mass confusion | ADHD Information

Kaleb did very well on the Depakote in the beginning.  Even though we adjusted and stabilized his blood level within the therapeutic levels, he plateaued and then had small setbacks.  He was taking the Depakote in addition to the Adderall.

I have no hangups about a mental health dx.  I don't care if he is bi-polar, autistic... it doesn't matter.  I just want to get him help.

I am at work now and will sit with baited breath to hear my phone ring and the school trip out b/c I did not give him Adderall this morning.

The psychiatrist point blank told me it would help to stabilize his mood.  And the nurses drug reference didn't list it as a benefit which raised some questions.  I know the psychologist also thinks anxiety/depression is part of the problem. So ok it deals with that.  The trazodone is only supposed to one half to one whole pill - AS NEEDED.  So how would that treat depression with any consistency?

I know kids that take Ambilify and Concerta for ADHD. 

I'll admit that I don't know tons about all of the meds.  I do try to go out and learn what I can and admittedly a little knowledge can be the 800 pound gorilla in the situation.

Thanks for all of the feedback.

I hear you SO LOUD AND CLEAR. With my son, we didn't care either. We just wanted help. To tell you how rocky the road can be, my son had two major dx. that were wrong before we got the right one--ADHD/ODD and bipolar (he has neither). Well, he has ADHD symptoms, but that's because he's on the autism spectrum and all ASD kids have inattentive symptoms, sometimes very severe. In all, my son was on (drumroll) Ritalin, Concerta, Adderrall (for us, this was a nightmare), Prozac (bigger nightmare), Zyprexa and Risperdal (had dangerous side effects to both and they made him depressed and very weepy/sleepy), Depakote, Trileptal, Lithium and Seroquel. He didn't need ANY meds, so I'm always in favor of making sure you get the right dx. before giving serious psychiatric meds to a child. If they're the wrong ones, the child can get worse, and your child IS getting worse. Sometimes meds trigger disorders that are latent--stims and antidepressants can trigger latent bipolar disorder, for example. Stims and antidepressants can also cause anger problems, rages and even violence in kids who had a predisposition to mood problems. And autistic spectrum kids, like my son, who are drugged up and don't need to be miss out on years of interventions. My son got autistic interventions even without the diagnosis--we were lucky--because he had other diagnoses such as SID, cogntive disorder NOS, language disorder NOS--so he's doing well now. He never did well on meds. You need to know the true devil to face to help your child and it's not easy to find out. If you don't like the Psychiatrist, heck, fire him. He works for you. We went through three. You don't need to stick with a doctor you don't trust, at least if you live in the US. If your son isn't getting better, the professionials aren't helping him and I'd move on. That's the only way my son got help and it took until he was 11 years old. I'm just grateful we found out before the teen years as undiagnosed autism can turn into a big disaster. I feel for you. Take care and keep pushing.So what are the new meds?

Ya know oldermom, my biggest frustration is that all of the diagnoses MATCH what the school said in October!!1  Quite a spin on your story ain't it?

I just feel as though we have wasted the last 7 months waiting on the initial appts and then waiting to find which drugs will work.

Kaleb started the Neurontin Thursday night, he was ok at school Friday and I was very anxious to spend the day with him and see first hand how he acted with just the neurontin on board.

He is definitely way more hyper... just trying to decide if it's "too hyper"

he is also way more happy.  He got hit in the face while playing with the neighbor.  She hit him in the face with a light saber and it cut him, he also had some one step on his big toe earlier and that bled... these are things that would have likely made him lash out with anger and hit back before and today he took it in stride.

Then again maybe I am just overly analytical and trying too hard to see affects of the meds???

I am considering firing the psychiatrist, but since we have a real shortage of child specialists around here I want to be certain before I burn the bridge.  my son already goes to a Children's hospital for rheumatology and when we are down there on Monday I may take a walk into the psychiatry suite and ask some questions!!

 my 7 yr old son has had a diagnosis of ADHD since age 3.  Was tested by school pysch last year and he ? depression or something else.  PCP reflected back and ? mood disorder like cyclothymia.  He agreed to treat with Depakote until we could get into  see psychiatrist. 

Fast forward to now...

Son is averaging 4 hours of sleep a night.  He does get longer sleep on weekends when i can allow him to sleep in. They psychiatrist tells me to up his Adderall.  He was supposed to up to x3 Adderall XR 20 mgs a day.  It didn't work and I D/C on my own.  We went to neuro psych screening and guess what the results are:   all the same things the school psych and PCP thought last October!!!!

My PCP is wonderful, but he felt this was beyond his normal scope and thought the psychiatrist would be best.  When I called him about the Adderall dosing he didn't want to interfere and suggested other things to help him get to sleep.

Now the psychiatrist is calling in new meds.  Now I am not a nurse, but I work with assessment nurses all day from various specialties.  Anyway, we went right to the drug reference they use and insanity pursues!!!

Son already has moodiness and irritability, arthritis, anemia, emotional lability... and several of the other things listed as side effects.

Now I know things with ADHD kids often work backwards, so my question to you people is does this drug effect ADHD kids the opposite way?  The psychiatrist also said to stop taking the ADHD meds for now - even though that is part of the dx because he wants to see what the Neurotin will do.  The Dr is also calling in sleep meds EVEN THOUGH the warnings for Neurotin says it will amplify affects of sleep aids.

Do you see my confusion?

