How long do you wait to see if MPH is working before increasing the dose ?

[Sikrouf]

Hello
as per the tittle, I'm so lost as when to increase the dose and consider the dose non effective
I've read a week, I've read 6 weeks, i'm currently waiting a week but I'm worried of doing it plain wrong

on a side note I'm in france so I don't avec access to AMP products

thank you for your help

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[littlefred]

ADHD​

[immediate-release form]Dose: 5-15 mg PO bid-tid; Start: 5-10 mg PO bid, may incr. by 5-10 mg/day q7 days; Max: 60 mg/day; Info: duration 3-5h; give 30-45min before meals, last dose before 6 pm

[qd-bid extended-release tab]Dose: 10-20 mg ER PO qd-bid; Start: 10-20 mg ER PO qam, may incr. by 10 mg/day q7 days; Max: 60 mg/day; Info: duration 2-8h; give 30-45min before meals; do not cut/crush/chew tab

[qd extended-release tab]Dose: 18-72 mg ER PO qam; Start: 18-36 mg ER PO qd, may incr. by 18 mg/day q7 days; Max: 72 mg/day; Info: not for pts >65 yo, duration 12h; do not cut/crush/chew tab

There's your answer (I bolded it).

Curious that France doesn't have AMP, wish the U.S. also adopted that.

 

[hamstergang]

Doesn't it work as effectively on day 1 as day 100? I get waiting a week (and do so) in order to better understand benefits and any adverse effects, but waiting longer just seems to be a waste of time.

 

[calvnandhobbs68]

Yeah a week is usually long enough although in real life I don’t see people back sooner than 4 weeks typically (and I don’t like to get people in the habit of self titrating their own stimulant). If you look at what they do in trials though, they usually titrate every 1-2 weeks. you probably get more accurate behavioral reporting especially for kids if you give it 4 weeks to get teachers and parents followup reports (vanderbilts, Conners, etc) so one bad day doesn’t throw the whole rating off.

Better than what i see from some PCPs though which is “here’s 20mg of Ritalin LA, come back in a few months” and a kids spent an entire semester suboptimally dosed.

 

[Merovinge]

Doesn't it work as effectively on day 1 as day 100? I get waiting a week (and do so) in order to better understand benefits and any adverse effects, but waiting longer just seems to be a waste of time.

Longer waits let teachers/parents/patient average experience across more days. There's a lot that can change in a week whereas averaging over 2-4 weeks helps to smooth out some of the noise. I wouldn't say there's anything wrong with titrating after a week (say at a PHP or IP), but I do think it would be weird to schedule f/u after a week in OP practice.