Metadate CD/Ritalin

[lovejud]

We started "A" on Metadate CD 10 mg Sunday and the only thing that I have noticed is that we have had times of hysterical outbursts. He had three such outbursts on Sunday--none of which were related to anger or frustration that I could tell. They were all related to more sadness or disappointment. Each resulted in about 30-60 minutes of crying, screaming, just hysteria. Since "A" is usually very easy to redirect this was unusual and I related it to the metadate. No issues Mon or Tues, but today he melted down over not getting to go with husband even though the rest of the family is staying home. And once again it was out of character crying--not temper tantrum crying--but just like he was severely disappointed and didn't know how to handle it. We saw his psychologist today and he said that maybe it was because "A" had a better ability to focus now and before his brain would have just been jumping on to the next thing and he wouldn't have registered the major disappointment as deeply. But taking medications he is able to focus and digest the emotion but at this point doesn't know what to do with it.

We started the Metadate after doing the first of our neuropsychologist evaluation. General Pediatrician prescribed it after doing a bare minimum of evaluation, but I waited until after additional testing to start because pscyhologist thought and I thought that most of "A" problems were anxiety driven. However, the preliminary results of the tests we have showed that he "scored off the charts for ADHD" (quoted by psychiatric). I'm interested to see the other results. I'm trying to push for full neuropsychologist evaluation but we had issues with Medicaid last year and we are trying to work around these for this year since it is still so early in the year.

Any pointers on Metadate CR? Psychologist thinks that because of "A's" high score on ADHD related tests that the lowest dose would definitely not be sufficient to control his school related issues. I haven't upped the dose yet; I'm not against it, just want to go slow.

And another question--I've had several people recommend Adderall instead. What experience do you all have?

 

[gcvmom]

Were the meltdowns towards the end of the day? I'm just thinking maybe it's a bit of rebound from the medications wearing off... It's really a little early to know for sure.

One thing about the stims (if you're worried about the dose being too high), if it's a straightforward case of ADHD, if the dose is too high it will make your child very quiet and withdrawn into themself. Whereas someone who doesn't have ADHD will just be very wired and jittery.

We have had experience with Adderall, and the short-acting version is what we started on years ago. From what I remember, it was o.k. But we switched to Adderall XR to get a single dose to last for the whole school day, and it eventually caused problems with aggression and irritablity.

We had the best luck for the longest time on Concerta. And now we're using the Daytrana patch with great success (I really like the flexibility it gives you for dosing -- you can take it off when you WANT the medications to wear off intstead of having to WAIT for them to wear off).

 

[smallworld]

What kind of tests were done to demonstrate that A was "off the charts for ADHD"? Questionnaires? Computer tests of attention?

Separating ADHD symptoms from anxiety symptoms is very challenging for the best of clinicians. According to a 2005 article in the New England Journal of Medicine, ADHD symptoms that overlap with anxiety symptoms include poor attention, fidgetiness, difficulty with transitions and phsyical reactivity to stimuli. The diagnostic dilemma, therefore, is that anxiety may be a source of high activity and inattention, and not ADHD at all.

To further complicate the problem, ADHD stimulants like Metadate CD can exacerbate pre-existing anxiety. So if A is experiencing more episodes of emotinal reactivity, it may be that the Metadate CD is causing his anxiety to rise.

This is JMHO, but I personally would hold off on any medications until I had the test results in hand and could seek a second opinion on what exactly the evaluaton reveals.

 

[LittleDudesMom]

I must say that difficult child had a terrible experience with "rebound" on metadate. I have it three days, but after my little boy (6 at the time) ended each of the three days crying, sad with himself and life in general, and banging his head against the wall because he was mad at himself, I pulled him off. It was the end of his K year, so we just waited until school started in the fall to put him on another stimulant.

I believe, that if you child is trully adhd, stims are like any other medication, some work, some don't. Hope you find some answers.

sharon

 

[Big Bad Kitty]

LDM is right. Some do work, some do not.

Tink got very weepy on Metadate. doctor switched her to Focalin, and on that she was very aggressive. After that he stopped stims altogether and tried her on Abilify. She is doing very well on that.

It really is a lot of trial and error. The good thing about the stims is that they exit the system by the end of the day (no weaning period necessary).