Strange med reaction -- thoughts?

Wow! I agree with you -- I wouldn't give him the Adderall again until the evaluation either. Has the psychiatrist considered any other diagnosis besides ADHD? In addition to getting kicked out of nearly 5 preschools -- which is significant enough -- what are the symptoms that led the pdoc to prescribe Adderall? While one bad reaction to a stimulant is not enough for a diagnosis, I'm guessing you're looking at something other than ADHD, perhaps early onset bipolar disorder (BP). What you described as his reactions to Adderall are "pressured speaking" and obsessive-compulsive disorder. Both can be components of BP.

I encourage you to report this reaction to the pdoc and see what he says. If you're not satsified with his answer (for example, if he says just try Adderall again), I would definitely seek a second opinion from a good child psychiatrist with experience in BP. And I think it's great that you have an appointment with a neuropsych in November. I think you'll get some good answers then. In addition, take a look at the website www.bpkids.org. See if the shoe fits.

Here is a warning from the National Institute of Mental Health, which pertains to this issue:

A Cautionary Note

Effective treatment depends on appropriate diagnosis of bipolar disorder in children and adolescents. There is some evidence that using antidepressant medication to treat depression in a person who has bipolar disorder may induce manic symptoms if it is taken without a mood stabilizer. In addition, using stimulant medications to treat attention deficit hyperactivity disorder (ADHD) or ADHD-like symptoms in a child with bipolar disorder may worsen manic symptoms. While it can be hard to determine which young patients will become manic, there is a greater likelihood among children and adolescents who have a family history of bipolar disorder. If manic symptoms develop or markedly worsen during antidepressant or stimulant use, a physician should be consulted immediately, and diagnosis and treatment for bipolar disorder should be considered.

Hi, everyone: Today I gave my 3 year old Adderall XR, 5mg for the first time, as a "diagnostic dose". (Long story -- we have an appt with neuropsych mid-November, but fifth preschool in 10 months is kicking him out next week, and I am desperate not to lose my job....). Psychiatrist prescribing meds said 5 mg might not be enough, and I would probably have to raise the dose to 10 mg. I was opposed to meds to begin with, but agreed to try.

About two hours after starting the med, ds started talking, very quickly, hardly taking a breath. And did not stop, literally, for three hours until I forced him to lay down and take a nap (after which he gradually began to get better). In addition, he developed this strong "focus" (obsession?) with one toy -- just sat on the floor with his matchbox cars (and insisted that I join him) for those three hours, talking in stream of consciousness and lining up the cars, moving the line, fixing the line, making new lines of cars, but never playing with the cars, just lining them up -- well you get the point. It was a little scary.

Of course, psych's office is closed. But based on this I will not be giving the adderall anymore and will wait for a proper exam in November.

Do you know if it's possible for an under- or over-dose of stimulant medication to "mimic" the OCD symptoms that I was seeing? Or is it more likely that the meds were suppressing something or bringing out something that was already there? He has always been a little obsessive -- I have some mild traits -- but nothing that's significant enough to have been considered a disorder. Until today.

Overall, we are mostly looking at tantrums, defiance and aggressive behavior, as well as impulsivity and inability to self-regulate. He's almost 3 1/2, and almost all of the professionals describe him as "young for his age". The current preschool has only had him 2 weeks and is requiring that he be medicated if he wants to stay there. I can't afford private care on my salary. I am working to get him a place in the coluntary preschool program within the school district here....but it's a long process. I just needed a few more weeks!

The psychiatrist was just trying to get rid of me, I think. He did not want to try to diagnose a child as young as my ds, and wanted us to come back in a couple of years.

I think that he thought that if the adderall worked, he'd be able to placate me by calling the problem "ADHD". What he didn't understand was that I did not necessarily want a firm diagnosis, but just wanted help!

I'll look at the bpkids website, thanks. I have looked at the DSM criteria for BP before, and find it difficult to apply to ds, maybe because he's only 3.

