Adhd

[peggyfromwastate]

So... Struggling here.

Is this typical? My ds8 has ADHD and has been taking Intuniv since September. Intuniv is to mostly help suppress his tics from Tourette's syndrome. The Intuniv is supposedly effective in treating adhd, and while we did see some improvement initially, by December Luke was really struggling with focus. Tics are ok-- not completely controlled but ok.

Anyway, about 1 month ago he finally was treated by a child psych who recommended Ritalin. We started slow, and with just morning doses. We could really see a huge difference in how he behaved with the Ritalin. He was able to plow through school work easier, and he was less impulsive. However, when the Ritalin wears off, whoa nelly. He is sooooo far more impulsive and irritable and difficult than ever before. He switched to long acting ritalin which is a slow release over about 12 hours or so. When he comes down off of that, near bedtime/dinner, he's a hot mess.

In tonight's breakdown (yes, they happen nightly) he has tears streaming down his face, and he tells me that he doesn't like the Ritalin because he feels "slow" with it and like "half his brain doesn't work." He has major self esteem problems, and says that Ritalin makes him boring and not fun and slow for tag at school. I told him that I'd call his doc and see about maybe switching to a different med.... And his eyes lit up... But, I just do not know if I can go there. With no add med on board homework time will revert to the horrible battle it was...

The Peds neuro doesn't think he should be on a stimulant med. the ped psych says current research shows it's ok for Tourette's kids to go on stimulants.

Ugh.

This year has been craptastic.

At least ds enjoyed his afternoon playing with the neighbor kids. The neighbors who are pretty much his only friends and are moving in 2 months.

[diggitydot]

Maybe ask about Strattera? It's a non-stimulant and has been a complete lifesaver for our little ADHD dude. He's never complained about feeling "slow", but it makes him a little tired if we've just upped the dosage.

[peggyfromwastate]

The peds neuro wants to try strattera. I have a feeling the child psych will want to take a wait and see approach...

I left a VM for the psych so hopefully he will shed some light on this.

Getting into counseling/therapy is also a monumental hassle. So hard to find someone.

[diggitydot]

I can't speak for anyone else, but Strattera has been a huge help in our house. DS feels much better about himself and doesn't seem "foggy" like some meds can make ADHD kiddos. He's still "himself", just better capable of using his own coping mechanisms and practicing his self-control. It does peter-out towards the end of the day, but we haven't experienced any meltdowns due to the wearing off.

I have no idea about contraindications for your little guy's other health issues, though.

[Gwendolyn]

We've been going through trials as well. We've just started in Feb, so you probably know more than I do. The Focalin (sp?) has been working well for DS1 (9yo), but it's not always great in the evenings. He did go through a phase where he would say he is feeling "alone inside" at night. Counseling/therapy has been a big deal for us. It helps give all of us a plan for when things are not working and with the medication, the plan actually sticks. Nothing helpful to add, but I understand what you have been going through. It is so exhausting...emotionally...but also just logistically. I have done nothing but take kids to doctor's appointments, school meetings and chasing pharmacies to get what we need in a timely manner. Not to mention competing perspectives on treatment options. I keep getting told that finding the right combination can take a while. I hope you get a lull in the process soon.

[diggitydot]

It can take a while, even when you find a med that you like.



Hang in there. It's a lot of one-step-forward-two-steps-back, but there will be movement and improvement. Promise.

[Phoebe]

I feel for you all. It is hard to find the right meds and sometimes they stop working or have bad side effects. My daughter is insane when the meds wear off, which is usually right before bedtime. She gets very hyper and has the urge to scream which isn't conducive for a sleeping baby in the next room. Focalin is a cleaner version of Ritalin. DD takes a small dose to get her through the day and we just added a tiny dose DD2 to for a jump start because her normal meds, Daytrana (a patch) is taking too long to kick in. I love the convenience of the patch for DD. It gives her flexibility if she needs a shorter dose or a smaller dose. It doesn't give her side effects of a stomachache like other meds did. We still struggle at night like your son.

[peggyfromwastate]

It's just very heartbreaking!!!

He has described feeling "foggy" on this med too--- Ritalin may not be a great fit.

I was unprepared for the big mood swings--- since he just started the slow release form April 14, the mood swings have gotten worse and impulsive behavior after the meds wear off has increased. As has his feeling that "no one likes him" and "why am I such a freak." And he's lost 3 pounds and he's already so skinny--- he's down from 63 lbs in Feb to 60 pounds and he's grown taller....

This is a complex issue. Thanks for the encouragement fellow travelers!!! Cheers!

[Meenah]

Is there something short acting that he could take a small dose of to get through the afternoon / evening? Or an espresso!

[Thirteen]

Ritalin made me feel like everything was in slow motion, but it also made me tachy. I stopped taking it very early on, and didn't try any new meds until DS was weaned.
I started on adderall xr, which I didn't like because it wore off around "zero hour" at our house (dinner, bedtime routine with DS), do I asked to switch to regular. I only take one when I know that I'm going to have a hard day focusing.
Does your school have a nurse that can administer meds? I found that the best time for me to take something is around 10:30am -- I still have coverage through dinner/DS's bedtime, it doesn't keep me up at night, and it gives me a chance to eat comfortably in the morning. (Most meds trash your appetite, or can even make you feel nauseated while in effect).

As you know, adolescence is right there on the horizon, and that can also compound sx/feelings of awkwardness. He does have a lot on his plate - balancing meds, schoolwork, social pressures, etc. I firmly believe in a drug/counseling combo, since ADHD is comorbid, and growing up is hard enough. I wish you good luck in finding a therapist, and in the mean time, assure him that just because others don't openly talk about their troubles certainly doesn't mean he is the only one who feels this way, or deals with ADHD.
I'm sorry you are going through this rough spot.


Sent from my iPhone using Tapatalk

[Deebs]

In our house, finding the right meds was really tricky, too. DH can't do generic anything, Aderrall (though I'm not sure he could even get it here anymore), Ritalin SR, or any of the non stimulants he tried. Ritalin with a funky dosing is all that has ever worked for him. I know how hard it is with a husband working through med trials, so I can only imagine how tough it might be with a kid. Hang in there.

[peggyfromwastate]

As an update-- we are about 3 weeks in on our switch to strattera. He is going much better. His teacher reports that he isn't improved in focus, but I believe she is not paying attention. Her technique has been to pair him up with a "good student who helps him focus." As one of those good students in my day... I resent this bc it is a disservice to the high achieving kid as well!!

Regardless-- we see he has improved at home with concentration.

When school starts again in the fall we might have to add some stimulant in low dose--- but hopefully it will be ok...

[HouseofWool]

My parents use a slow release med in the morning for their adoptive son and he gets a booster around 1. Then, they end up giving him a depressant at 6 so that he can sleep. He also had several comorbid dx and it is tricky as heck to keep it all balanced.