5 year old son on Ritalin....need advice! | ADHD Information

Hi everyone! I'm new here. Man, the first post I read in here just made me burst into tears!  No one seems to understand...until now!  Wow. I apologize for going on and on in this post...I know I am going to just because I have so much to vent about! 

My son is 5 years old, in Prep Kindergarten, and was diagnosed with ADHD almost a year ago. He can be so sweet and loving. He doesn't have a potty mouth as far as cursing, whatsoever. BUT WHAT AN ATTITUDE!  Rolling of the eyes, tone of voice is sarcastic and rude.  He is not physically abusive to anyone in our family thank God. He was considered at a 6 to 7 year old level when he was 4 and registering for pre-K.  He can actually read a whole Dr. Suess book, for example, "Are You My Mother?", knew his alphabet and could tell you what each letter was and line up the blocks from A to Z by age 2, all his colors, shapes, etc, by then, and could count to 100 at 3.  He's so smart!  His doctor said that he is at a 2nd grade level that way, but emotionally/behaviorally is at age 3.    Since then we've had so many ups and downs.  We were new to the area and just had to get a quick appt because I had checked his blood sugars (I am type 1 diabetic since age 5) because he was always thirsty and they ran high.  (Tests came back negative.) While we were there his doctor asked me if he was hyperactive OFTEN, etc, because of the way he was acting in the appt...climbing on the table, pulling roll of paper on the table and breaking it, turning on and off the lights all while smirking at me, like he was taunting me.  I told him yes, it had been that way since he was 2 1/2 or so, but other doctors have told me that he was too young at age 4 to really diagnose ADHD.  He prescribed 10 mg twice a day. I didn't know what I was doing at that time being new to this so I didn't ask the right questions and he never told me when the pills should be taken, when is too late, etc. So the day I got his prescription I gave it at 4:30 and he didn't fall asleep until 2 a.m.! UGH...they then said I shouldn't give it past noon. Now this was short acting Ritalin. Being new to the area a year ago I hadn't looked into a good doc before I chose this one, so I went to the local pediatrician after some looking and asking around, so I could get a second opinion. She thought that was a lot for a beginner and said to just give 10 mg in the morning. I didn't know if it was working at first, or was he just being good at those times?, he stopped with his scribbling and started drawing actual pictures, was completely involved with his workbooks...he could finish one big one in a couple days.  I realized it was working but I could tell when the medicine wore off. Now it gets a little fuzzy. She increased the dose to 2 a day I believe, but there were problems when he would take it too late. He would talk about the "spy around bug" which supposedly was this buzzing sound the would keep distracting him from sleeping, he also saw (what seemed to me like an overactive imagination in the dark) the ceiling fan was a hippo and the pile of blankets were a scary lion. I had to put on music or a fan or humidifier so he wouldn't hear the buzzing. Anyone else experience this?  So she switched him to Concerta extended release, 30 mg. This medicine had really no effect on him. The doctor said that sometimes medications release different in different patients and it must not have released for him. Weird in my opinion and to be honest I thought that didn't make much sense. So she switched him to ritalin long acting. This was very good except that he would wake up at 3 in the morning and not be able to get back to sleep! So we went back to ritalin short acting, 3 times a day, 8:30 at breakfast, noon (given by the school, which sucks!), and 4 when he gets off the bus. Now for some reason the sleeping problems and overactive imagination at bedtime have stopped, but it seems to only work for an hour and that's it!  So I find myself looking at the clock constantly waiting and wanting to give the next pill. We went into the dr again (I know I am their biggest pain in the butt!) and when at the doctor he turned the water on like 5 times when being told to stop and her talking to him with a very matter of fact, calm nature...he just blew her off. Started taking paper towels out of the holder and wearing them on his head...over and over. Then he had to have an EKG because of the effects that ritalin is having on adults and their heart I guess? That was tough! She said that it has no effect on children but they still have to be tested. This makes me nervous. It is also scary for me to think that my poor little Reese is going through all of this. I mean is Ritalin making him worse? It seems like he needs more and more medication every month! Do you think that they withdraw from it when it wears off (addicted??) and that's why he's behaving so badly in between pills?