Of course, I'm not a doctor, but I'm fairly certain an overdose of stimulant medication can induce strange behavior. Too low of a dose usually doesn't do anything. The 5 mg Adderall XR your son took is a low dose. However, I do know that that dose brought out severe facial tics in my 12-year-old ADHD son, who has a mild tic disorder, and we discontinued Adderall XR after one week. So anything is possible. In your shoes, I wouldn't try Adderall XR again, but if you're up for trying another stimulant (and I'm not saying you should try one), I would recommend Focalin. It is a refined version of Ritalin that is supposed to cause fewer side effects. It comes in both short-acting (4 hours) and long-acting (8 hours). If your son has another strange reaction to a stim, I say definitely wait until you get a firm diagnosis.

From your description of your son's symptoms, it sounds as if he could have BP. It is challenging to diagnose at such a young age because the symptoms don't neatly fit the DSM criteria for adult BP and childhood developmental stages come into play. I'm getting a good education on BP because my 10-year-old daughter has suspected BP. I say suspected because our pdoc says it is too soon to diagnose her. The difference between our pdoc and yours is that ours is treating my daughter with meds for BP because of her symptoms. Do you have any BP or other mood disorders in your family tree? It is a hereditary disorder.

Here's what happened with my daughter: She was diagnosed with depression last spring and put on the antidepressant Paxil. Soon after she started taking Paxil, she began to experience uncharacteristic late-afternoon episodes of aggressive and uninhibited behavior (only at home). Every time we mentioned the episodes to the doc, he upped the Paxil dose. The episodes grew stranger and more frequent. The doc kept upping the Paxil until we lost confidence in him and switched to a new pdoc, who immediately took my daughter off of Paxil. My daughter is now on Depakote, a mood stabilizer, and doing better, although not perfect by any means. We still have a ways to go. But at least we are working with a pdoc who "gets" what's going on and is helping us move in the right direction.

If you feel your pdoc is trying to get rid of you, I strongly urge you to find one who understands BP and will work to help you with your child's symptoms. Even though he may be too young to diagnose, he is not too young to be medicated for the symptoms he is experiencing. In my book, it is not OK to suffer for a few more years until this pdoc decides it is acceptable to diagnose and treat. In the meantime, you and your son are suffering.

Be careful of a BP dx too....my son had all the same traits as your child. He was misdx'd as BP. He took tons of meds to treat BP only to later find out he wasn't.

Why don't you come to the Alternative board. Maybe PM MegMcGuire...she has a 3 year old too....and they are med free. They go the alternative route.

Hi my son started adderal xr 10 mg last week. he didn't last long he was up all night long and couldn't sleep. but i was able to get ahold of his dr during his vacation and he just cut the dose to 5 mg and changed it to reg adderal. but my son did talk alot that day along with taking the xr. but my option is i'd rather see a talkative child than a maybe worse reaction from this med. i will try the reg form next week my sons got the flu atm so i didn't start it this weekend. good luck

My son, when he was that young, would line cars up like that for hours. We used to joke that he would be a valet parking guy when he grew up!




