Switch to another stimulant? | ADHD Information
Iganio - sounds like your son is very lucky to have a family like yours. It's encouraging to see how he has found success with his regimen! Thanks for the words of encouragement and helpful info.We all need words of encouragement from time to time, and a glimpse of hope. I love my son very much, but there are days when.....oh never mind you know the feeling! He has been a challenge that has given me a mission. I went back to school and got a second masters in Special Education because of him. I work with kids like him everyday, which makes me appreciate him all that much more. Family support is essential in success. I try to make my student's parents see that. The children need to know that the school and the family work together to benefit them, even if that means following through on consequences at home. Justin has more good days than bad by a long shot, but that wasn't always the case. We use a number system with his teacher this year that has worked out well. In his homework pad everyday he gets a number 1 through 4. Four means an exceptional day. Three is a day where he needs a few reminders to stay on task and not speak out but is overall good. We request a three from him daily. Four earns a prize. There are consequences linked to ones and twos. It is all on a chart for him so he doesn't even need to ask. He looks at his number for the day and he knows if he gets a reward or consequence and what it is. We have lived by charts for Justin. Mornings are crazy and he has a checklist that he follows and checks off every morning. This includes everything from shower, to getting dressed, to feeding his dog. The last box says coat and backpack by the door ready to go. This has relieved a lot of stress in the mornings in our house. If he does all of this and is ready to go before 7:20 he gets hot chocolate before we leave. He loves this treat! Simple, cheap, and it works.My son was on Concerta for almost four years and did wonderfully, however, he reached a point in third grade where he was experiencing his "brain moving too fast" as he described it. We had him reevaluated and he was tried on Ritalyn...which did nothing for him. We then went to Adderall. He is in sixth grade now and we have stuck with the Adderall with pretty good effects. He is on what I refer to as a "cocktail" blended just for him. We are constantly re-evaluating this and "tweeking" it as necessary. I guess my message here is don't give up and if stimulants aren't the answer, there are other options. I loved the post with the treatment chart. Very helpful!!It is just great to hear how successful the plan you have in place is for your son. Also, as I am sure you know, your education is a great benefit to him and those whose lives you touch!
Being the mom of a 21yo dd and (as mentioned) a 15yo ds, when it comes to parenting, I think of a saying from a boss I had in the past, which is "hindsight is 20/20." How true, in our case!
Regarding our son, when I think of things we could have handled differently, I sometimes feel discouraged; not to ignore the fact that over the years, a number of folks (parents, family, school, BH professionals) have worked with him.
You and others have encouraging words about not giving up and that really makes a difference to me. Sometimes, I'll tell my son that maybe we're down for the count, but we still have a chance to get back up and fight!
On a positive note, I have seen him make strides at home over the years - and I emphasize years (attention span-wise, more organized, helpful, willing to please, and a "somewhat" more mature attitude - go figure; he's a teenager). Unfortunately, according to faculty at school (his first year in high school) he is still struggling significantly. Luckily, we meet with teachers, guidance counselor, and school psychologist tomorrow to review results of an extensive evaluation done in recent months.
Wish me luck and best wishes to you and yours!
[QUOTE=vickie]Do you know that there are studies showing better outcomes in some disorders when the patient is an active participant? [/QUOTE]
That is a reassuring statement. Thanks!
Soberxinsanity: Regarding racing thoughts/do ADHD meds help...make it worse? Good question. My teenager is the only one in my immediate family who has ever been prescribed a stimulant and, at that, only been on Concerta for a relatively short period of time, so I have no knowledge as far as possibly other stims being more effective/not producing racing thoughts for him (he never mentioned racing thoughts prior to or after those that occured while on the Concerta); and yes, from my point of view from what I gather (although just an opinion) ADHD meds are supposed to help those dx with ADHD focus, which, I assume, might mean "calming down" racing thoughts? Anyone else?