Yesterday morning he came into my room and woke me up. He says, "Mommy, do you know what today is?" I said, "Wednesday." He said, "Nope it's opposite day. So when things are clean you make them dirty." I said, "Noooo...if it's opposite day then that means that we need to clean the kitchen and do the laundry because they are dirty." He said, "No." So I walk out of my room and just glance into their room. I ABOUT HAD A NERVOUS BREAKDOWN. Every single blanket was thrown on the floor, dirty clothes thrown everywhere from the hamper, about 5 puzzles thrown upside down and the pieces all over the room, 4 packs of flashcards...EVERYWHERE, a big candyland/chutes and ladders/hi ho cherryo game and all it's cards and pieces destroyed, and every single book from their bookshelf...seriously like 50-75 books...thrown all over the room. My 2 year old Caden is standing in his crib, innocent as can be, but there are flashcards and candyland cards all over the crib. Of course Reese tried to blame Caden but it didn't work this time. LOL  I have so many stories like that.

Once we went to Walmart and I had to have a chocolate milk while shopping because my sugar was getting low and we were in the middle of Walmart. They both whined to have a drink. I gave them both a drink but told Reese I had to had the rest because I was feeling sick, like, "Remember the time mommy had to have juice to make me feel and talk better? That's what might happen if I don't have this chocolate milk to make me better."  That was fine but I had to put the empty container in the cart so I could pay for it at the end of my shopping trip. Reese had a fit and said I HAD to throw it in a garbage can. I explained that I had to pay for it because if I didn't it would be stealing. He argued with me and said I can't pay for an empty container, and I said that I couldn't drink milk without paying for it so when I bring the container they will scan it like they do the rest and I will be paying for what I drank. He would not have it!  He starts screaming and crying and throwing a fit because I HAD to find a garbage can!  I think he could possibly have OCD as well?  Things have to be just so. Or is it possibly ODD?  He asks questions constantly and I give the answer and he says, "NO, it's (this.)" I say, well then why ask me?? 

I am just at my wits end. I remember feeling such relief when he first started his medication and to think that we've went a year and this is how far we've come??  I called Community Mental Health, suggested by his pediatrician when I asked about him seeing a psychiatrist. They had me do a screening and asked me specific questions about Reese. At the end of the 20 minute conversation she tells me Reese doesn't qualify for CMH because he doesn't have severe mental/emotional problems and that I could appeal this but she recommends that I call a social worker, and gave me a name. She said this woman could help me with Reese's meds as well. So I call her and she tells me that her colleague can start seeing him but that I was misinformed about them helping with his meds, in fact they are told they cannot even advise about medication. I'm at a lost as far as that goes. His doctor hasn't returned my 3 calls in 4 days and I want to schedule something with someone...anyone who knows anything...but we live in a very small town and I don't think I have a lot of options. Definitely no specialists in this area.

Ok update!  His doctor just called me and said she wants to start him on Strattera. Ok now I'm really nervous because of what I read about suicidal thoughts with this med.  I mentioned it to her and she sort of blew it off. Said that that is basically an interview or questionnaire filled out asking them if they've ever THOUGHT of it and there is a big difference between thinking of it and doing it and this is a side effect of every antidepressant as well. ??  So she's leaving me 2 weeks of samples at the front desk for me to pick up today. Wants me to give him his regular dose of ritalin as well for 2 weeks and see her in 2 weeks.

Please...I would love any comments at all, welcome any questions or advice from anyone. I feel so lost here.  Thank you so much in advance!!

mom2boyz7539584.3449074074

Hi, welcome.

Sounds like a day in the life.......................of all of us .

