'd found the answer, so it was hard not to feel as though we were taking a step backwards. But I'm realising that changing medication isn't a sign that anything has gone wrong. It's just part of finding the right fit, and I imagine that's a journey many families end up on.
During the gap between prescriptions, Smiler had a few medication-free days while we waited for his appointment. It was clear just how much the medication had been helping him. I think we'd quite quickly become used to the Smiler who has the medication quietly scaffolding him in the background. Without it, things felt much more erratic, and it reminded us that, despite the side effects, the medication really is making a difference.
That's why we've encouraged him to persevere with trying an alternative. We've always told him that taking medication is entirely his decision, and that hasn't changed. In the end, he has decided he was willing to give the new medication a go, to see whether it improved the appetite issues and low mood.
If this medication doesn't work, there is also a non-stimulant option available to us, which is reassuring. I'm also becoming increasingly aware that there probably isn't a “perfect” medication. It's more about finding the one with the fewest negatives and the most positives.
Smiler will soon be starting his most important exam year at school, so we're hoping we can get him settled on the right medication before the pressure starts to build again.