New & not sure which direction to go | ADHD Information

My son is five years old and has severe adhd.  He was diagnosed about a year ago and put on Focalin XR.  It works fairly well part of the day but wears off about 2:00.  It's like I have two totally different children.  When his medicine wears off he is completely uncontrollable.  Nothing works.  He is hateful and mouthy and completely bounces off the walls.  You can not even talk to him logically.  He will not even listen.  I talked to the doctor about a Focalin booster in the afternoon but he will not put him on it because he has not gained 1 pound in the last year.  The Focalin does not suppress his appetite.  He actually eats better now then he did before the Focalin but he just can't seem to gain weight.  Also I just learned by reading the posts that he may have ODD with his ADHD.  It fits him very well.  He also has serious anxiety issues but the doctor has not addressed either of these issues.

What is recommended? Not sure what to do or what works?  Has anyone had success with the behavioral counselling?  His pediatrician has not recommended that either.

Our experience...we have not found a behavior plan/therapy/counseling that works.  The first Dr. that diagnosed DS at 5 (now 7) said that he was VERY Hyper and Impulsive.  He indicated that behavior therapy for him wouldn't work until he was 6th grade plus...  unless he was on meds (that worked).  For him, stimulants don't work (dark thoughts/hate talk & Tics) ..therefore no success in the behavior department.  We are struggling daily.

Hang in there..you are not alone!

 

psbml540377.3767824074What you're describing could be a rebound due to the medication wearing
off.

About the weight - I'd try adding a nutrition drink, like a Carnation
instant breakfast shake. Then he can eat just about whatever he wants
during the rest of the day. That's one good thing about ADHD - you
won't have to worry as much about an overweight kid no matter what they
eat.

My son's school thought he had ODD, but he didn't, he had ADHD that
was basically driving him mad. When we got the ADHD under control, he
didn't have the ODD type symptoms.

Has your doctor suggested non-medical treatments? My son did
fantastic with a schedule he could depend upon, with having physical
outlets, and access to quiet calm rooms when his ADHD started getting
ramped up. My son does do therapy where he learns to control himself
better, but it's most useful to him as a safe place to confess what he's
done and not create a blow up so he can forgive himself and stop the
cycle. Also check out the book The Explosive Child - it outlines a way to
teach a child to think about how relieve their frustrations rather than
letting them consume them.

I wouldn't stand for the doctor's refusal to adjust the medication. There
are other doctors out there, and there are other medications. I can see
the doctor's concern about his weight, but it's outrageous to me that he's
ignoring the fact that the current medication is not doing well enough
and not trying anything more. It would be like a doctor telling an
asthmatic, well, you're not passing out from your attacks anymore even if
you are having one every hour on the hour, that's good enough for me.

Your gut is telling you that it's not working as well as it could be. Trust
your gut, and advocate for your child. Find a pediatrician who specializes
in ADHD - it will make all the difference.

Good luck!

You know when his medicine is working he is better with his behavior but still not quite where he should be.  I just started the carnation about a month ago and hope it will help with his weight.  I let him have two to three a day.  He is just so active that he burns the weight off.  He eats more than some adults.  He is a very healthy eater. 

He is a very emotional child.  He will go from one extreme to another in a matter of seconds and everything is the end of the world.  Even on his medicine he's pretty emotional but not as bad.  Now he's started a new thing that he wants to go to a new home with a mommy that will let him do what he wants and I'm the worse mommy in the world.  It's very frustrating and it breaks my heart to hear him talk this way. 

The evenings are definitely the worse.  When he comes down from his meds he is unbelievably all over the board.  When we have company he's bad whether he's had medicine or not.  I think it's just too much stimulation.

The first doctor thought he might have bipolar disorder and sent him to a child psychiatrist to diagnose him.  The psychiatrist said it was just severe adhd he believed.  That was in South Carolina and shortly after that we moved back to Tennessee and his pediatrician here is not addressing our problems.  I think you're right and I need to try to find a new doctor.

Sounds like medication rebound. Different meds have different rebound effects on different kids. You never know. Try a different stimulant?? I agree with Corrina, if the doc is not flexible, get a new doc. You cannot get into the ODD thing unless you know this is not just mostly medication rebound, IMHO. Besides, that's is NOT a label you want hanging around his neck; certainly don't share that idea with anyone remotely involved with his school.

Also, my youngest is now 8, and gets like this, more so when she was 5, slowly getting better. Sleep is a big factor for her. Maybe check on him 30 minutes after he goes to bed and see if he's fallen asleep. Ask if he wakes up during the night. When there's an emotional outburst I have always made her go to her room to "get herself under control" or to "get some down time." I've been sending the message for a long time that she is responsible for maintaining control of her emotions. This was totally ineffectual at age 5, but now at age 8, she can go from an outburst to under control when I intercede.

I doubt cognitive behavioral therapy would work until teen years or older.Jessica N40377.4865277778This sound somewhat like my son at that age. We started out with ADHD and later other diagnoses where added. My son has sensory processing disorder / sensory integration disorder. I found this was much more the cause of his hyperness, and uncontrollability (don't think its a word lol). An OT picked up on this when he was being evaluated because his handwriting was horrible. When not medicated, I often described him as a pinball in a pinball machine. Bouncing and banging from chair to table to wall to sofa just to navigate through a room. He was tiring to watch. He was very easily frustrated and had a melt down over the tiniest perceived thing. Once meds were right the OT and behavioral therapy had a chance to work. If you can, read the book "Out of Sync Child by Carol Kranowitz.

I agree with the previous posters...it sounds like he's having rebound.  Rebound IS NOT something he needs to put up with!  It's completely unacceptable that the doctor seems to think it's ok to do nothing!   At the very least he needs to let him take the booster dose in the afternoon!

My son had horrible rebound on Adderall and nothing worked to soothe him when it hit.  It just had to run it's course.  At first, upping the dose helped some but it completely went away once we switched to Ritalin. I recommend going to a specialist (psychiatrist, phychopharmacologist etc)  They know best how to get these meds right. 

If his negative behaviors are caused by ADHD then the behavior therapy won't work until he's stabilized on the meds.  Nothing worked for my son until we got his meds right.  Once we did, the behavior techniques started to work!  Good luck and I wish you the best!