My son was diagnosed with ADHD last year at the age of 4, and he was attending preschool.  He suffers from hyperactivity and impulsivity, and is sometimes aggressive.  We initially tried Clonidine in an effort to control his impulsivity, and he did not react well.  He turned into a moody and emotional kid, prone to throw one heck of a tantrum.  So we took him off of it, and started at 12mg of short acting ritalin/day.  It seemed to work well for him, and at the same time, he got a new preschool teacher who really understood how to work with him.  He thrived and flourished in preschool.

Flash forward to starting Kindergarten.  He has an excellent teacher with lots of experience and a special ed degree.  She really tries hard to work with him.  He was a little shy the first week or so, and since then has turned completely out of control.  He is loud disruptive, impulsive, defiant, aggressive, all of the standard ADHD problems.

We initially tried upping his ritalin dosage to 25mg/day,  and it made him even more aggressive, bouncing off the walls.  He moved from being disruptive to unmanagable.  After discussing with his ped, we decided to try some other stim meds, and started with Concerta, 18mg/day.  This resulted in continued disruptive behavior, and he became more emotional, having temper tantrums again, for the first time since he was on the Clonidine.  Again he was very aggressive and bouncing off the walls.

Is this a sign that he is either under treated, or misdiagnosed?  We worked with psychologists, and psychiatrists to diagnose him, so I am pretty confident in their findings.  But why would the stimulants make him more hyper when they are supposed to have the opposite effect on kids with ADHD?   Will all of the stimulant meds affect him in the same general way?  Should I bother trying Adderal or Metadate, if he seems to respond negatively to Ritalin and Concerta? 

He is a pretty big kid for his age, 4 feet tall at 5-1/2 years old.  Could we be really underestimating how much he needs, and at the moment he is basically untreated?

I am really struggling with the day to day, and feeling bad for his teacher.  I KNOW he is a huge handful, and I can't imagine having to teach while he is in "the zone".  Any insight anyone can offer would REALLY be appreciated!

Julie (Mom to Paul 5.5yo and David 1yo)

The only med that I have a lot of experience with is concerta. Did you up him from 18 to the next dose? It sounds like it was too low.

My son did have a horrible reaction when we had him on strattera, we tried the concerta/strattera comb so that a med was in his system at ALL times and didn't metabolize out after a period of hours. But it made my son want to kill himself and die. He also didnm't handle adderall xr well at all. That med made him psychotic - eyes were dialated, he got in kids faces, he became aggressive and then had horrible melt downs, not being rebound. Both adderall and strattera were stopped immediately.

My son is on 90 mg of concerta, he is 11 - and remember age and size have nothing to do with the right dose for each person. It is based on success, at what dose the individual is most successful. My son also takes guanfacine for overstimulation.

Everyone handles these meds differently. There is rebound in the afternoon usually when the med is leaving the system, it is explained that it is as if they are thrown to the floor unexpectedly and can be uncomfortable. I used to give my son a chocolate bar to help him through it and it worked for him - it helped raise his blood sugar. Now we don't deal with that.

What you need to do is start a med and increase the dose finding either that it is working or too negative for you child. Then try another. We found even at a low dose when the med wasn't for our son. We also knew when he needed an increase. the results are immediate. We knew the first day he took the new dose if it was the right or wrong dose and moved him up the next day if necessary.

I hope this is making sense

Make sure you are dosing before quitting, otherwise the med may have been the correct med but the dose was too low before you quit that med all together. It is a roller coaster, but worth it in the end!

best wishes!

Thanks Bethann,

My son is acting similar on the Concerta, pupils dialated, really wild and aggressive throughout the day.  I wanted to take him off of it right away, but my husband was resistant, wanted to give him a few days so that we could observe him at school on it.  Turned into a disaster, he carried that behavior into the classroom.

Looks like we may need to try the ritalin again, at a higher dose, since he seemed to respond well to the loser doses.

This whole process seems so scary to me.  I don't like seeing my son like this!  I hope we eventually find something that works for him.

Thanks again,

Julie

My son is on Vyvanse and has none of those signs. When he was on Focalin he was a zombie. He is still prone to throw a fit or two but not like before.

He also takes Zoloft for moods and anxiety.

It sounds like you need to call your doc and tell them what is going on. That is not a good reaction and it might just be the Ritalin(we can't take it). Maybe another med might help. Good Luck!