Help-do we start medicine or not?? | ADHD Information

My son ryan is in grade three at a private school .His birthday is August 21 so he is young for his class. Since Kindergarten, we have been forthright with the teachers to hold him back if they see the need. It has never happened. He is an A/B student who makes B's and sometimes other bad grades because of careless mistakes. His teacher this year has really picked him apart and complaines of his inability to focus and complete work that he needs to be doing for her. He has also had a petit maul seizure diagnosis since age three. At age six he had been seizure free for two years and we came off of meds. The seizures came back with less frequency so we went back on meds. and have been fully controlled for another two years. We are presently coming off of Lamictal and pray that he has outgrown them. His neurologist wants him to have a full evaluation, but just recently suggested he take Straterra. I don't know what to do. It is the last nine weeks of school, and he is not failing, however, he has become very aware of his inability to get things done. ANY ADVICE??This is what I am beginning to lean toward also. I do not know why Ryan's neurologist suggested Straterra to be honest. I assumed it is because his main characteristic is  his inability to focus. I also suspect that we will not be able to get an appointment for his neuropsych. workup until the summer. I would really like to see if maybe being able to come off of the Lamictal helps with some of his problem. If not then I would like for him to go into the neuropsych. evaluation med. free and go from there. School will not start again until August 18. By then, he will have been off of his seizure medicine for two months hopefully, with no reoccurence, and if his evaluation warrants medication for add, we will have been able to start that . I am fortunate that I work in a public school system as a speech therapist, and I am able to be with him all summer and watch him .

Mom2ryan,

My first thought was that it would be a perfect time during the last few weeks to try a trial of meds if the doctor were suggesting a short acting stimulant, however, since he is suggesting Straterra, it does have a "build up" effect .  Did he suggest Strattera because of his seizure history and not want to try stimulants?

Okiemom

Because you are looking at straterra and the potential for sezure. I would try the med once school has ended, assuming he is at home during the summer where you can observe him. This way you can work the med up slowly and watch for side effects. You can pick reading or other activity to judge effectivity. Further adjustment will probably be needed once school restarts to make sure the challenges of school are covered.

If it were a short acting med and no potential side effects, I would go for it now...

Just my 2 cents.

Hi.  This is always a tough choice, but I'd definately get a full evaluation.  Both the teacher and neurologist is concerned.  That would be enough for me to take action.

It only gets tougher on the child as the grades advance.  There is a huge difference between the work and pace of a 4th grade class versus a 3rd.  It is a major transitional grade.....one that has a reputation for being the turning point from where they "learn to read" to "read to learn"...meaning there are more worksheets, self directed stuff....etc.  Things that ADHD kids struggle more with.

You state he is not failing, but has become very aware of his inability to get things done.  This is a BIG red flag....... and an almost surefire setup for anxiety and depression if the child keeps feeling this way.  Don't wait until he is failing.  The whole point is to be proactive and keep him from getting to the failing point!

Many of us have been in your shoes.  I'm just giving you my opinion from my perspective.  My son is now 14, but  I remember those years like they were yesterday.        

Okiemom

okiemom39163.3542476852Thanks for the reply. I know that the evaluation is a must. But starting the medication now that it is the last nine weeks of school??? I don't know if we will see any results from the medication since school will be ending in 6 weeks. I am going to meet with his pediatrician and let him in on what is happening since I will be getting the medication prescription from him once we start it. Hopefully , I will KNOW IN MY HEART without any doubt of what to do.

Hi momtoryan! I skimmed the posts so bear with me, I work overnight and have been up all day

What you are talking about in the posts rings a bell here at my home. I really depended on my son's teacher, who had diagnosed my son herself and had been a teacher for 40+ yrs,even though a neuro psych diagnosed him professionally before he was 5. She had seen it all!!

I needed her feedback at the end of each day. It started with her telling me that my son was so impulsive that he didn't even realize he did it until it was over. And she knew he didn't mean to do it! She always said he was such a sweet, kindhearted, good boy, BUT could not control this. That broke my heart

We immediately started the medication roller coaster and have done REALLY well!! This teacher told me how my son's day really was and when the meds needed an increase, etc. She pretty much held my hand!

She is now retired, but loved her job so much that she is his substitute teacher, as well as a lot of parents in town teacher!

Because of all her years of teaching experience, she really was a great ally for my son on the medication. You may want to use your son's teachers for this as well! They can tell you how each day is going while you are in the trial stages.

We started with her help at the end of the school year then went to a psychopharmacologist during the summer and continued on my own with the psychopharm. on my own and my son eventually leveled off. He has been at the current dose for 2+ years!

I hope this is of some reassurance to you and especially your son. My son suffered because I was afraid of meds, but he needed them, not ME! How ironic if you think about it.

Best regards,

Beth

I typically preferred to start new meds during the school year because then the teacher could note the change!  The biggest change always took place for him in school. 

I use a number system with my son.  He comes home with a number written in his agenda (1-4).  One is a horrible day probably including putting his hands on someone else.  Two is a difficult time following directions, very non-redirectable.  Three is an average day...may have needed a few reminders but was redirectable.  Four is a great day.  Minimal or no redirection needed!!  We have a reward/consequence plan in place for each number. 

But, when meds change we monitor these numbers for positive or negative changes.  These numbers are written everyday on his own pocket calendar we keep.  This calendar also notes when a medication change took place to see if anything corresponds with the behavior change...we have also noted patterns on here like he typically has a harder time on Monday after the weekend, and the week after a long vacation is crazy.  So, I don't know if this helps at all, but I hope you can find some assistance in it.

Strattera is a non stimulant. I think seizures are associated with stimulants. I would not bother with meds this school year, it's almost over. You could explore the med issue this summer. It sounds like you need an experienced medical management specialist. I have heard, but not experienced, that the curriculum becomes much more challenging in fourth or fifth grade. If he was younger, i'd say just wait and see what the next teacher is like.

Hi there. Are you sure his inability to focus is ADHD or is it a side-effect of his anti-seizure meds?   I suspect that stimulants would not be good for a patient with seizures. I think a full eval is warranted at this point. Good luck and let us know how it goes.

As to your question, I wouldn't add another med without a full eval first.

Thanks for all of the replies. I am waiting to hear when the eval will be. I really like the idea of a number system and look forward to using it with Ryan. It is comforting to read all of the different perspectives and has helped in our decison making process.