OCD or anxiety | ADHD Information

My son is 8 and has been on one stim or another for 2 1/2 years.  They have helped him enormously -- he literally cannot function in this world without his medication.  He's currently on Daytrana 15 mg. and just started Tenex (.5 mg in the p.m.) He is extremely EVERYTHING about ADHD -- very hyper, very inattentive, very impulsive. 
Anyway, as the years go on, he has become more and more anxious and obsessive about his anxieties.  I think it's just "him" because he's been anxious/panicky even without methylphenidate in his body.  He obsesses to the point of freaking out and screaming for us because he is afraid of bad weather (always just around the corner), his fish dying (any day now), or death in general.  The last one is the worst because there really isn't much you can tell the kid logically and he demands to know how we would know the answers.  It has gotten really bad lately, and it is hard to do anything with him because he starts to panic and freak out.  There is almost no way to calm him down.  I feel like it's more of an OCD thing than an anxiety thing because he can't stop thinking about one particular bad thing happening.  Maybe it's both.

Does anyone have any success helping a kid like this?  Any techniques?  Did a med change help?  I am afraid to change medications at this point because we have had some bad experiences (Concerta -- hallucinated, Strattera -- became angry and violent [although the starting dose was probably too high], Metadate -- didn't work at 10 or 20 mg and 30 mg made him see double).  Should the Tenex help this when we get to the right dose? 

We have had such good luck with Daytrana for a year that I'd hate to give it up.  I do wonder why he has had such extreme reactions to the other medications and whether they uncover something else that could go wrong, and I worry, worry, worry that he will never be really stable. 

Advice and understanding please!!

Joy2
Dear joy, It is not just your son who has anxiety.  My son who will be 11 in november also has adhd and he is very anxious about things too!  For example if his dad is late coming home from work right away he thinks something bad happend to him.  He will say to me I hope my father wasn't killed in an accident.  Right away he thinks the worse.  If I go out at night which is rare but when I do he can not go to sleep until I come home!  He has even cried if I was late!  I know that little kids would do this and it would be considered normal but like I said he will be 11.  I think a lot of kids who have adhd also have anxiety.  I hope you do not feel alone because my son is very anxious also!  Well I hope this helps  Dans momMy daughter took Zoloft with a small stimulant dose for a while and it worked well. I know no one wants to give multiple meds, but it's a thought. She did well on Zoloft and a small dose of Ritilan LA. I'm wondering if he couldnt be on a Zoloft and maybe 10mg of Daytrana? The Tenex may help, but I doubt it. It will help more with impulsiveness and hyperactivity.

I agree with Diane V. A small dose of Zoloft (helps anxiety and OCD) and a lower dose of Dytrana could be helpful. I would run it by your doc and see what they say. My son also suffers from anxiety and thinks the worst immediatly. where's Dad? is he ok? Is he going to die? Are the dogs going to die? It goes on and on.

Espcially regarding schoolwork. Very anxious. WE are not on meds His choice. He refuses to take them. It made everything so much calmer here. I long for those few weeks back.

We tried treating the ADHD first and did not have good results he freaked out and wouldn't take his meds. Now we are treating the anxiety and he seems much calmer and maybe open to the ADHD meds down the line with the therapist. So we are treating what we can(the anxiety) and will then try to tackle the ADHD again at a later date(we just started the Zoloft and it is doing wonders for his mood.)Thank you to everyone for the prompt replies! This is all very helpful as we sort through everything.

3boymom, some studies are showing CBT helpful in ADHD also. There's some information here on the alternatives board. Or you can google CBT and ADHD. That may be a great thought in your start for therapy.

As far as meds go, my daughter has taken tricyclic antidepressants for ADHD with some success. I'm not sure how/if they are prescribed for OCD, but may not hurt to research while you're waiting for your evaluations. Norparmin, Nortryptiline and Desipramine are the ones. My daughter gets terrible side effects from most meds, but the TCA's only made her tired, no other side effects. We recently started Strattera, please don't rule that one out either.

Good Luck, things get so much more complicated with co-exisiting conditions, but not impossilbe.

Hello,

I am brand new to this forum and appreciate any advice, as well, on the topic outlined above. My son is 11 w/ ADHD and OCD (just diagnosed). So far we have tried only a few stimulants, but they are creating the expected emotional fragility/teariness. So I'm thinking stimulants may not be the answer. BUT - for those of you who are doing the antidepressants: did you try the cognitive behavioral therapy first? That is what I've heard can be so helpful in making the bad thoughts go away...I can't decide which is worse, the ADHD or the OCD - and if I can't get a stimulant to work - and if that leaves only Strattera left to try? - I'd like to get going on the therapy before we "resort" to antidepressants.

Does anyone else share this view, and - in general - can they reassure me that antidepressants are ok for these kids?

Thanks much,

3boymom

OCD is an anxiety disorder. Children with ADHD can have generalized anxiety which is very different than OCD as OCD is an extreme anxiety disorder separate and apart from ADHD and the generalized anxiety that usually comes along with having ADHD. If you suspect that your child might also have OCD I suggest that you have your child reevaluated to rule it in or out. Stimulant medication can be given very effectively to a child that also has OCD once the symptoms of OCD are put under control. If the symptoms of
OCD arent addressed first or not addressed at all stimulants can make the anxiety as a result of having OCD worse. Making the distinction between generalized anxiety and OCD is critical because it makes all the difference in terms of the treatment. Children who are taking effective medication for ADHD usually start to experience less anxiety if they only have ADHD. If the child is experiencing more anxiety then that's something that needs to be explored by a professional.  Good luck.

Thank you, this is helpful since to date we have been advised to resolve the ADHD first (as in, find a med that works), then pursue the cognitive behavioral therapy (or accurate diagnosis, if in fact it's GAD vs. OCD). What I'm hearing you say is that the reverse would be a better option - particularly in light of all the effective meds out there that are stimulants. I will raise the OCD vs. GAD issue w/ our clinical psychologist. She has only "diagnosed" him via a parent meeting, so - yes - we definitely have some fine-tuning to do there (the ADHD was diagnosed through a full psych evaluation/testing).

Thank you for the prompt reply.

3boymom

 

Correct 3boymom. The OCD has to be addressed first and once effective treatment is sought out for OCD, the symptoms of ADHD can be treated. I always recommend that a child be tested by a child pyschiatrist in such a circumstance as they are trained to make a differential diagnosis whereas a psychologist isnt. In any event, please keep us posted :)The doctor my son sees at the ADHD clinic at Children's Hospital here recommended the 'Worry Dragons' books for us. I haven't used them myself yet, but I've spoken about it with several other parents at the clinic, and they said it is a great resource. You can google Worry Dragons for more info

Good luck!
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