difficult child, Male, 11 yo, ADHD, ODD, (poster boy) HELP

Discussion in 'General Parenting' started by lmd02814, Apr 10, 2009.

  1. lmd02814

    lmd02814 New Member

    I found your site last night. What a god send. I'm grateful for all the posts. We need a medication for our difficult child (finally breaking down) to combat ODD stuff. He's currently on Focalin for ADHD -- works well 'til it wears off then LOOK OUT! YIKES! Major BS'er, brat, liar, etc. doctor prescribed Lexapro 5 mg. yesterday to mellow him out. I asked about Wellbutrin (for dopamine effects). It made more sense to me. doctor disagreed. Does anyone have any input or experience with-medications for the ODD symptoms. His behavior is bad. When on the Focalin, He's a great kid, smart, funny gifted athlete. But it messes with-his eating and sleep. He's on Clonodine too at bedtime. The ODD behaviors are destroying his life. Suspended already from school (6th grade), no friends, low self-esteem. He's finally becoming aware of how lousy his life is and feels bad and remorseful when brat fit is over but he can't shut the mouth, especially with-authority.
     
  2. busywend

    busywend Well-Known Member Staff Member

    Welcome!

    I do not have any experience with Focalin or Lexapro. Others will though.

    Your son seems to be aware of his behaviors. Have you ( or therapist) tried giving him some tools to use when he gets this way? Sometimes a code word from a teacher or even just getting up to go to the bathroom can work.
     
  3. helpangel

    helpangel Active Member

    Welcome, this is a cool site isn't it? What you described sounds similar to what both my girls experienced with stimulant medications- rebound is what its called and it can be very hard to deal with. Have you had a neuro psychiatric evaluation done for this child? If after more testing it is still believed that adHd is the source of the problem you might want to look at some of the non-stimulant medications for adHd like Strattera, this has helped many kids who can't handle stimulants. With my girls they didn't respond well to any kind of treatment for adHd because they didn't have adHd it was a symptom of something else, in their case we needed to address the mood symptoms first then see what was left after mood symptoms were under control. Hope this helps.
     
  4. TerryJ2

    TerryJ2 Well-Known Member

    Hi Imd, welcome.
    I'm glad you got some info from helpangel because I'm not versed on those medications.
    I'm also glad that your difficult child shows remorse after one of his episodes--that's a step in the right direction.
    Are you in family counseling? If not, I would definitely go. He needs skills in anger management, impulse control and planning. You will be amazed at the things you learn! I know I always am.
     
  5. smallworld

    smallworld Moderator

    No medications treat ODD specifically. medications DO treat the underlying disorder driving the ODD behaviors. So the question is what is fueling your difficult child's ODD behaviors.

    Are the ODD behaviors just occurring after Focalin wears off, or are they occurring during school (because you said he was suspended from school and has no friends)? How long is Focalin lasting? There is an extended-release version known as Focalin XR, and some kids also take a regular-release dose of Focalin after school to help with homework.

    If anxiety and depression are fueling your difficult child's ODD behaviors, then Lexapro might help. But if it's a mood disorder on the bipolar spectrum, Lexapro could make things worse by destabilizing your difficult child's mood. Lexapro has helped my daughter's anxiety and depression, but she doesn't have ADHD (or ODD).

    Wellbutrin is not generally used in addition to a stimulant like Focalin because both work on Dopamine. Wellbutrin is typically used when depression is making someone inattentive. My own son takes it for depression and does very well on it. But he takes no stimulants because stimulants tend to make his mood worse.

    In terms of sleeping, many of the kids here have problems sleeping because of their medications or because of their disorders. All three of mine take something to help them sleep. If you don't like Clonidine, you could try Melatonin or Benadryl, which are both "milder" solutions. In terms of eating, is he falling off his growth chart? Is his pediatrician worried about his height and weight?

    Hope some of this info is helpful.
     
  6. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Hi there.
    I was wondering if you're satisfied with the diagnosis or if you think maybe there's something going on that was missed. Are there are psychiatric problems on either side of his family tree? Any mood disorders or substance abuse? Did he have any early delays and does he have any trouble socializing?

    ADHD/ODD combined is very often something else. Who evaluated him? My son was misdiagnosed so many times, and he didn't get better until he was re-evaluated intensively and tested for all disorders by a neuropsychologist. I'm always "iffy" when I see the ADHD/ODD diagnosis. Stimulants can make certain problems worse. And no medications at all can mess with certain disorders too. Other disorders require certain interventions that you just don't get when the diagnosis. is just ADHD/ODD. Your son sounds very different. Can you describe him in more detail? Has he ever had an intensive evaluation with testing?
     
  7. Marguerite

    Marguerite Active Member

    The wearing-off reaction you describe sounds like rebound. To me, rebound feels like all the difficultbehaviours that were kept at bay all day by the medications, have now all slammed into us at once. Talk to the doctor about it.