Sorry for the longwinded answer - my family members roll their eyes at me and tell me I always go into too much detail (just a little "habit" of mine passed on from my dad...).
Good luck with the Concerta but let your prescribing doc know your concerns. In reading posts on this board, I get the idea that there are folks who have had success with Concerta and it works for them.
Thanks, Vickie. I am sure the information you passed along will be very helpful. The more I learn, the better equipped I am to help my son.
In addition, what are your thoughts on using antidepressants if stimulants are not tolerated? There are 5 antidepressants listed on the link in this website in which "effectiveness and safety of these compounds has also been studied fairly extensively."
Also, I understand that antidepressants are "...generally not as effective as stimulants or the newer nonstimulants treatments at improving attention span and concentration." (info. derived from usnews.com, content last updated 02-14-06).
Methylphenidate has 2 forms (isomers - or right and left facing compounds)mixed together. One form is more centrally active and one form is more peripherally active. Focalin is only the centrally active form. It can be used for someone who had some good effects from regular methylphenidate, but with also had side effects.
Other options are the amphetamine meds like adderall, which can be very effective but can cause anxiety. Or strattera which is a non-stim ADHD med.
Unfortunaltely, it may be that several meds or forms of the meds need to be tried before finding the best fit for the individual.
Here is a med chart (a bit old, but still usefull) to compare some of the meds available. This might help with your discussions with the doc on options.
http://www.myadhd.com/treatment_tools/medicationchart.html
Thanks for the information. It's much appreciated. I don't know anything about Focalin but will look into it.
Bits and pieces:
Anti-depressants can be very effective for some patients. When a brain is stressed and anxious, it does not function properly and ADHD symptoms can start or get worse. So aleviating anxiety can make a person better able to compensate for ADHD symptoms. This can be one of the chicken/egg questions. What came first the anxiety/depression or the ADHD symptoms? Kids do not express anxiety the same; it could come out as fear or anger or defiance.
Stim meds can even quit working under stress. Strattera was originally developed as an antidepressant. It was not so good in that area, but turned out to be pretty good for many people with ADHD.
Oh, and about your sig...We have a joke at work that you never know about that light at the end of the tunnel...sometimes its and oncoming train.
LOL 
A new way to think about that light...
Also, I do realize the doc has to determine what med would be best but I like to check into these things - I feel better having some knowledge about possibilities for treatment.
Thanks, again.
I totally agree with educating yourself for the discussions with the doctor. I am a firm believer in being an active participant in my healthcare and that of my kids. Do you know that there are studies showing better outcomes in some disorders when the patient is an active participant?I read information on this website regarding ADHD medications and have investigated elsewhere, specifically, about use of stimulants to treat children with ADHD and have come to the conclusion that if a patient has a reaction to a stimulant, they may be given a trial of another stimulant, which may in turn work.
In my case, my child had been given Concerta, had several instances during the course of approximately three weeks of racing thoughts and memory loss, and subsequently, his prescribing pediatrician took him off the Concerta. No other medication has been tried for my child since then.
He is presently in a "transition year" at school, again experiencing great difficulty staying on task; again, extensive school evaluation results recommend seeing a physician regarding medication, along with academic interventions.
I presently have him scheduled for out-of-school evaluation at a behavioral health facility to possibly eventually see a psychiatrist for discussion of medication. My question - if it gets to the point where they determine he may benefit from medication, wouldn't it be likely that he would have the same reaction to methlyphenidate (i.e., Ritalin, Methylin, Metadate CR, Metadate ER, Methylin ER, Concerta, Ritalin LA, Ritalin SR) or stimulants in another class?
Any advice will be greatly appreciated!
Some children have reactions to one med, and do fine on one of the others....focalin has been said to be better tolerated...that may be one to try.
The best thing is to have a trial of meds....you at least know what to look for now. My son did well on concerta for about 8 months, then it became less effective, and he switched to ritalin LA, which he proclaims is nothing like the concerta ("way better") even though they are both ritalin in different time release forms.