I am trying to get an appt with the PCP tomorrow to go over all of this.  He is the doc I trust most, but his day is full.  They will call if there is cancellation.  We all work for the same hospital so I know they will take care of me when and if they can.  That does give me some solace.

Does anyone have any advice for me? Please!  i am begging here!  Thanks in advance

First of all, Adderrall itself can cause severe moodswings and doesn't agree with many kids. I'm surprised the PCP doesn't want to take him off of it to see how he does. Was he like this before the Adderrall? Onto Depakote:  Depakote is an anti-seizure med that is used to stablize moods in bipolar disorder, which is often first misdiagnosed as ADHD. In that case, the ADHD stims are bound to make the child even worse. If you read side effects, you'll be afraid to give your child even an aspirin. Everything has side effects. I would see the Psychiatrist. Even if your PCP is very nice, he is not an expert in psychiatric or neurological childhood disorders. I'm really puzzled that he doesn't suspect the Adderrall as the culprit, unless he has always been this way. If so, he never should have been put on a stim in the first place because they reek havoc with moodswings...Do mood disorders or substancse abuse run in your family tree on either side? Does your child rage a lot? 

 

OlderMom38855.5860532407

I agree with everything OlderMom says.

What meds is your son on now (per the psychiatrist)?

ok, we put my son on Depakote at Christmas.  Three days of total he*!!.  he would not sleep.  and when he did sleep, he jerked so bad it would wake him up.

Depakote doesn't normally work that way. It takes eight weeks to kick in. I still wouldnt give that child any meds, including Adderrall, until he is assessed. If he's acting out due to the Adderrall, I can't see how adding meds will help. Depakote can make kids very spacey. Adderrall can make them hyper and mean. I'd want a drugs free assessment by a Psychiatrist or NeuroPsych.

Sorry  Neurontin (generic brand=gabapentin) 100 mg

and Desyrel (generic brand = Trazodone) 50 mgs

 

I mentioned the neurontin before and just found out the name of the other one when i picked up the meds.

Neurontin is an anticonvulsant that is not particularly helpful for mood stabilization (i.e., it is not a first-line mood stabilizer used to treat bipolar disorder), but it can be helpful for anxiety and pain relief.  Trazadone is an antidepressant frequently used for sleep.

 

Adderall was a God send when he was put on it.  It actually stopped the raging almost completely.  We tried Concerta for a while and he actually HID the pills.  Our PCP told me that Kaleb has never been "normal."  All three sibs have some form of ADD and one is ODD so it fell right in line. 

This year things really started getting bad.  The rages have been around forever, they are just getting a little more frequent.  There may be 3 a week now.

The problem with the psychiatrist is that he kept jacking up the Adderall and nothing else.  It was the PCP who had first thought cyclothymic.  The psychiatrist is the one who said no.  Now the pschologist says it and he's all in agreement.

I know the PCP isn't into all the psych stuff, but there are so many other DXs like reactive arthritis, asthma, anemia, BJHS...  I just want his perspective of Kaleb's overall picture and not just the psych stuff, too.

I got the new scripts filled and will start them tonight.  I think in some ways I am just as mental as my kid.  A lot of run around in the last week from the psych's staff and three months of nothing but jacking the Adderall haven't allowed me to build any trust with the psychiatrist.

One of the things I like best about the PCP is that he truly encompasses what the role of a PCP is supposed to be.  He is great with the "usual stuff" and has enough knowledge and is humble enough to know when things are out of his comfort zone.  With all of Kaleb's unusual issues and DXs, our PCP has been headed in the right direction EVERY time.

Sorry I am done defending him now. 

There is no known hx of bi-polar tho his dad never met his dad kinda thing so that is a big ???  But all of the half sibs are through his dad so I always tell him that is where they get it from.

As far as reading the drug manual, I know everything has some side effects, but the really scary one for me is the chance of arthralgia b/c my kid HAS arthritis.  He takes NSAIDs for that and Zantac to counter the effect of the NSAID on his stomach.... it's just a big circle.

Sorry if I sound defensive.  It's just the frustration talking.  I read way more than I post so I see how supportive this board can be - which is why I flew in here earlier!  I appreciate the feedback.  My friend has 6 foster kids and 5 are on concerta and various meds.  She is ALWAYS telling me what to do.  I don't personally agree with some of her choices so I like to come here for the varied viewpoints!

Just want to agree with what everyone else has said.

Curious, how did your son do on the Depakote? Did you have blood draws done? How long was he on this medication?

Depakote is a mood stabilizer used to treat Bipolar disorder. If there are questions regarding your child's dx, and Bipolar is one, any stimulant you may use to treat the ADHD could be disasterous to the Bipolar (or whatever mood disorder).

Dylan has had 17 medication trials over 6 years. He was originally dx'ed ADHD, and NONE of the meds worked. He's tried all the stimulants. He's tried all the non-stimulant stimulants. He's tried all the atypical antipsychotics. They all made the Bipolar worse.

If your child has a mix of a mood disorder and ADHD,  your best bet is to take care of the mood disorder first with a mood stabilizer. Then, once you've reached the theraputic level or the amount of time has kicked in that it's working, you can add something else. For us, we chose NOT to add another stimulant, knowing how disasterous it could be, and went the atypical antipsychotic route (Abilify).

Hope you find some answers soon. I don't know anything about the current medications, good thing smallmom is around

Janna