Flapping or Flopping?

Nathan has been taking Intuniv for about a year and a half.  It is actually a medication for ADHD, but helps Nathan with impulsiveness, flapping or stimming (this is when Nathan runs around in a circle, with his hands and arms flailing making a high pitched squeaking sound), and meltdowns.  In general, I don't like medicating kids.  But after consulting with our pediatrician we decided to start the medication during a particularly bad school year, when he was having daily outbursts.

Nathan was doing so well on his medication,
I thought he didn't need it anymore

About a year after he started taking it, Nathan was doing amazingly well.  So, of course, I thought he didn't need it anymore.  I reached out to the pediatrician and asked him about taking Nathan off the medicine.  Since Nathan was on the lowest possible dose- 1 mg/day- we didn't have to ween him off of it.  Within days, I realized I had made a huge mistake.  Nathan was having more severe outbursts than ever, hitting his aide in school, his brother, cursing, throwing things.  It was like he was possessed or something.

Minutes after a meltdown, Nathan would fall asleep,
even sitting up, on the couch

After a couple of weeks, I called the doctor again and he said to resume the medication.  It didn't seem to work anymore.  We kept him on the 1mg dose for about six weeks (we were hoping his body would get used to the 1mg dose), but we didn't see any improvement.  I called the doctor again who increased Nathan to 2mg.  We saw an improvement in flapping, but Nathan was so tired.  He had no energy at all, and his body was just floppy.  He napped in school, he napped at camp, he napped at theme parks!  At first the doctor said to give it time.  He was also still having pretty bad meltdowns, then immediately afterward, he would just fall asleep.

He even fell asleep while at Six Flags Great Adventure

A couple of weeks ago, I switched his medication from the morning to evenings.  I was hoping if we gave it to him at night he would have more energy during the day.  No such luck.  I started to get nervous that perhaps there was something else going on.  I called the doctor again who said to bring Nathan in for a series of blood work.  I asked him if we should try a lower dose first he said ok, we can try it.

This weekend, Nathan asked me and Drew to play Operation

He even sat patiently and waited during Drew's turn,
and congratulated Drew when he won!

Well, it's been a week since he started the lower dose, and Nathan is like a totally different kid!  He is spending less time on the computer, he actually asked me and Drew to play Operation with him this weekend.  We spent time laying in the hammock talking about our upcoming trip to Walt Disney World, and he bonded with his cousins while staying with my parents.  He has had a few outbursts, but much less frequent- although still really bad.  And he's flapping- a lot.

Nathan and I relaxed in the hammock in the
backyard and talked

I still don't like medicating children, but sometimes it's necessary.  Finding the right dosage can be hard though.  We need to keep the impulsiveness to a minimum, but I would much rather have him flapping than being so tired that he's floppy.  But medication should not be used in place of therapy either.  We have a therapist coming to the house to help Nathan control his outbursts and to help us know what to do when they happen.