Medicating

[suzie62902]

I posted a few months back about my son being diagnosed with ADHD by his pediatrician. Since then we have been seeing a behavioral therapist. She thought that he could be bipolar as well as adhd. She gave us several things to work on with Ayden to help some of his behaviors. We have tried many things with little to no success. He attends a mini camp (preschool setting) 3 mornings a week and has been having problems there. Continually running around the classroom, he will not sit when he is suppose to, will annoy the other kids and just not listen to the teachers. There are days where he will have multiple time outs becuase he just can't calm himself. The teachers have a hard time getting him to even sit in a time out. At home, he is not only hyper active, but is extremely explosive and can get physically violent with his sister and me (especially when I tell him no or tell him he needs to go to time out). Anyway, after a few months seeing a behavioral therapist and no progress...we met with a psychiatrist yesterday. It was the BT's suggestion, I think she wanted a second opinion on a diagnosis. The psychiatrist sees mainly ADHD, but the possibility of a mood disorder along with it. He wants to treat the ADHD and see how he changes and then go from there if he needs something further for a mood disorder. The rx that I have is for Focalin XR, is anyone familiar with this drug? He also wants Ayden to have an EKG done prior to begining the medications.
I am feeling really guilty. Putting him on medication was the last thing I wanted to do. But I really feel that this is a last resort. We are going to behavioral therapy and I have drastically changed his diet with absolutely no success. He is starting kindergarten next month and I really want this to be under control so that he can do as well as I KNOW he can.
Anyway, if any of your kids have been on Focalin xr, I would love to hear about it. I am afraid of Ayden losing his spunky personality...that is the last thing I want to happen.

 

[BusynMember]

First of all, my son was put on every stimulant, including Focalin, and it made him even more hyper & also mean.
I have a few questions: How is his early development? Speech? Can he interact with other kids? How is his eye contact? Does he ever seem like he is in his own little world? Does he know how to play with toys? Does he like to cuddle? Any psychiatric problems on either side of the family tree?
From my own experience, Ayden is too young for anyone to know for sure what is wrong--diagnosing is a fluid, neverending process. But it's always good to have a neuropsychologist evaluation done. I like them a lot better than Psychiatarists because they run actual tests, they don't just listen to you and watch the kid for a few minutes and pull out a prescription pad. Your child may be hyper for reasons other than ADHD. I like the long, intensity of a neuropsychologist evaluation. They sort of covers all the bases and can get as close to the truth as you can get with a little one.
Sometimes interventions work better than medication. I did medicate my three year old son and I'm sorry I did. He was misdiagnosed and didn't need medications--he needed interventions and a different way of understanding the world. in my opinion it's very good to be cautious about medications--and it's also smart to see a neuropsychologist because they are more intensive and careful with their testing and diagnosing. Good luck.

 

[suzie62902]

First of all, my son was put on every stimulant, including Focalin, and it made him even more hyper & also mean.
I have a few questions: How is his early development? Speech? Can he interact with other kids? How is his eye contact? Does he ever seem like he is in his own little world? Does he know how to play with toys? Does he like to cuddle? Any psychiatric problems on either side of the family tree?
From my own experience, Ayden is too young for anyone to know for sure what is wrong--diagnosing is a fluid, neverending process. But it's always good to have a neuropsychologist evaluation done. I like them a lot better than Psychiatarists because they run actual tests, they don't just listen to you and watch the kid for a few minutes and pull out a prescription pad. Your child may be hyper for reasons other than ADHD. I like the long, intensity of a neuropsychologist evaluation. They sort of covers all the bases and can get as close to the truth as you can get with a little one.
Sometimes interventions work better than medication. I did medicate my three year old son and I'm sorry I did. He was misdiagnosed and didn't need medications--he needed interventions and a different way of understanding the world. in my opinion it's very good to be cautious about medications--and it's also smart to see a neuropsychologist because they are more intensive and careful with their testing and diagnosing. Good luck.

Early development was pretty much right on. He has always been extremely smart for his age. He can interact with other children very well. Eye contact seems fine. He does "zone" out some times. He will space out when he is suppose to be listening and he does appear to be in his own world. Yes he knows how to play with toys, and he does like to cuddle ocasionally (when in a good mood). I really don't have much doubt about the diagnosis, I had suspected it from a very early age (before 2). When he was younger he would jump from one thing to the next, didn't play with one thing for very long, extremely active. Things have just gotten progressively worse from there.
Family history...well...he definitely did not inherit great genes, that is for sure. I suffer from anxiety and mild ADD. My husband suffers from depression and ADD. My mom-depression, my dad-Obsessive Compulsive Disorder (OCD), my older brother-bipolar and ADHD, my younger bro-Obsessive Compulsive Disorder (OCD). My husband's brother has ADHD as well.
I honestly do feel that medication is a last resort, but I do feel that we are there. It is the last thing I wanted. But we can not keep going like we are going. It's not fair to the family as a whole, and most of all, its not fair to him. He doesn't like being the way that he is. He has told me multiple times that it is so hard for him to stay seated when needed, and it is very hard for him to stay focused and pay attention and that he doesn't mean to do the things that he does. I do believe that he does not like that he is this way. I want to give him the best chance for success going into the school year.
The only thing that I am worried about is the chance that the medication could make his "moods" and anger worse. The psychiatrist we see is not usually quick to prescribe medications, he came highly recommended, the behavioral therapist works with him with many of her patients, medicated or not.
I do however like the idea of having a neuropsychologist evaluation, that is something that has not been brought up to me, nor did i know was an option. What kinds of things do they do?

