While on the stimulants (Daytrana & Metadate CD) he was getting in trouble for things like talking too much, not keeping his hands to himself, throwing food in the lunch room. He couldn't control himself in the hallways at school at all. The biggest problem was the anger. He said he felt angry all the time (except when doing the things above). His teachers felt like he was way more hyper but yet could focus also. (Bizarre in my opinion). At home all I saw was the incredible amount of anger. He managed to contain it at school although he was worried that he would end up getting himself in trouble but at home he was so evil that I was expecting his head turn all the way around at anytime!! Of course that would be around the time that the medication should be wearing off. The very small amount of benefit did not outweigh the side effects. Prior to trying the stimulants I was only hearing from the teachers that he was extremely distractable, fidgety in class, inattentive and at times seemed like he was in another world.
The Straterra worked AMAZINGINLY well until he started getting sick. He also caught a really bad virus during this time and it was hard to determine whether he was struggling with the virus or the medicine. In a week and half I took him to the doctor 3 times only to be told that it was a bad viral infection but after he had lost 8 pounds we had to stop the medicine. He was already worked up to the 40 mg. at that time.
It sounds like maybe he was being upped in medicine too quickly. What is the danger of a person being on too low of a dose of Straterra? This time around the doctor talked like he would be leaving him on the 25mg indefinitely.
The side effects from a too high or too low dose can be severe mood swings,that is the only one I have personally experienced and it seems to be most common.
I realize now that the EEG was only to rule out the possibility of seizures.
Basically what I have is this:
He meets DSM criteria at school and at home.
He was tested for a Math Learning Disability this past school year that only revealed problems with short term memory and rote manual dexterity. But not enough to qualify as a Learning Disability.
And of course the TOVA testing and opinions from pediatrician and psychiatrist.
I don't have a problem accepting the diagnosis ( I think I have been in denial long enough). I guess the problem that I have is when I talk to other parents of middle school age kids and hear the very same complaints and know that my son is actually getting better grades than many. It makes me feel like maybe I am jumping towards the medication route too quickly. When my son was younger I did have suspicions that he was a little too hyper but at that time I kept telling myself that he couldn't have ADHD or he would'nt be doing so well in school. Now he can do well but bless his heart he has to work sooooo hard. It might take him an hour and half to answer 6 questions if he has to refer back to the book to find the answer. He get lost in the flipping back & forth.
Thanks for all the support!!
It can be rough to get a definitive diagnosis on adhd especially when it is near the borderline. The TOVA is not a real good tool for this as it has too many false positives and false negatives. If you follow Russell Barkley he does not indicate much use for this type of instrument. I am not aware of an EEG being used successfully for this diagnosis.
A big problem is that it is a developmental disorder for the most part and such there is nothing "broken or wrong" to fix a diagnosis and as such no "test" that has any real good validity in this area.
There is usually nothing that comes out on a evaluation to precisely pinpoint and give the clarity you want. It is (as in most psychiatric diagnoses) a "best educated guess". The easy one are the kids who are big time adhd and the ones who are clearly not. The ones in between gets the best diagnostic shot and see how it holds up over time. Also be aware there a number of issues that can mimic adhd and you almost never able to rule all of them out. My suggestion is to go with what you have and carefully monitor.
If you do feel the need for something more definitive then I might suggest the large teaching hospitals or medical school related clinics. These are normally very up to date on the latest valid diagnostic methods and treatments. Might set you mind at ease.
Any this is a toughie. Good luck and don't take anyone's word as set in granite: hard plastic perhaps but that is far as I would go. Keep plugging and you will get closer to what you need.
Diz
You might pick up Russell Barkley's book "Taking Charge of ADHD" from the library. He has some useful ideas,
If the child is adhd then he he may have a deficit in working memory. Have him as he reads the book make short notes and connect to page numbers to the notes. Tell him you want to see his pencil moving as he reads. The notes can then be his substitute for working memory. You might try having shorter work periods. Have him work in 15 minute segments then take a 3 or 4 minute break, get a little snack and something small to drink then back to the work. These are only a couple of ideas and may or may not work as each child is different but they work fairly well for a number of adhd children. Might be worth a try. Barkley does have some good ideas and some may work for you and your son.
Good luck and keep on plugging.
Diz
After a long and difficult diagnosic process for my youngest, I was very cautious with my oldest, for fear of jumping too quickly or reading too much into her issues. For her struggles with organization and losing things, we worked for years on organizational skills ideas, but nothing worked. In the past, she would fall apart during the last trimester at school. Last school year her grades started dropping mid school year, earlier than usual (she could not finish her work and would lose it, but her test grades were high). We opted for a med trial. On the lowest dose, she could focus better. On the correct dose, she said that she could "hear" the teacher's explanations and was completing her work mostly in class. She has not missed an assignment since, and got straight As. This has allowed her to live up to her full potential. The doc has made it clear to her that the meds are like glasses and help get the brain in focus.The effort and accomplishments are hers.
So I would suggest trying all the statagies suggested and see where that gets you. If it does not take things far enough, maybe a med trial to get your son's feedback would be helpful.
Just becasue your son has ADHD he may NOT need medication. As Vickie says it's all about figuring that out. So many kids can get by with interventions and strategies to help with organization. The wrightslaw website also has some really good suggestions for classroom help and homework help. My daughter HATES homework. The suggestion of 15 minute intervals with a 5 minute breaks works for her. I use an egg timer (for just about everything ) and when it goes off she can take a quick break. She does better this way and always better when I stay as far out of it as possible! Keep reading and esearching and talking to the doctors, you'll get a feel for what he needs. If you do try meds, you can always stop if it is not something that works out. No decision is permanent.I can't help much, b/c I am old school with kids having been diagnosedDiagnosing ADHD is tricky, and meds are trial and error. Was he started on 25mg of Strattera? It is supposed to be started at 10 and ramped slowly, at 92 lbs his target would be between 49(50 actually) and 73 mgs.Is he on meds now?
If he is getting hyper on Stims then chances are he does NOT have ADHD, and maybe you need to look at another issue?
edbson39272.5787847222Hang in there. I know it is so frustrating. It is even harder for us with older children and for anyone who has inattenive only ADHD to know meds are helping. You dont see that dramatic change in hyperactivity. My daughter will be thirteen next month. We've been doing meds for a few years and tried SO many and so many combinations. Its exhausting and frustrating, but try to stick it out. When everything is working they are so much happier and so is everyone else. All you can do is try them. There is unfortunately no way to know how meds will work until they take them. At this age you alos have to throw hormones into the mix as they are all over the place.Right now he has been taking the Straterra (25mg) for 5 days. He has been very tired & sluggish almost lethargic. But that seems to be getting a little better. The doctor wanted me to start the Focalin the same day but I couldn't bring myself to do it because of all the trouble we have had. This is the second time trying Straterra and both times he was started on the 25 mg.