Anon Timing of ADHD meds

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For those of you with gymnasts on ADHD meds, do you adjust the timing of when you give them based on her meet schedule? My DD takes an extended release formula, but the manufacturer’s info shows the INR is highest around 4-5 hours after taking it and tapers off quickly after about 8 hours. We don’t use instant release booster doses.

For 8am meets I usually try to give it to her by 6am and for a recent 2pm meet, I gave it to her around 11:30am. However, our next meet is a 5pm session so I’m just trying to figure out ideal timing.

I’m not asking for medical advice as her doctor has just said to use my best judgment, but I’m curious to hear what others have done. Thanks.
 
OP here - I didn’t mean INR above, just level of the drug in the blood stream. I got the terminology confused with my husband’s blood thinners. ‍♀️
 
Yes. We have done that for years. Especially as she has gone up the levels and has late night competition times--the long acting is just no longer in her system by 5 or 6 pm at night. Our doctor has been ok with it.
 
This sounds like it verges on the use of ADHD meds as a PED. Be fair. Give them to your kid whenever you ordinarily world.
Not meaning to dispense medical advice. I am a prescriber myself fwiw. ADHD medication is not a PED, and it is ok to adjust the timing of the dosage depending on the medication and the prescriber's approval. ADHD is a medical diagnosis. I agree with what you say above if the individual does not have a diagnosis of ADHD and is using the medication solely for the purposes of getting through an exam or a gym meet.
 
Not meaning to dispense medical advice. I am a prescriber myself fwiw. ADHD medication is not a PED, and it is ok to adjust the timing of the dosage depending on the medication and the prescriber's approval. ADHD is a medical diagnosis. I agree with what you say above if the individual does not have a diagnosis of ADHD and is using the medication solely for the purposes of getting through an exam or a gym meet.
You might not think of ADHD meds as a PED but there’s a reason why Simone Biles needed to get a therapeutic use exception so that she wasn’t banned from competition for using it.

I’m not saying kids shouldn’t take it. If they need it, they should take it. I take it. What I AM saying is that parents tweaking their kid’s dosages (either time or amount) for maximum performance is pretty suspect and I’m almost 100% that the drug testing agencies wouldn’t allow a TUE that says “take adderall as needed daily for concentration, timed to whenever best works out for your rotation schedule at states.”

The reality is that a lot of kids would perform better with 5mg of IR adderall 30 minutes before a comp.
 
My child is not functional without his medication. His meds only work for about 8 hours and after that he’s DONE doing anything that takes a modicum of attention or impulse control. My ADHD kid is a competitive swimmer and his medications slow him down a bit but they also allow him to not miss his races and not to swim the wrong strokes! It’s not performance enhancement, it’s disability reduction! Adjusting the timing is totally normal and appropriate. Generally trial and error in consultation with your child’s prescriber is the best you can do.
 
You might not think of ADHD meds as a PED but there’s a reason why Simone Biles needed to get a therapeutic use exception so that she wasn’t banned from competition for using it.
She had to provide documentation that she has a diagnosis of ADHD, which she provided. This is because stimulant medication is a controlled substance and is intended for use in individuals with ADHD. If she has the diagnosis, it is not considered a PED.
I’m not saying kids shouldn’t take it. If they need it, they should take it. I take it. What I AM saying is that parents tweaking their kid’s dosages (either time or amount) for maximum performance is pretty suspect and I’m almost 100% that the drug testing agencies wouldn’t allow a TUE that says “take adderall as needed daily for concentration, timed to whenever best works out for your rotation schedule at states.”
I give my daughter her medication on school days at 6:30am and on weekends when she wakes up which might be several hours later. No doctor I have ever encountered has ever suggested that this was a problem. It is perfectly fine to give the medication at 9:30am versus 6:30am. I prescribe and I have plenty of colleagues who prescribe, and not one person I know of who prescribes would have an issue with this. If you take the medication in the late afternoon, it could potentially affect sleep. I have never heard of any drug testing agency sports or otherwise state if you have a diagnosis of ADHD, you must take your medication at the exact same time every day or it is considered PED. By the logic you are using here, we really shouldn't give an athlete a naproxen for a strained muscle within a certain time frame before they compete because it will "enhance" performance. This just doesn't make sense.
The reality is that a lot of kids would perform better with 5mg of IR adderall 30 minutes before a comp.
You are conflating athletes who do NOT have a diagnosis of ADHD taking stimulant medication with athletes who HAVE a medical diagnosis of ADHD and no, children who do not have a diagnosis of ADHD do not need the medication and really shouldn't be taking it. And yes, pretty much everyone without ADHD will experience improved focus and energy on a stimulant medication. I don't see anyone here saying that children who do NOT have ADHD should take a stimulant and tweak the dosage for the sake of a gym meet. The same applies to students who buy the medication from classmates to improve studying and exam performance.
 
