yikes! | ADHD Information

KDLMaj wrote:
Yeah, suicide isn't something really attributed to
stimulant medications. The only reason why it's even
mentioned is that if a person ON stimulants ever becomes
suicidal, they have to report it as a potential side-
effect.

Thank you for setting the record straight. Suicidal tenancies are NOT a side effect and certainly not a common side effect of stimulant med's. There is usually something more going on when such a reaction is seen. For example , when the child has  undiagnosed bipolar disorder, when stimulant med's are given, it can trigger  a mania in the child. Every child is different so there are many scenarios or reasons the child might act out in such a way. I would indeed get another opinion.

Yeah, suicide isn't something really attributed to
stimulant medications. The only reason why it's even
mentioned is that if a person ON stimulants ever becomes
suicidal, they have to report it as a potential side-
effect.

And I wouldn't give up on medication just yet. But next
time, start it over a weekend to give him time to
adjust. And give yourself time to see what's going on.
If methylphenidate didn't work, then maybe it's time for
amphetamine. If that doesn't work, strattera. If THAT
doesn't work, it probably means there's a misdiagnosis
going on.

One thing that struck me was how you mentioned that he
was a sweet, polite boy off of his meds. Now, don't get
me wrong, that could be just you pointing out that he's
no longer trying to kill his peers. But, it sounds like
he's not having a lot of behavioral problems. Was he,
by any chance, diagnosed as ADHD Primarily Inattentive?

Approximately 80% of people with ADHD respond well to
stimulants. And of the 20% who don't- ADHD-I is
overrepresented. This has lead some researchers to
conclude that ADHD-I is actually a different disorder.
Particularly when you're talking about young boys (girls
often express hyperactivity differently), no big issues
with impulsivity (outside of age-appropriate behavior of
course) and hyperactivity is a red flag for a potential
misdiagnosis. Auditory Processing Disorder, visual
processing disorders, reading disabilities, etc. ALL
cause symptoms of inattention that meet the diagnostic
criteria for ADHD-I.

It may be worth it to investigate that a bit. Has your
child had a full neuropsychological evaluation? Your
school should provide one for free. It may yield
interesting results.My son started Concerta yesterday, so he's had two doses. The school just
called me to say that for the past two days he's been making verbal threats
to other students, to the point that they're not letting him around other kids
and they're sending him home in a van vs. the bus. Seriously bad news.

So I immediately called the doctor and we decided no more meds. I'm
keeping him home from school tomorrow to make sure they're cleared out of
his system and to give the school a break.

Let me find the silver lining - I promised my son that if he "changed" we
would stop the medication. I get to keep my promise to him now.How great of you to not break the promise. That is a bad reaction and I would have done the same! Would love to know how things progress.

Sorry to hear about this.  It's been a stressful time for you and your ds, anyway, and now this on top of it.

At what dose did you restart the meds?  The lowest dose and working your way up slowly, or the previous therapeutic dose?  I'm not a dr., but I know a long break from meds can require readjusting.  Actually, for some people, even a weekend off requires some readjusting on Monday. 

Also, are you sure that the verbal threats are a reaction to the meds?  I know he didn't want to restart meds, so maybe he's very angry in general?  It's probably the meds, but I want to make sure all possibilities are considered.

I hope things get better soon.  (((hugs))) to you!

My son has never been medicated for ADHD before. They started him off at
the lowest dose.

The common side effect (though it's usually seen in teenagers) is suicidal
tendencies. The doctor said it was actually a good thing that he directed it
out instead of inward. (Yes, I know I'm grasping at straws trying to see the
positives.)

The doctor said it was most likely a side effect of the drug. We'll see - if he
keeps this up we'll know. But he's currently a sweet polite little guy (now
that the drugs have worn off).

Thanks for clearing up a few things.  I hadn't realized that he's never taken ADHD meds before.  You probably know that people can react differently to the different stimulants.  Unfortunately, it might be trial-and-error until you find the right one.  Or, it's possible that his body could adjust to the Concerta, but I also would have discontinued it w/ that strong reaction he had. 

What's your next step, if you've yet decided?  Will you try a different medication?  Please know that it's very rare for people to develop suicidal ideation when taking any of these medications.  Of course you need to watch for the signs, but it's extremely uncommon.