Tantrums | ADHD Information

This is my first post here. My son Owen is 9 now (we have another son who's 5 but seems to have no ADHD symptoms), and we've been pretty sure he was ADHD since he was about 3 or 4. It's pretty mild, and he does well in school with or without medication. We just started him on meds this past fall - but the reason we tried medication is because he has severe separation anxiety and it was only getting worse. We tried Buspar and that did nothing. We tried Zoloft, and that did wonders for his anxiety, but it made him act out pretty severely at school. So, we took him off the Zoloft. Next, we tried Straterra, which he is still taking. I guess it's been about 6 months he's been taking it. (60mg/day) It's not helping with the anxiety, but it has helped him focus in school a bit better, we think.

Here's my main reason for posting: This kid has the worst tantrums imaginable. He gets angry, lashes out verbally and physically, throws things, breaks things. It's awful, and it comes on very suddenly. One day he'll be able to control his anger, but the next day he just loses it. We can see an improvement over the past couple years in that he does try to control the angry impulses, and often succeeds. But when he doesn't succeed...bad.

Last night my wife was asking him what he wanted for dinner while he was playing a video game. He wasn't doing well on the game and was getting angry, and he suddenly threw the game controller, called my wife a bitch (3 times) and ran upstairs (after we told him to go to his room). While running upstairs, he made sure he threw everything off the stairs, and went to his room and began throwing things around. He made a mess. And then we heard a crash, and he'd broken a window. I went upstairs to see what happened, and saw the broken window, and my son was just hiding, crying that he didn't mean to break it. I tried to comfort him, but he was pretty inconsolable. Needless to say, he was in his room for the night. And he can't play video games for a month. And he has to do a major chore to pay for the window.

He woke up this morning chipper, ready for the day.

My wife and I are wondering if this sort of aggressive, defiant behavior is common for ADHD. Also, could it be from the Straterra?

Part of me thinks we shouldn't be too hard on him as he seems unable (sometimes) to control his impulses. He does fairly well behaving at school, and I think controlling his impulses all day really tires him out. So he takes it out on us when he gets home. Clearly, that isn't acceptable, but it's really difficult to know how to deal with it. My wife leans more toward coming down hard on him (no games for a month was her idea, I was thinking more like a week.)

And these tantrums aren't nearly as rare as we'd like them to be.

Anyone think he might have something other than ADHD? Ideas on how to deal with this behavior? He's getting bigger, and is going to hurt someone (or himself) if this doesn't stop. (Not to mention all the *things* he has broken - too numerous to mention...)

Thanks in advance for any advice/thoughts.

Dan
drylightning39526.3582060185I would call your child's dr asap. Does he see a psychiatrist or other
therapist? Sometimes defiant behavior goes hand in hand with adhd, but
that is no excuse. Please call his dr and explain what is happening. It could
be the meds are wrong, or something else. Hang in there. [QUOTE=chinamom]I would call your child's dr asap. Does he see a psychiatrist or other
therapist? Sometimes defiant behavior goes hand in hand with adhd, but
that is no excuse. Please call his dr and explain what is happening. It could
be the meds are wrong, or something else. Hang in there. [/QUOTE]

He sees a therapist and a psychiatrist.

Our next appt with the therapist is in a week.

My son, also 9, has had his share of these type of tantrums. With him they are directly related to anxiety and frustration. We saw a huge decline in them after he started on meds (focalin xr), but he still had a lot of anxiety last year because of a not so great teacher. This year he has great teachers and hasn't had any major tantrums- I think the last one was last year when he punched a hole in a door. He still has his moments where he's angry and nasty and stomping around the house yelling at me, but nothing especially violent or destructive.

Has he always had tantrums like this or did they start (or worsen) with the meds? Sometimes meds can increase irritability- I was on strattera for a while but I don't remember if that was one of its' side effects. You could also have him re- evaluated to look for co- morbids.

I've also found it helpful to intervene when my son starts to get frustrated. He doesn't usually appreciate it, but it usually heads off a bigger outburst. I find the video game one to be pretty common- when I hear him starting to get frustrated with the game I let him know that if he's getting frustrated that it's time to take a break. Then I back off for a few minutes to see if he'll get himself under control, and if he doesn't I tell him to turn it off. He'll yell and scream, but nothing like if I let him keep playing, and with the added advantage of being right there to grab the controller when he starts to throw it.

What is his weight? It could very well be the Strat, especially if it is too high, and it sounds like it might be. [QUOTE=edbson]What is his weight? It could very well be the Strat, especially if it is too high, and it sounds like it might be. [/QUOTE]

He's about 65 lbs. Skinny, but muscular, little guy....

Thanks,
Dan

I have the same question as jaderock, is this new since meds? Or always? I would also call the doctor either way.

