Hello! New to this forum. I don't want to give our whole story b/c it is not too much unlike many others I have read. A quick summary though. I have a 5.5 yr old twin daughter diagnosed with ADHD (impulsivity). First trial was concerta 18mg. Behaviours actually worsened so upped to 27mg. No change. Quickly came off of that one.
I have to note that my DD cannot swallow these pills. I had to literally place it at the back of her throat and I will never go through that again.
Psych. then prescribed Dexedrine (5mg) because it can be crushed. It has been about 6 weeks. We have seen some improvements. We can only give one pill in the AM and one at lunch, we had to stop the dinner pill because she would not go to sleep. I am able to crush it and put it in a drink and no problems. So she takes 10mg a day. She also takes .5 of Resperdal at night.
I have read just about anything I can get my hands on and talked to anyone who would listen. I see many stories where parents try several meds before finding the one that works. My question is because we have seen some improvements do we consider this pill the one? She is still implusive, easily frustrated which can lead to fiery violent temper, very low tolerance level. Instead of a meltdown once a day we may see one every other day. We still watch what we say VERY closely so we don't 'set her off' and I still sigh when I hear the phone ring b/c I expect it to be the school.
So experinced parents, please offer advice? Is it likely another medication would help more? We do behaviour modification as well. We realize medication is not the only solution. Our biggest problem is however, we are limited as to what she can take because she cannot swallow. The med needs to be crushed, liquid form or whatever else is out there.
I appreciate any feedback. We are off to the Psych again tomorrow.
I am wondering though
Welcome to the board RCmommy :) Was your dd also diagnosed with a mood disorder? Based on the behaviors you describe and the fact that your dd was prescribed Resperdal prompts me to ask that question. If that were the case then ADHD med's would exacerbate the symptoms of a mood disorder and should never be given until the mood disorder is put under control. While you can relate to many here and the stories, every child is different so more information would be helpful :)
To answer your question about ADHD med's, several med's and/or doses sometimes have to be tried before seeing desired results. The results should be maximum benefit and minimal side effects. Maximum benefit means that all of the symptoms of ADHD are managed fully and results are seen right away because these med's are not blood level medications The child should be focused, not impulsive and also no longer extremely frustrated because their thoughts are no longer all over the map and they now have the ability to make a choice. If you have to question whether the med's are working then that means they are not working or perhaps working at a minimal level.
You will find a lot of support here so please come back and keep us posted and again, welcome to the board.
hi again,
no my DD has not been diagnosed with a mood disorder although we know that it is a possibiliy since ADHD seems to go along with another disorder like OCD, bipolar, ODD. The doctors here don't want to touch the bipolar diagnosis b/c they say it is very controversial (at her age.) She was pescribed Respirdol because it can help as a mood stabilzer but mainly b/c the doctor thought it would help her sleep at night. It does as well. She is ready for bed exactly two hours after taking it. Mind you she has always liked sleep but she has always been a night waker. Nearly every night, often several times a night, for years now.
I think you are right. if I have to question the pills effectiveness it likely isn't right. Or maybe the dosage is just not enough. I like many others hate to switch to another medication b/c of all it can entail.
Sometimes I read stories on ADHD and they sound nothing like my daughters "issues." When I read the impulsivity checklist is where the similarities are striking. She is quick to anger, frustrate, blurts out things (like "FINE!" is one I get constantly) "you aren't listening to me!" "I can't do this!"
However, she can hit a point of no return. She screams in a fit of rage, throws, name calls, hits me or bangs on the wall) After telling me how mean I am, she then cries and tells me she cannot take it anymore. She is very difficult to calm does not listen to reason. We look for triggers, sometimes there are some, often there is not. At first it was always at home. However now at school as well. I have had meetings with the teachers and the psychologist together. Lately she does it in places that she never would have before. While visiting firends the other day she became extremely frustrated that the other children were not following the rules of hide and seek and I swear became fixated on laying dwn the law and making sure each kids heard her rules! There was no redirecting her.
ahhh....there is a special place in Heaven for parents of these children!!
I just wanted to add that we have one psychiatrist and one psychologist who agree on ADHD. (of course there is a possibility of something else, or along with) but nothing confirmed yet.
so I was told if she is truly suffering from ADHD and not a mood disorder then the ADHD meds would help. So when we saw some improvement we chalked it up to her definitely having ADHD and the meds seem to be helping. However, she started the respirdol at the same time so how could I know for sure ??
