Mydayis

Description

Advantages
Lasts longer than any other amphetamine-based ADHD medication.

Disadvantages
Significantly more appetite and sleep problems.

Excerpt from the book: ADHD Medications: Does It Work and Is It Save? Available on Amazon

Throughout this book, I have emphasized the importance of main- taining a steady blood level of the stimulant medications to prevent the need for multiple dosing throughout the day. Multiple dosing increases the likelihood that a child will miss a dose during the day. In addition, multiple doses result in a roller-coaster effect of the medications, moving in and out of the therapeutic index range, leading to emotional volatility. Many of the medications listed here have delivery mechanisms that delay and slow the release of amphetamine. Mydayis may have taken this to an extreme.

Mydayis is a capsule that contains coated beads, much like Ritalin LA, Metadate CD, and Adderall XR. Those three medications have two different types of beads: an immediate release that releases its medication right away and lasts for about four hours, and extended-release beads that then kick in and last another 4–5 hours. Mydayis takes this one step further by adding a third bead that has an additional, second coating so that it releases additional medication over the next eight hours, bringing the time of total effectiveness up to sixteen hours.

The active ingredient in Mydayis is exactly the same as Adderall XR (mixed amphetamine salts), and the ratio of dextro-amphetamine to levo-amphetamine is 75 percent to 25 percent, again, just like Adderall XR. Levo-amphetamine adds little benefit. In addition, the different salts add nothing to the therapeutic benefit of the medication. The only difference is that Adderall XR lasts about nine hours, whereas Mydayis is designed to last 15–16 hours. If Adderall XR is taken at 7 a.m., it will wear off around 4 p.m., whereas Mydayis, if taken at 7 a.m., should last until 10–11 p.m. That is a huge benefit for the older child who might not start homework until late in the evening.

However, a medication that lasts until 11 p.m. predictably will have more side effects than any other preparation of amphetamine-based medica- tion, and Mydayis does not disappoint. In studies done by the pharmaceuti- cal company, children who took Mydayis were 30 percent more likely to experience reduced appetite, and more than 30 percent had trouble falling asleep.8 These studies were done in children thirteen years of age and older. One would expect the rate to be even higher for younger children.

Mydayis is approved for children thirteen years of age and older. Doctors have the right to prescribe a medication “off label” (for a pur- pose or at a dose not approved by the FDA), so it can be prescribed for younger children. If Mydayis is used in younger children, remember that if it wears off at 11 p.m., then that younger child may not be able to fall asleep until midnight or even later. So, a medication lasting 15–16 hours might be a better option for a sixteen-year-old, but it is likely to cause significant problems with sleep in a ten-year-old.

Many children with ADHD have significant sleep difficulties, and this has been thoroughly discussed in Chapter 8 on side effects. Interestingly, some children might actually sleep better on Mydayis (as long as they can get to sleep), because it has been shown that some existing sleep difficulties will decrease or even disappear when stimu- lant medication is started.

Finally, when considering whether Mydayis is right for your child, consider whether it is covered by insurance and consider the cost. Mydayis might be right for your child as long as it does not last too long and cause significant sleep and appetite difficulties and as long as it is covered by insurance. Otherwise, consider another long-acting amphet- amine (such as Dexedrine Spansules, Adderall XR, or Vyvanse) or consider a long-acting methylphenidate medication (such as Concerta, Daytrana, or Focalin XR).

Mydayis comes as a capsule that can be opened and sprinkled on applesauce or pudding to make it easier to swallow.