It sounds like your son is having some rebound, which is the body's reaction to the meds leaving their system. It is very common. It happens differently for people, for my daughter she was extremely silly, others feel very emotional, others overly hyperactive. Generally this is better with the longer acting meds, but there's no way to know until you try them.

As far as Strattera, my daughter has been taking it very succussfully since Novemebr, her mood is fine, it helps a LOT for around the clock coverage. We do use a small 10 mg stimulant dose for school and it seems to be just what she needs to even her out without giving her any side effects.

You do need a psychiatrist to manage meds. Does your insurance have a website that lists providers or an 800 number? If not, I'd hit the itnernet or yellow pages and start calling around. It's worht travelling for child psych to manage meds.

LOL yes Diane, it is so nice to find a place to read about others going through the same thing! 

Thanks for the advice and such a quick response!  I think I'm gonna like it here.

I believe Reese would be starting on 10 mg of Straterra as well. I think we will stop the Ritalin once the Strattera kicks in...she said it takes awhile. She thought I'd see SOME change in a matter of 5 days, but full effect in about 2 weeks? Is your daughter on anything else at the same time?

I agree about the psychiatrist. I was just about to look online...yellow pages, etc., but DUH I didn't think of going to the insurance company's site.    Good idea!

Strattera is dosed by weight. Everyone starts at 10mg and ramps up to the appropriate dose. What is his weight?

My daughter takes 60mg per day of Strattera and 10mg a day of Methylin ER (which is like a long acting Ritalin).

We saw changes in about 2 weeks on the Strattera, but it takes 4-6 weeks after hitting target dose for optimum results,

He's 45 lbs. So if you need Ritalin (or something like it) at the same time, what does it help with that Ritalin doesn't?  Do you think she will lower his Ritalin or keep it the same? Does your daughter have sleep problems with Methylin ER? Has she ever been on anything else or did you hit the nail on the head the first try? :)

You dont even want to know our med journey. It's been LONG.

Rarely does anyone hit it right the first time.

He may need only the Strattera, thats the goal. His target dose would be between 25-36. So I assume shes starting at 10, then will go to 18 then 25 like that. Ideally it'll handle all his symptoms. It works OK for my daughter, but not quite enough during high stress for focus. She is older 13 and in middle school, lots of hormones and state testing and "stuff".  She has NO side effects from either med. This is the first time that has ever happened for us. She generally loses her appeteite always, but so far, so good this time around. The Strattera doesnt usually do that.

Ideally you will see results within 4-6 weeks after reaching the target dose( 25-36 mgs), thus the reason for continuing the Ritalin. If he is not ramped properly, or raised too high too fast, or not on the right dose for weight you will see symptoms get worse, not better. I would efinetely see a Psychiatrist for meds. If your ped will not get back with you call the Psych who diagnosed for a referral?

Strat is a great med for Moods IMO, DD did extremely well on it for over 2 years.

edbson39583.5965393518

Welcome!

Congrats on having the longest post I have ever read!

That's okay, at least that means it was interesting! I also have a young son with ADHD. He just turned 6. He is in Kindergarten and does exceptionally well academically, but has behavior problems. He is a great kid! Many of the things he does sound like your son. I can totally see him doing the whole trash thing at the grocery store. My son will *freak out* about the smallest thing, I never know what it will be!

We have tried many meds for him. We started out with Ritalin, and went through what I believe the whole Methylphenidate family They all seem to work about  the same for him, but the rebound varies. We have been on the Daytrana patch for about 3 weeks, and so far, I really like it. I know that could change any day. I think it is quite normal for our kids to try many, many different meds and dosages. It requires constant tweaking. I have seen others on this board refer to it as the "medication dance." I would have tried Straterra by now, but DS can't swallow pills yet. I may try it this summer. Battling over a pill is not something I want to add to my To Do list anytime soon though. I hope the Daytrana continues to work!