Psychiatrists or Pediatricians? | ADHD Information

For med management DEFINETELY a Psychiatrist. For diagnosis, a Neuropsych. NEVER a pediatrician, they are not trained to manage ADHD meds, or diagnose ADHD. My insurance covers all visits except a copay.

If he is possibly Bi polar why is he on stims?

What I am wondering is if most moms are using Psychiatrists to manage meds or pediatricians???

My son is 8 - ADHD, probably ODD and maybe mood disorder/bipolar. He is gifted, high reading, etc. and very challenging.

Because of these complex issues, we've had a lot of testing and evaluations. He's tried several stimulants and right now 27 mg concerta seems to be working well, but I think he is developing a tolerance. So, I called his phychiatrist today and we have to have another visit at 0 for 30 min. He sees a counselor weekly and this psychiatrist has had multiple visits with me and my son all about medications. At 0 and hour, and with him not on my plan, it gets expensive.

We're using standard stimulants, so I'm thinking of just asking his pediatrician to prescribe the meds. If I have to take him in, it's a copay. Does anyone have any comments on this? Anyone feel they've been paying out a lot just to get simple prescriptions?

Stay with the psych for med management. Our psychiatrist does not take any insurance we also pay out of pcoket, so I hear you! It's worth it though, he knows his stuff. My daughter's pediatrican told me herself, these meds are not my expertise, you need someone specifically trained, and she was right, we did need him, still do.

I agree stay with the psychiatrist. I also pay out of pocket for all our therapy needs as well as Doctors Appts. and it is worth having someone who knows what they are doing even if I can barely afford it.(especially with co-morbids). A Ped just doesn't have enough info.

Good Luck

Some rules of thumb that might be of use:

If it is regular uncomplicated ADHD with few or no cormorbids then the family prac or ped can do a good job. If there are complex med issues, bipolar, or other major comorbids then the psychiatrist is the way to go.

Part of the equation is where you live and your insurance coverage. Many live in rural areas and it might be a 200-400+ mile round trip to see the psychiatrist. Others do not have coverage for a psychiatrist or cannot find one who will take their insurance.  Not everyone can afford many expensive fees. What some do in these situations is to see the psychiatrist as needed and let the local doctor do the med management with consolation.

One size does not fit all.  It would be easier if it did though.

Dizfriz

When my son got settled on his meds, we were able to scale back the visits to the psychiatrist to once every 3 months.  I just go in on the other months and sign for the scrip because it's a stimulant.  

Is it possible that there is  nurse psychiatrist in your area who does adhd meds?  That may be less expensive and you will still be with a professional who really knows about the meds.

FYI - I was at the pediatrician once with my son for a check up and when we went into the room for the eye test, all of the charts of all the kids who needed refills for adhd medication were lying out with the names of the kids and their meds. I couldn't believe it especially with HIPPA!  I assume most pediatricians don't operate like that but it really freaked me out!
I have done both and from experience it's well worth the $ for the phychiatrist. They are highly qualified and especially since your child has the bipolar disorder, I pray that you get the help you and your child needs through this very hard time. My mom has the bipolar disorder and my child has ADHD. Sometimes it gets pretty hard. God Bless

I tend to agree with the majority here.   It kind of depends on your individual situation.   My daughter was diagnosed with ADHD and ODD 1.5 years ago.   Much of the ODD lessened when we put her on med's. 

For my daughter,  we use a nurse practitioner in the Children's Psychiatry department at the local children's hospital.   Her job is medication management and she has been doing it for a really long time.  She is also easy to get a hold of and returns her own calls.

We have no mental health coverage on our insurance, but her services are covered.   I don't know if it because she is a nurse or how they bill it.  I've never asked.  I'm just thrilled she was covered as the psychologists aren't.

Good luck with whatever you decide.

Hi,

I agree with others. If your child's ADHD is garden variety vanilla flavor an "experienced" ped can do the job.  My daughter is monitored by our ped.  She has no other issues (at least at the present time).  My son is managed by a ped  psychiatrist because of my son's other issues.  Good luck.