	Strange med reaction -- thoughts? Susan, Wow! I agree with you -- I wouldn't give him the Adderall again until the evaluation either. Has the psychiatrist considered any other diagnosis besides ADHD? In addition to getting kicked out of nearly 5 preschools -- which is significant enough -- what are the symptoms that led the pdoc to prescribe Adderall? While one bad reaction to a stimulant is not enough for a diagnosis, I'm guessing you're looking at something other than ADHD, perhaps early onset bipolar disorder (BP). What you described as his reactions to Adderall are "pressured speaking" and obsessive-compulsive disorder. Both can be components of BP. I encourage you to report this reaction to the pdoc and see what he says. If you're not satsified with his answer (for example, if he says just try Adderall again), I would definitely seek a second opinion from a good child psychiatrist with experience in BP. And I think it's great that you have an appointment with a neuropsych in November. I think you'll get some good answers then. In addition, take a look at the website www.bpkids.org. See if the shoe fits. Here is a warning from the National Institute of Mental Health, which pertains to this issue: A Cautionary Note Effective treatment depends on appropriate diagnosis of bipolar disorder in children and adolescents. There is some evidence that using antidepressant medication to treat depression in a person who has bipolar disorder may induce manic symptoms if it is taken without a mood stabilizer. In addition, using stimulant medications to treat attention deficit hyperactivity disorder (ADHD) or ADHD-like symptoms in a child with bipolar disorder may worsen manic symptoms. While it can be hard to determine which young patients will become manic, there is a greater likelihood among children and adolescents who have a family history of bipolar disorder. If manic symptoms develop or markedly worsen during antidepressant or stimulant use, a physician should be consulted immediately, and diagnosis and treatment for bipolar disorder should be considered. Please keep us posted on your progress. Hi, everyone: Today I gave my 3 year old Adderall XR, 5mg for the first time, as a "diagnostic dose". (Long story -- we have an appt with neuropsych mid-November, but fifth preschool in 10 months is kicking him out next week, and I am desperate not to lose my job....). Psychiatrist prescribing meds said 5 mg might not be enough, and I would probably have to raise the dose to 10 mg. I was opposed to meds to begin with, but agreed to try. About two hours after starting the med, ds started talking, very quickly, hardly taking a breath. And did not stop, literally, for three hours until I forced him to lay down and take a nap (after which he gradually began to get better). In addition, he developed this strong "focus" (obsession?) with one toy -- just sat on the floor with his matchbox cars (and insisted that I join him) for those three hours, talking in stream of consciousness and lining up the cars, moving the line, fixing the line, making new lines of cars, but never playing with the cars, just lining them up -- well you get the point. It was a little scary. Of course, psych's office is closed. But based on this I will not be giving the adderall anymore and will wait for a proper exam in November. Has anyone had any experiences like this? I am curious about your thoughts. Susan Do you know if it's possible for an under- or over-dose of stimulant medication to "mimic" the OCD symptoms that I was seeing? Or is it more likely that the meds were suppressing something or bringing out something that was already there? He has always been a little obsessive -- I have some mild traits -- but nothing that's significant enough to have been considered a disorder. Until today. Overall, we are mostly looking at tantrums, defiance and aggressive behavior, as well as impulsivity and inability to self-regulate. He's almost 3 1/2, and almost all of the professionals describe him as "young for his age". The current preschool has only had him 2 weeks and is requiring that he be medicated if he wants to stay there. I can't afford private care on my salary. I am working to get him a place in the coluntary preschool program within the school district here....but it's a long process. I just needed a few more weeks! The psychiatrist was just trying to get rid of me, I think. He did not want to try to diagnose a child as young as my ds, and wanted us to come back in a couple of years. I think that he thought that if the adderall worked, he'd be able to placate me by calling the problem "ADHD". What he didn't understand was that I did not necessarily want a firm diagnosis, but just wanted help! I'll look at the bpkids website, thanks. I have looked at the DSM criteria for BP before, and find it difficult to apply to ds, maybe because he's only 3. Thanks again for the help. matthewsmom38639.7799537037 Susan, Of course, I'm not a doctor, but I'm fairly certain an overdose of stimulant medication can induce strange behavior. Too low of a dose usually doesn't do anything. The 5 mg Adderall XR your son took is a low dose. However, I do know that that dose brought out severe facial tics in my 12-year-old ADHD son, who has a mild tic disorder, and we discontinued