Just linking this one in here for others that come across this...

 
Only getting 8 hours of coverage a day from the meds must be difficult. On most days it would only cover school. Meaning she is left to struggle with other things like homework, gymnastics, being able to enjoy downtime, socialising etc. It might be worth seeing if there are options to extend with her doctor.

Obviously you have the option of taking the meds later but you must weigh up the benefits verses the problems. I can see two issues.

1. sleep - she may struggle to sleep if there is still much in her system at bedtime. This would need to be weighed up with what has to be done the next day.
2. a difficult morning before the meet - if she doesn’t take meds until lunchtime she may have a very difficult morning before that, which may affect her ability to do well in the meet as well, if she is wound up or stressed from that.
 
I know I'm late to the party, but I wanted to contribute. My ADHD child takes their medication shortly after they awaken most days that is around 7:30 a.m. and the effect is seen around one hour later. This means that by the time evening practices roll around her medication is largely worn off, but exercise increases dopamine so she doesn't struggle too hard with focus during practice. However, meets are another story, as you don't have the same effect with warm ups with a meet. Usually we let our daughter sleep in if there is an evening meet and give her the medication no later than 10 a.m. to ensure she can sleep that night.

Another thing I will say which came from her psychiatrist, is that he indicated that most of his (local to us anyway) colleagues think that stimulants should not be restricted medication when prescribed by a psychiatrist as they are only levelling the playing field. The correct dosage, as another poster said, merely levels the playing field (or almost does) but does not give anywhere near an advantage. You need only to look at the effects on the ADHD brain, versus a neurotypical brain. In an ADHD person the medication slows down their focus and makes them more steady and less fidgety, in a neurotypical it tends to make them hyper - the opposite effect.
 
I'm late seeing this post, but want to add my 2 cents as someone who prescribes these medications (with the caveat that I am not dispensing medical advice, just another perspective). Extended release medications have their own sophisticated process of working and changing the timing alone is not always the answer. It's not always easy to predict peak timing of long acting stimulants and changing the timing too much can have down sides before and after the peak. If this is a common problem you encounter in the evenings, you may want to talk to your child's medical provider about an afternoon short acting adjunct medication. Please note, this is not to be construed with performance enhancing measures. This is only to say that if a long acting is wearing off prior to evening needs (ball games, home work etc), and increasing will cause negative side effects (and not increasing would be dangerous), then short acting adjuncts are often utilized.
 
We sometimes give a break on weekends and holidays but my daughter's paed said that if she has gymnastics or anything else that needs a lot of focus or stability, to give her a dose and tweak it as we see fit. She only gets 4 hours of coverage (can you imagine only having FOUR hours in a whole day where you feel in control of your body physically and emotionally, can concentrate, block out other stimulants in your surroundings etc?) so whether this be for sport or needing to get through an over-stimulating birthday party it is absolutely fine, and recommended to us, to tweak the timing of stimulants, it is the non-stimulant we can't.
Her coaches see a noticeable difference on Saturday if we have given it compared to after school as meds have well and truly worn off by then. Thankfully they are incredible and patient and understand her circumstances so adapt to her needs. It's better for everyone (coaches and team not just her) if she's on meds but unfortunately it's not possible. She only had two comps last year after her diagnosis and thankfully had one early enough in the day for meds to still be working and she had a noticeable improvement on beam and floor (vault was the opposite haha). Not because it's a PED (meds are a life changing necessity for most adhders) but because she was able to focus and remember the nitty gritty of her routines, bringing her on a level playing field with the other kids.
Long story short, do it as you see fit and what's best for your child as long as it's not too late it impacts sleep. No judgment.
 

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