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ADHD Medication Titration Adderall, Dexedrine and other stimulant medications for ADHD have a long-lasting effect that can last for up to 14 hours. They have more effect than stimulants with shorter durations, like methylphenidate. The procedure of titrating medication is utilized by doctors to find the appropriate dosage for every patient. This article will discuss the procedure of titration, its side effects, and when you've reached your “target dosage”. Take notes for your next visit to the doctor! Dosage Titration is a method which determines the dose of medication that will reduce ADHD symptoms most effectively while minimizing the risk of side effects. The doctor will start with a low dose and gradually increase the dosage over time, usually every one to three weeks. The doctor will also play with different kinds of medication to determine the most appropriate one for your child. It is crucial to stick on the titration path, even if it takes a few weeks. It is not uncommon for a child to be required to try three or more kinds of ADHD drugs before finding the perfect one that is a good match. The goal is to control your child's ADHD symptoms and minimize the negative impact they can have on his or her everyday life. The most popular stimulants used to treat ADHD are methylphenidate (Ritalin) and amphetamine salts (Adderall). Examples include methylphenidate (Ritalin), and amphetamines salts (Adderall). They are available in many forms including chewables, tablets, chewables capsules, liquids, and tablets. The dosage can vary, but the standard is 10 milligrams a day. This dose is sufficient for some patients to alleviate their symptoms. Some patients will need an increased dose. It is also important to take into consideration the release profiles of the medication that is being taken. Some stimulants have a fast beginning and fade rapidly, while others have a more gradual effect. Some people are poor metabolizers which means they won't benefit from higher doses but still show improvement at smaller doses. The titration procedure should also consider whether a patient takes any medications that block CYP2D6 like SSRIs. This will affect the effectiveness of the medication for them. Prior to each dose increase, it's important to get parent/teacher ratings as well as symptom reports. It is crucial to use a rating scale that has been tested for ADHD, such as the Follow Up Vanderbilt form or the Adult ADHD Symptoms questionnaire. This will ensure the information is correctly collected and the dosage of medication is accurate. Certain children are prone to certain negative effects of ADHD medications, for example irritability or a change in appetite. This could indicate that the medication isn't working and need to alter it. Other negative side effects, like feeling tired or sedated can be a sign of an overdose and should be addressed by reducing the dosage. Side effects It can take weeks or months to reach the optimal dose of medication for ADHD. During this period, patients should keep track of symptoms and adverse effects on a daily basis. It is suggested that this be done on a calendar or in journals to ensure that it is easily communicated to the physician. Stimulants, which are the most commonly prescribed medications for ADHD, can cause various side effects. These can include headaches, dry mouth, stomachaches, sleepiness, a loss of appetite and a sudden rise in blood pressure or heart rate. Patients may also be prone to the tics. These are minor repeated motions of the body, such as squinting, blinking or repeated facial expressions. These side effects, while not typically serious are important to report immediately to your doctor. Certain stimulant-related side effects like irritability and insomnia, tend be more noticeable at first but improve over time. Additionally, certain medications are processed differently by different people. It is important to determine if an individual has a slow or a fast metabolism, so that the right dosage can be given. While it's not a common occurrence, it is possible that the initial medication won't be effective for a child suffering from ADHD. If this is the case the doctor will change to a different medication. It is not unusual for doctors to switch their medications. Parents and children need to support this process and understand how important it is to choose the right medication. It is also important to keep in mind that even though the titration process may appear to be slow, it's important for a child's long-term health. The process of changing ADHD medication too quickly could result in negative side effects and a lack of benefit. Titration can be used not just for stimulants to treat ADHD, but also for other medications such as antidepressants or antibiotics. Titration isn't just employed to treat stimulant medications, but can be used to find the most effective dose of any medication taken long-term. Schedule Titration is a process to determine the proper dosage of medication for a person. The dosage is determined by a variety of factors including height, weight and symptoms. It is important to be aware that drug release profiles can vary (i.e. the way a stimulant like Methylphenidate wears out or affects the body). These are all things that your doctor will be experimenting with when you are titrating. Most of the time, a doctor will start with a very low dose of the medication and gradually increase the dosage. This is to allow the doctor to create an “target dosage” that is effective in controlling symptoms, but has as little negative side effects as it is possible to. titration adhd is crucial for parents and children to be involved in titration by completing ratings scales for each dose and then returning to the clinic to review the effectiveness and side effects. It can take months or even weeks for a doctor to get the child's ADHD symptoms under control with the right medication. Parents need to be aware of this and work closely with their clinician to ensure that they don't get dissatisfied. This is particularly true for children who are more active and have a lot of stimulation in their lives. The timing of titration can vary from patient to patient however, it is generally a matter of increasing the dosage in small increments each time for 1 to 2 weeks. Once the child is on a target dosage and is performing at their best with minimal side effects, the doctor will decrease the dosage to a maintenance dose. It is also important to discuss with your titration prescribing doctor the best time to take the medication. Generally, it is best to take it in the morning to ensure that your child is able to concentrate on schoolwork. Some patients may discover that taking the medication later in their day is more beneficial since it allows them to concentrate on their work or driving. It's also a good idea to take your medication on a regular basis to avoid missing doses or forgetting to take them. Monitoring The goal is to find the best dose of medication to manage ADHD symptoms with minimal adverse side negative effects. It could take 3-4 weeks or more of a careful adjustment to attain this equilibrium. It is crucial that the physician and patient work closely to monitor the effectiveness of the medication and any adverse effects. It can be useful for physicians to have the patient rate each dose using the free Follow Up Vanderbilt form or Adult ADHD rating scales from Frida. This lets them track the effectiveness of the medication in a more objective way rather than relying on subjective ratings by parents and teachers. The reaction to a certain dose of stimulants can differ dramatically among individuals. To avoid overdosing, patients must be gradually titrated. Some individuals are not able to metabolize drugs and may exhibit signs and symptoms even at very small doses (eg atomoxetine, which is found in 7%-10% population) (Belle et al. 2002; Hechtman, 2005). A slow titration regimen is recommended for patients taking any drugs that block CYP2D6 such as SSRI's. This will prevent patients from developing tolerance to the drug (eg atomoxetine, bupropion and Clonidine). Monitoring long-term medication maintenance must be an ongoing process. It should include a review of symptoms to be monitored, including the ability to complete homework and school related activities, as well as an evaluation of the effects on appetite and sleep and asking teachers and parents for a periodic assessment of the impact on the child's behavior and functioning and self-ratings from adolescents and adults. [CG] The process of titration can be a source of frustration for some patients and their families. Having a clear understanding of the rationale for medication and the expectations that should be set for effectiveness and tolerance can lessen frustration and disappointment for the family. Similarly, educating the family members on ADHD can decrease feelings of shame or blame for their child's behavior issues. It is also important to let everyone in the family understand that these issues aren't due to a lack of discipline or bad parenting. They could be the result of medically-mediated issues in the brains of those with ADHD.