ADHD child- unaware of surrounding | ADHD Information

My son is 10 and dx ADHD.  Very hyper/impulsive but I also notice a focus issue.  He often seems completely unaware of his surroundings.  I am at my wits end.  He actually hyper focusses on something and then tunes out everything else. 

He is very respectful and I use a rewards system for behavior that works well- but I don't know how to deal with this mindless, spaced out behavior. 

Any suggestions

KidsInSpace39284.6808101852

Is he on meds?

My daughter age now 13 next month and was very, very much like this before. Lately she seems to be coming out of it and I am assuming it is due to med regimen.

He is currently off meds, in the past we have had success taking summers off but based on his behavior as of late, we may need to reconsider.hmmmmmm yes that may be it. My daughter has never really been "off meds" since we started meds. She tends to get that way more on stimulants, and when we are ramping something new (so I assume shed be this way off meds). We are doing non stimulant now. Does this behavior go away while on meds? What does he take? I assume a stimulant.

His normal medication is Concerta (stimulant).  All of his symptoms (impulsivity, excessive talking, forgetfullness, disorganization, innattention, unaware of surroundings, hyper-focus) are less prominent when he is medicated, but they all still exist to some degree. 

Do you mind sharing the non-stimulant you use- is it Strattera or similar?  Is it working well?

 

KidsInSpace39284.7615625I think a pragmatic approach is recommended. You need to point out the very obvious. Give a running narration of your environmental observations, your interpretations of body language, tone of voice, etc.

Sounds exactly like my daughter.

 We are using Desipramine. It is actually a tricyclic antidepressant. Some others in this family are Norpramine and Nortryptiline. She took Nortryptiline a couple of years ago through last Nov, after many trials on stimulants. She did pretty well, but it was quite sedating and she is super sensitive to meds (especially if they cause fatigue). This year we took her off to give stimulants another try (bad idea), so now we went back to the TCA as she was best on those. We are still tweaking her dose, but lately has seemed so so so much better. She is happy, gaining weight, very personable, her anxiety is down (still there though so we may to increase it a bit more). Her ability to stay on task seems good. It is summer so there's no school and she is always worse for school, but we are using the summer to try to get her adjusted. Last time I felt we were at a good dose she was like this, GREAT, then started with her ADHD symptoms creeping back as her body got used to it, like always "bored", fidgety/impulsive (like not being able to resist poking some one if she is sitting next to them for more than 30 seconds ), interrupting every converstaion, etc, etc. So we increased and she has been GREAT, now yesterday she started with the bouncing from thing to thing and that stupid poking thing, but I am hoping it was just one day! If not I'll call him and maybe we can increase again.

The thing with TCA's is you have to monitor with blood work and an EKG so a lot of doctors dont like to use them. We've had success and they've been around a LONG time, used for ADHD prior to stimulants. She has no side effects from the Desipramine so to me it's worth the monitoring. The side effects from the stims for us are terrible. I'd rather force her to suffer through a blood test than never eat and be so anxious and the tics and just not really happy. She's been through worse unfortunatley. She asked me once why there isnt a pill she can take that wont make her tired, but also wont make her head spin and not able to eat...........the poor kid . She loves what she's tkaing now. I recently added a magnesium/calcium supplement.