 

[Big Bad Kitty]

Hi!

My daughter (who was diagnosis'd ADHD and ODD) was given first Metadate and then Focalin. The Metadate made her very weepy, and the Focalin made her angry. There are different reactions to different drugs by different kids. Your child may do just fine on it. The good thing about stims is that they do not remain in the system for long. If you give him the Focalin for a few days, and you notice a bad change, you can stop right away and by the next day it will be out of his system.

Medication is something that most of us do not wish for our kids. Sometimes it is necessary. And when dealing with mental issues, a lot of it is trial and error.

Best of luck to you!

 

[BusynMember]

A neuropsychologist evaluation is hours of intensive testing for every disorder out there. I highly recommend it. ADHD behavior can be seen in many disorders--he may not even have it, even though he's hyper and has trouble sitting.
We didn't really know what was wrong with my son until the neuropsychologist report. You can find NeuroPsychs at university and children's hospitals. They tend to spend more time with the kids and observe more and actually run tests. No other professionals get that indepth. Unfortunately, ADHD/ODD often isn't...but it IS often the first diagnosis., especially if a very intensive evaluation is not given. Good luck.

 

[susiestar]

Medicating is an extremely personal decision for a family to make. We decided to medicate our difficult child (Wiz) at age 7. It took us 4 years to get to a doctor who would even consider it. We gave the first dose of stimulant right before a soccer game.

EVERYONE noticed the difference. He could stay in his area, concentrate on the game, and not only played the best he ever had, he had more FUN than he had ever had. After talking with him about how he felt, we decided to keep him on medications.

From that age I spoke with him very very frequently about the dangers of mixing his medications with drugs - even if the "drugs" are medications prescribed for another person. While he has his problems, hejust this weekend told me he thought drugs were dumb, and that with his luck he would end up dead within 30 mins of taking a drug. I did NOT tell him the 30 minutes, but that is what he believes. He takes his medications with no problems.

I really think that he takes his medications now because he knows they help him function. He also knows that if he talks to us about any medication making him feel bad, strange, whatever, we will talk with the doctor and advocate hard for a medication change. If we hadn't done that throughout the years then I think Wiz would refuse medications.

Your son is much younger (Wiz is now 16), but you have many of the same questions and problems we had. Stimulants are great in many ways. They are one of the few classes of medications that you see results right away. First dose rather than the 2-3 months to get to therapeautic dose and then 6 weeks at therapeutic dose that some medications require. You will be able to see what kind of changes happen right away.

And if the changes are bad, you will be able to stop the medicine quickly.

For some children (and adults) they simply do not have the same brain wiring the rest of us have. They need the stimulant to help their brain and body synchronize to work together. Some kids need other medications. It takes a LONG time to get the right medication combo for many kids.

I wish you much luck finding the right treatment (medication, therapy, mix of the 2, and even other things).

Susie

 

[Marguerite]

We've been where you are twice before. I don't count easy child 2/difficult child 2, her presenting problems were different. But with both boys we had tried diet, we had tried behaviour modification - nothing was working.

difficult child 1 was 6 when he started stimulants. The difference was great. He wasn't perfect, but he was coping a lot better. What was really important - HE felt better about himself and realised it wasn't his fault. That made a HUGE difference.
We did have problems later on with aggression and black moods but this was as thr medications were wearing off each day - it was as if all the behaviour that had been controlled all day came out in one big rush, like a dam bursting. It was rebound, we later discovered.
Changing to a different stimulant fixed it. No rebound at all on current medications.

difficult child 3 - he was 3 years old when we started him on dexamphetamine. And yes, we copped heaps from people about it, but what we saw at home was almost miraculous and so we felt good about sticking to our decision.

Before medicating the kids - I felt as you do. But after seeing the dramatic improvement, I was happy to continue.

Temple Grandin calls it the WOW factor. If you try something and notice an amazing improvement, then chances are, it's the right decision. But if you notice problems, or maybe nothing dramatic at all (barely negligible) then you go back and question whether it's worth it.

Your child's personality should be fine. If anything, it should make it easier for the child to be his true self because he won't be fighting the ADHD or whatever is causing his difficulties interacting with the world.

And as others have said, the action of stims is short, it washes out of the system quickly so if it's not the right decision, you can go back to aquare one without too much trouble.

The doctor doesn't medicate easily, you say. That is good news. So if he's now recommending medications, then chances are he really thinks it's necessary.

Don't see this as a failure, or admission of defeat. Think of it instead as you having made careful consideration and meticulous exploration of all other options. This is simply a different direction, another way to try to help your son.

Marg