newbie; ?s, meds, intro | ADHD Information

I'm new here.

First, about me...

I'm a teacher, formerly of 4th grade, this year of science for K-5 at our elementary school.  I have been diagnosed with depression, but never felt "depressed."

I have triplets, age 11. All girls. One has serious emotional issues. Diagnosed as "undefined mood disorder" and depression. Takes Abilify...when she's not being manipulative.

I also have a daughter, age 6, diagnosed this summer with ADHD and a son, age 4.

I am writing about the daughter, Marley, age 6. She started on Strattera, but getting her to take the medication was extremely difficult. Both she and my other daughter do not swallow pills, and the Strattera, I guess, tasted really nasty. I had to fight her about taking it.

I then switched doctors (due to problems with other daughter). After debating about our choices, we decided to go with Daytrana because the idea of putting on a bandaid was much easier to cope with for her. She was on it for a short time, but was having terrible rebound. Doctor switched her to Addaral (sp?). It was easy to mix with applesauce, etc., and she didn't know she was taking it until I (stupidly) opened my mouth and told her. Then she became difficult about taking the medicine again. We switched back to the Daytrana path. It is much easier for us.

However, we noticed two days last week that she was NOT under control, even though she was on the meds. The teacher thought I had forgotten to give her the medication (I was out sick that day, Marley goes to the school I teach at). She was supposedly the worst that she had ever seen her. She was also totally distracted the next day, during soccer. There was also an aggressiveness toward her brother and sister that came with us to the soccer game. She was mean.

There have also been some new problems with her relationship with her grandfather, which has always been close. This bothers me more than anything. She did not want to leave her afterschool program with him, and she threw a huge fit. Their relationship has not been the same since, and he is afraid to come pick her up anymore.

Is this medicine related, or just normal 6 year old behavior? Is it that she hasn't been on the medication long enough yet? She is on 15 mg, and has been for about 2 weeks. Do we need to go to a stronger dose?

The other issue is her academic performance. She is very bright. I thought she would come to school and really do well. She has not done that. In kindergarten, she did ok, but not what I thought she would do. This is what told me there was a problem.

She is performing ok. There is not a risk of her being behind. But you have to know my child and how early she has done everything....is it too much for me to expect her to be able to outperform some, or even many, of her classmates?

I did not expect that of two of my older daughters, but one of them.

Any thoughts?

It sounds like it is not the med for her. I would speak to her psych about it.

On a side note, you are aware that Strat cannot be opened, and takes 6-8 weeks to work.

 

I'm not sure that I am ready to say it isn't the medication for her. It has calmed her down a lot in the classroom. Usually, the teacher has good reports about Marley's behavior...there were only a few blips when we switched. So we could not understand the problem on the one day. There have been no problems yet this week.

I was going to wait a few more days to see if there were any more incidents, and then call the doctor again. Seems I'm always calling her for something...but usually with my other daughter!

I usually wait 2 weeks for the meds to either work, or not, unless it causes a MAJOR issue. You usually know right off it the med is wrong, but calling the Psych doesn't hurt.

Maybe chagning the Dosage will work better. My DD has been using Daytrana for over 2 years, and we are extremely happy with it.

edbson39364.8300578704

I have doubts that a very bright ADHD child could outperform some or many of her classmates unless she has the perfect treatment program in place. They are too inconsistent in performance and behavior. Sometimes they outperform in a certain subject or they outperform for a limited time period.

Getting the right medication at the right dosage takes time. You might need a lower dose.

Have you had a professional talk to her about why she needs medication and what it does? This seems to be an issue, no? Maybe someone could address her concerns, whether it's how it makes her feel or difficulty swallowing a pill. She is nearing the age of reason so this should become easier. Maybe you can discuss with her that she can practice swallowing cake spinkles, move up to tic tacs, etc, until she can swallow a pill--make a plan. Maybe a doctor could explain that medication should make her feel this way but not that way, and she just needs to describe in detail how she feels so that he can fix it. Do you think a few hours talking to a child psychiatrist about her issues with medication would help?

Talk to the doc about the options. Depending how long she has been on the daytrana, it could be that she ajdusted to the med and needs a higher dose, OR she may have been on it long enough that she may need the dose decreased. One thing different about daytrana (compared to the oral meds), is that the delivery becomes more efficient with time and the dose may need to be decreased.

Other things to consider is co-existing anxiety that can come out as aggression.

I also would give it more time. Then my first step would be to play with the dose, either up or down. My daughter has had to make a LOT of medication changes (due to side effects), my husband is convinced it's made things worse, all the "changing". So mnay other things affect behavior. On the flip side of that, in my experience, behavioral changes that happen that close to a med adjustment (positive or negative) or related to the med change.

If she understands about the need for meds, could you talk her back inot the sprinkled Adderall? Or Focalin (can also be sprinkled)? It may be worth helpng her with the ability to swallow pills too. That certainly made our lives easier. Although we're also using Daytrana now and she doesnt need to, I am able to give vitamins, any medication now in pill form.

I couple people have said that she might need a lower dose. We started with the 10 Daytrana, but upped to 15 because the 10 didn't have much effect. I was wondering if she needed the next dose up, not down.

Of course, she has only been on this dose consistently for 2 weeks. The Daytrana website said that some improvements would happen over time, and two weeks hasn't been much time.

I have had little success with psychiatrists talking to my children about their need to take medication. Marley understands that she needs to take medicine and how it helps her, but she is only 6. Bethany, the 11 year old, is a whole different situation.
FYI - Strattera can be made into a liquid by a compounding pharmacy (look in the yellow pages for one).  We bring it to a place that makes it into a chocolate liquid.  My son says it tastes ok.  It can cost between and to have it done on top of the cost of the prescription.  For us, it was totally worth it.  Because of the strattera, he was able to go all summer without stimulants (life without rebound or food fights!) and now that school is back he in using a 10mg. daytrana patch instead of the 40mg. he was on last year.

It took us a while to get this right and I'm hesitating to even put this in writing because I am so scared that the minute I say we have found the right formula I'm going to jinx it get a call from school!