As far as discipline, he needs the discipline, but a month or week wont matter as far as being more effective. The best dicipline for these kids is immediate and brief. Stong is ok, but I'd take away everything for day or two rather thanone thing for a month KWIM? So no tv, phone, video games, computer for two days and pay for the window. But three weeks fomr now he's not still learning the window lesson, and has potentially had another outburst since.............another thing is to take it away and make him earn it back. Not time frame, this what I tend to do, no computer until you earn it back with good beahvior. Then I decide when they get back............

His target at 65 lbs is 34-50 mgs, so 60 is too high, and that is probably why he is having issues. I would speak to the Psych ASAP, and have the dosage lowered. A dose that is too high can result in mood swings, tantrums and liver damage. [QUOTE=Diane V]

I have the same question as jaderock, is this new since meds? Or always? I would also call the doctor either way.

[/QUOTE]

He's always tended to have these kind of tantrums, but they seemed to have gotten less frequent and less severe as he's gotten older. Until the past few days, when he has had two really nasty tantrums.

Regarding the discipline, I agree. I just need to convince my wife...
my daughter is 83 pounds and takes 60mg of Strattera, so as Edbson says his dose is probably too high.

Another possibility is he could be rebounding from the meds. Has he always been this way(easily irritated or angered)? Does it seem to be worse in the evening as opposed to the morning or afternoon? I know my son still rebounds and sometimes it can get ugly because I find myself reacting as if he is being this way on purpose. Then I have to keep reminding myself it is the meds. Most of the time I am able to keep him out of any possible situations that would set him off. However, if something does set him off, I just remove him from the situation. Either take away his DS, make him get off the computer or put him and his sister in seperate rooms. Those are the things that normally set him off when rebounding.

It is so strange because he does not go off like that on days when he doesn't have the meds. even when he encounters the same situations. That is why I know for sure it is the meds and not him just being a pain on purpose.

I do agree with everyone else, you need to get him an appt. with his prescribing doctor and lower or change his meds. Good Luck to you and your family.

My daughter used to have terrible tantrums as well. She would hit, kick, etc as well as throw and damage things. At least she never swears. 3rd grade (9 years old) was really bad and when we had her evaluated and diagnosed with ADHD. We started meds shortly after this and the tantrums pretty much went away. 4th grade was a fabulous year.

At the beginning of this year (5th grade and almost 11), we started having problems again.   We had 3 months of tantrums that were getting progressively worse again. While working on adjusting the meds, we also started working with a therapist.   His view on things is that there are 'never' behaviors - like violence and others that are 'dial-down' - like yelling.   'Dial-down" behaviors you work on decreasing the frequency and the intensity. The 'nevers' should never occur and the consequences for these are VERY VERY expensive.

So, at it's worse this past fall - she pretty much had everything taken out of her room and then had to spend an entire weekend in her room with a couple of books and an audio book to listen too.   This was torture for her. She hated being alone.   Since that weekend, she has only had to spend time in her room for violence a couple of times.   She understood that we were serious about her stopping this behavior.    In the past 3.5 months, we have only had one incident that I would consider violent and even then it was a far cry from what we used to get.   The combination of appropriate medication dosages and an excellent therapist has made huge impact in our family in a positive way.
HorseMom39526.9705902778Hi Drylightning,

I'm a newbie too and have posted about my son -- 8 1/2 years old with ADHD, currently on 40 mg Straterra.

We have the same issues with rages and, in fact, had a bad trantrum last night that continued for nearly 1 hour. We called our psychiatrist who suggested that we think about adding either Tenex or Trileptol (please excuse any misspellings). Does anyone have experience with either of these drugs, particularly with respect to rages?

We are also thinking of stopping the Straterra for a week while our son is on vacation to see what effect if any that has on his anger. We've done this once before and had not noticed any difference, but maybe it's worth trying again. We have tried other meds (Focalin, Concerta) but they made him angrier. Straterra is the only med that seems to work, though we believe its efficacy is somewhat limited. In other words, it helps some.

Thanks for your thoughts on TENEX or TRILEPTOL...
My daughter take Tenex with her Concerta. We started it a few months back to help with tics. It's helped some in that regard, but not made them totally go away.

It has helped reduce some of the hyperactivity we would see in the evenings when the Concerta had worn off. I also think some with anxiety.   I never really thought of my daughter as being overly anxious, but she is more comfortable now in situations that would have stressed her out before.

Angry-wise - I'm not sure how much it helps with that. For us, we have anger issues when her Concerta isn't at the right levels.
We added 1mg tenex in the evening with Wyatt's 54mg concerta and the tantrums have almost stopped. It takes the edge off and I think also helps him sleep so he has more tolerance.