    The ODD - you can get something that looks a lot like ODD, purely from the way we try to discipline a kid who can't be managed in the usual way. The common technique, and the way so many of us were raised, is to tighten our control when kids seem to be OUT of control. But while this is brilliant for osme kids, for a lot of others and especially those with a number of underlying disorders, this is the worst thing you can do.

    Also, a lot of the time we are trying to control too many behaviours at once with too many causes, or we're trying to control too tightly, and the kid simply isn't capable of holding it together.

    If, for example, you try to manage issues which are primarily rebound, and you're trying to manage them with being stricter with the discipline, you're punishing him for raging, for bad language, for yelling at you, for tantrums, all at the end of the day when his control is shot to pieces - then you will CREATE something that is indistinguishable from ODD in appearance.

    You can turn this around. It can be done. It can take time, and you have to let a lot of things go, but frankly, learning to let a lot of things go at least for a while is the easier option. It's definitely easier than slamming your head into a brick wall, which is probably what your current scenario feels like.

    For the guidebook on how to do this, and how to really understand your son so you can help him learn self-control, read "The Explosive Child" by Ross Greene. I swear, you will be recognising your son in the first few pages.

    Welcome to the site, there is a lot more I could say but I won't overload you for now.

    Marg
     
  8. crazymama30

    crazymama30 Active Member

    You have gotten some great advice, just wanted to pop in and say hi. What kind of a doctor is seeing your son?
     
  9. lizanne2

    lizanne2 New Member

    Welcome.
    And yes, you have gotten some great advice. Form A great site.

    My 15 difficult child has been able to turn around his behaviours but it has been at a slow pace. I will say that the change seems to be a good and enduring one.

    It is true that the normal hard core discipline didn't work for my difficult child. We worked as a team- difficult child, Special Education trachers, therapist, counsellor- to create structure, understandable expectation, appropriate and relevant consequences and difficult child particiapted as best he could in counselling to provide him with better insights and coping techniques.

    in my humble opinion, a smart difficult child sees through all the normal discipline techniques.

    My difficult child's medication went oiin this order--- zoloft 3rd grade then added concerta 4th grade then added risperdal in the 6th grade. It all worked all thought the dosage of zoloft has been the trickiest to master. Good luck
     
  10. lmd02814

    lmd02814 New Member

    Thank you all for the insight. It's obvious that no one knows it like those who live it and live with-it. Marg, you seemed to have hit the nail on the head. I'm ADD myself and was given Concerta in January after being taken off Adderall (jaw clenching). I, along with-others noticed that I became very irritable later in the day -- hmmmm... Aha! I've cut my dose in half and am going back to difficult child's pediatrician Neurologist and seeing if there's an alternative to the amphetamines for awhile for him. Whenever there's trouble with-him, it's later in the day when he medication is gone, then look out. He's always been very sensitive to any medications. He began Lexapro two weeks ago. It seemed to have worked (improved that simmering rage) for the first week but not so well after that. It's 5 mg. She may up that dosage. I'd rather do Lexapro and get him off Focalin because I do believe many of his reactions are rebound based. I appreciate any further input. I'm buying "The Explosive Child" this week. Thanks
     
  11. Marguerite

    Marguerite Active Member

    Amphetamines as a group aren't necessarily all bad. The two main ones, ritalin and dexamphetamine, can give different reactions. Our kids got rebound on ritalin but not on dexamphetamine. We now get our dex made up into sustained-release form by a compounding pharmacist.

    We've tried alternatives, but for us they don't work. However, it's d ifferent for different people.

    No management treatment is going to be perfect; you need up doing the best you can with what you've got. There is, unfortunately, no magic pill that akes it all go away and turns yourchild into an angel. And even if there were - there is still rthe long-term fallout of the probles your child has been having, which hve imprinted onto the child's personality (the low self-esteem, the "I can't do anything right, everyone hates me and always yells at me" stuff, the slower emotional/social maturity - a bigpackge) which you still have to deal with, that since it is not related to medications, no medications can really fix the underlying problems).

    medications can help, but there are also a lot of personal therapies you need to put in place. And when I say "you" I mean the family (including the child) have a lot of work to do. Therapists can help, but all they can do is point us in the right direction and perhaps add a temporary guiding hand at times, to make sure we are staying on the right track. The hardest work is generallyhaving to be done by the child him/herself. For the parents, we always feel we are worknig even harder on this than our child, but this isn't a competition where we're on differentsides. The child's goals and the parents' goals are the same.

    So you find what helps, you all work as a team and keep an air of cooperation and mutual support. Don't expect miracles, be glad of every improvement and keep written notes so you can look back later on to see just how far you've come.

    When you're climbing a mountain sometimes you have to kep your foot firmly on the path so you can safely put one foot in front of the other and not fall. Your legs feel tired, you get hot and sweaty, you feel you're going nowhere. If you look up to see the top of the mountain it always looks further on - you think, "We'll be at the top when we pass that next rock," but you get there to see that the mountain continues. It's when you occasionally stop for a breather and look back at the view below, that you can see how far you have come. And that is what gives you the heart to keep going.

    Marg
     
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