I too have heard that stimulants will increase anxiety like symptoms. Her symptoms haven't gotten worse by any means but I wouldn't say they are fewer either. what we have seen a difference is that she doesn' blow up every time something doesn't go her way. Sometimes there is a small window where we can talk to her and redirect her and get her to listen to reason.
On a side note: Is it normal for children with ADHD to worry? My DD frequently tells me she is worried the house will catch on fire? She is worried she will lose her favourite blankie...
Hi- welcome to the forum. I recently learned from our psychiatrist that stimulants can cause behaviors that are psychotic and she said we need to be aware of this. Perhaps your doctor can try a different stimulant medication and you can see if there is a difference. It is usually just one day at a time.
Good luck with the doctors and I hope you and your daughter do better.
Hey, and welcome,
Good points, I will ask them tomorrow at our appointment.
it is very helpful to have others who travel down this road.....
thank you
randyjim wrote:
I recently learned from our psychiatrist that stimulants can cause behaviors that are psychotic and she said we need to be aware of this.
It's not stimulant medications that cause psychotic behavior. A child that has undiagnosed Bipolar Disorder when given stimulant medications can trigger a mania episode. Children with an undiagnosed anxiety disorder like OCD when given stimulant med's can trigger even more anxiety Also, if the child is taking other medications its a good idea to ask the pharmacist if the other medications might cause a bad reaction when mixed with stimulant med's. Lastly, if the medication is abused and taken with other substances like alcohol there could be a severe reaction but this is true of all medications.
Its important to be specific because generalizations can cause mass hysteria amongst parents. There are specific circumstances whereas the child would have such a bad reaction to stimulant medications. In general, stimulant medication is very safe when taken as prescribed, unless there are extenuating circumstances that might cause unacceptable side effects but that's true of any medication. The child should not have such a severe reaction to stimulant medication under normal circumstances.
[QUOTE=graiae66]Hey, and welcome,
Our doctor asked us to try medication for about 4 weeks and unless there were problems, she said to give it that amount of time before trying something else. So, it sounds like you've given it time.
What would the doc think about 10 mg AM/5 mg lunch?
Dee
This is true of Straterra which is a non stimulant because it is a blood level medication so it takes 4 to 6 weeks to see maximum benefit.. With stimulant medications, 3 or 4 days is more than enough time because when the child is experiencing maximum benefit, results are seen right away.
We have been told the same thing about stimulant medications---if they are going to work, you will see results right away. For severe ADHD symptoms we were told you could see results in 20 minutes.
For us, after starting the dexedrine it was nearly two weeks before our daughter had another huge meltdown. I am not talking a temper tantrum. I am talking she is screaming so loud we have to make sure the windows are closed so the neighbours don't call the cops. Anyway, after those initial two weeks we are seeing some negative/unwanted behaviours again (a few melt downs) but it has also been the holidays and we took a vacation. back to school these past two days and good reports from the teachers (I have to admit I dreaded her going back)
I am not in denial about bipolar and I would accept if they diagnosed my daughter but I honestly just don't see it. my mother is bipolar so I have lived with it my whole life. (this is also difficult to tell the doctors since it could make them quicker to jump to a conclusion without the proper criteria) Since being on stimulants I have not seen any manic like behaviours/symptoms from my daughter.
If any of you have children with bipolar can you tell me what symptoms/behaviours they exhibit that caused the docotrs to come to that diagnosis? Personally I see more anxiety related issues in her than anything else (wll besides impulsivity) The worry, the embarassment she feels, her shyness and withdrawl in a new situation.
Is it just me or am I the only one who gets this diagnosis for their child but still cannot rest? How many 'second' opinions or confirmations of diagnosis did everyone get for their child?
I knew he was where he needed to be with some help from the teachers. If they will not discuss as, as some will not, just go by your gut and his home behavior.
YOu will know when he is successful during the day ( or the period of time that the meds are in effect)
We took about 6 months finding the med and then the right dose. My son moved up quickly, plus we added guanfacine as well, which really is great. He metabolises the meds fast so his dose needed a lot of twicking.
Best wishes!!