Focalin XR is supposed to be a once a day dose. However, the studies were done in adults. Children metabolize methylphenidate much faster than adults. Focalin is the right hand only version of methylphenidate or Ritalin which is supposedly the only half that works.

If Nate's liver enzymes are elevated, it means he has more of them. This means he will metabolize the Focalin even faster than another child. So a dose that is supposed to last 10-12 hours in an adult lasts only about 6 or less hours in him. This is why an alcoholic needs so much more alcohol to "appear" drunk than a light or non-drinker. That is until they do damage to their liver and then it is the opposite.

If you can afford it and have access to a good health food store in your area, try getting him some milk thistle. It will help with the liver trouble. His blood tests don't mean his liver is damaged, just overworked. Eventually, if nothing were done, it would become damaged but it isn't now. With the doc's approach to meds, he will get better.

Incidentally, Alex is also going to be switched to Abilify because of his elevated liver enzymes and high cholesterol caused by Invega. Apparently, Abilify doesn't affect their metabolism as badly. The bad part is, Abilify isn't approved here yet but it should be soon.

Kristin
Alex 18-GAD, mood disorder, ADHD - Abilify Maintena 400mg
Matthew 16-ADD 40mg Vyvanse