Adderall XR after one week. So anything is possible. In your shoes, I wouldn't try Adderall XR again, but if you're up for trying another stimulant (and I'm not saying you should try one), I would recommend Focalin. It is a refined version of Ritalin that is supposed to cause fewer side effects. It comes in both short-acting (4 hours) and long-acting (8 hours). If your son has another strange reaction to a stim, I say definitely wait until you get a firm diagnosis. From your description of your son's symptoms, it sounds as if he could have BP. It is challenging to diagnose at such a young age because the symptoms don't neatly fit the DSM criteria for adult BP and childhood developmental stages come into play. I'm getting a good education on BP because my 10-year-old daughter has suspected BP. I say suspected because our pdoc says it is too soon to diagnose her. The difference between our pdoc and yours is that ours is treating my daughter with meds for BP because of her symptoms. Do you have any BP or other mood disorders in your family tree? It is a hereditary disorder. Here's what happened with my daughter: She was diagnosed with depression last spring and put on the antidepressant Paxil. Soon after she started taking Paxil, she began to experience uncharacteristic late-afternoon episodes of aggressive and uninhibited behavior (only at home). Every time we mentioned the episodes to the doc, he upped the Paxil dose. The episodes grew stranger and more frequent. The doc kept upping the Paxil until we lost confidence in him and switched to a new pdoc, who immediately took my daughter off of Paxil. My daughter is now on Depakote, a mood stabilizer, and doing better, although not perfect by any means. We still have a ways to go. But at least we are working with a pdoc who "gets" what's going on and is helping us move in the right direction. If you feel your pdoc is trying to get rid of you, I strongly urge you to find one who understands BP and will work to help you with your child's symptoms. Even though he may be too young to diagnose, he is not too young to be medicated for the symptoms he is experiencing. In my book, it is not OK to suffer for a few more years until this pdoc decides it is acceptable to diagnose and treat. In the meantime, you and your son are suffering. Please feel free to post again with any questions. My thoughts are with you. I had the same reaction to Ritalin. I am bipolar. Adderrall is speed. It acts like speed in people without ADHD. Perhaps your daughter was misdiagnosed. It is hard to pinpoint what a problem is at three. I'd lay off the meds if it were my kid. She's too young for anyone to know if she has ADHD, bipolar, or something else. If you want a further evaluation, I'd see a NeuroPsych, however even NeuroPsychs can make mistakes on very young kids (and even older ones at times). I would not continue a type of med that makes my kid act, frankly, as though she were on speed, which is exactly what she is taking. Good luck. Be careful of a BP dx too....my son had all the same traits as your child. He was misdx'd as BP. He took tons of meds to treat BP only to later find out he wasn't. Why don't you come to the Alternative board. Maybe PM MegMcGuire...she has a 3 year old too....and they are med free. They go the alternative route. My son was misdiagnosed with ADHD/ODD and bipolar. I have bipolar and couldn't see it in my son, who is adopted, so it wasn't a genetic thing. He has high functioning autism. All three of t hese disorders mimic each other, however if a child is bipolar, the child needs meds. Period. It is way too early to be able to distinguish one disorder from the other, so if it were me, knowing what I do now, I'd hold off on the meds unless the child is dangerous to herself or others (a big red flag for bipolar). If mood problems or substance abuse are in the family, the dx. would point to bipolar, since it is very hereditary in families with this history. But, again, he is only three and it could be something that nobody can see clearly yet.Not to sound redundant, but lining up cars for hours is a very common trait of autism, high and low functioning. It's as though they are possessed by the need to do it. If the child is having serious social problems, I'd take it to the next level and see a NeuroPsych for a total eval. My son never lined up cars, but MANY autistic kids do repetitive behaviors and the car thing is common. Good luck. Hi my son started adderal xr 10 mg last week. he didn't last long he was up all night long and couldn't sleep. but i was able to get ahold of his dr during his vacation and he just cut the dose to 5 mg and changed it to reg adderal. but my son did talk alot that day along with taking the xr. but my option is i'd rather see a talkative child than a maybe worse reaction from this med. i will try the reg form next week my sons got the flu atm so i didn't start it this weekend. good luck Holly How funny about the lining the cars up behavior. My son, when he was that young, would line cars up like that for hours. We used to joke that he would be a valet parking guy when he grew up! He was not on meds either - how funny! Maybe he could finally concentrate on something and that is what he chose.	Enter Your Email below to claim your Free Book