Musings about medication

Discussion in 'General Parenting' started by Malika, Sep 17, 2012.

  1. Malika

    Malika Well-Known Member

    Well, it's funny how things change. This time two years ago, I was sceptical about J having ADHD, really didn't want to saddle him with a label and was quite firmly opposed to the idea of medicating children. Today I am absolutely sure J has ADHD, though he has a lot of potential and is good at rising to the occasion when he needs to. I'm also pretty sure that he has - though I'd love to be wrong on this one - some form or forms of learning difficulties, seeing what is happening for him with reading, which he is just not relating to at all as yet.
    And medication... well, of course I still don't like the idea of it and am very frightened of the side effects of loss of appetite, stunted growth and (most of all) difficulty getting to sleep. Not to mention the rebound effect. But we have now had so many incidents where J's impulsivity causes problems for himself and others, so many incidents of rejection and misunderstanding, so many dents, doubtless to his self esteem, that really I am open to it now if medication would improve his quality of life.
    Of course I realise that there is the whole question of which stimulant and what dosage, but what could be realistically expected might change if J were to try a stimulant in due course - he is still not 6, the age at which it is prescribed here.
     
  2. TeDo

    TeDo Guest

    My difficult child 1 can't take stimulants so we do the non-stimulant. He had loss of appetite for the first month or so then that went away. They have never interfered with his sleep and there is no rebound. It works wonders for us though others here have stated otherwose in their case.

    Anyway, I put difficult child 1 on medications for his ADHD when he was barely 5. I hated the idea but I didn't like the "quality" of his life having to deal with symptoms medication free. Things improved drastically because they slowed his mind down enough to be able to think things through BEFORE doing/saying them. It also helped with school, he wasn't "bouncing off walls" and he could concentrate on his schoolwork.

    I had decided that quality of life was more important than my bias. The decision about medications for young children is one of the hardest decisions we have to make. There are so many medications with such a wide variety of side effects that it really is scary. I am just glad it worked out ok for us.
     
  3. InsaneCdn

    InsaneCdn Well-Known Member

    Depending on the nature of the ADHD... for K1, medications "slow down" the reaction time so that he can stop and THINK before he REACTS - impact on that impulsivity. K2 doesn't have impulsivity. The medications buy her time to "park" the random thoughts that come floating through her brain and distract her from the task at hand... without it, she's gone in a thousand directions and nothing gets done.

    I really don't think medications "solve" the problem, per se... but they seem to "buy brain-cycles" so that the person has more ability to choose to act differently. Which then reduces problems... AND provides the ability to LEARN to the basic skills that are missing - like "think before you speak" etc.
     
  4. whatamess

    whatamess New Member

    Malika, there is a wide range considered normal for acquisition of reading skills. J definitely falls within the normal range at age five if he can recognize most letters, know the sounds they make, and can write a few. I believe children within 'normal' parameters learn to read from age 4-7. Obviously, three year olds who are reading are slightly out of the norm and hence the term hyperlexic and if your child is struggling to read and sound out basic words by age 8, then there is likely to be some dyslexic impairment.

    Regarding medication, I was definitely (and still am with certain medications) as concerned as you are about trying this with my son. Please don't let a fear of side effects stop you from attempting a small dose of Ritalin or the equivalent. It seems that your decision to try medications with J is almost like someone who intensly fears heights and yet is at the door of an flying plane ready to skydive for the first time. I have a feeling that once you took the leap it would all be very anticlimactic. What really is preventing you from trying a medication with J? I am quite sure you will be on top of the efficacy of the medications and will discontinue their use if anything remotely unpleasant presents or if the medications have no effect.
     
  5. Malika

    Malika Well-Known Member

    He knows a handful of letters, seems not to remember the rest however many times they are repeated, knows the sounds of a few of them and can write hardly any. I'm personally not worried but he is far behind what the other children in his class (all four of them) can do. I would be happy to leave reading until age 7 but the system demands otherwise of course.
    As for being scared of the medications... well, I think they ARE scary in terms of young children and a developing brain. Really a big decision, I think, not something to be entered into lightly. A bit like marriage :)
     
  6. InsaneCdn

    InsaneCdn Well-Known Member

    If it's any consolation... K1 started Ritalin at age 6, K2 at age 5. K1 had a bit of rebound, especially at lunch - not nearly so much on Concerta. K2 never had rebound.

    Stunted growth? If that happened at all, then I am thankful (imagine about 200 lbs of teenage male... and he is NOT overweight...) I expect it's related to the dosage.
     
  7. HMBgal

    HMBgal Active Member

    I could have written this post about my grandson. He turned 6 in July and he's now been on Concerta for nearly a year. We all literally cried when he swallowed his first pill. We were full of sadness, regret, fear, and all the other stuff that goes along with the journey. We tried everything the docs, teachers, parents, me (Special Education teacher), Explosive Child skill teaching, Raising a Thinking Child workbooks , behavioral specialists, play group therapists--the usual players--could think of and nothing worked durably. We all swore we would never push a pill down a child's throat. We read the horror stories, we read all about all the drug-free therapies that work wonders, read the research about the long-term effects.

    All of his behaviors didn't get in the way of his academic learning, (hooray for a 504 plan after being suspended 8 times in two months, and only being allowed to be in school 90 minutes a day). We finally got him back in school full-time after the winter holiday. A half-year gone, but he finished the first grade curriculum at the end of his kinder year. He's so strong in reading, math, science, etc., that the psychiatric that tested him said to keep him challenged and let him go ahead as fast as he wants. His teacher was great at differentiating the curriculum for him so he was still part of the class, but working at his own pace. Socially was another story, and that's just starting to turn around now.

    Are there side effects that make us sad? Yes. He used to enjoy eating and sometimes he'll get excited about something on his plate that he used to like, only to push it away because "my tummy doesn't feel so good." Other times, he'll inhale huge slices of pizza, bowls of pasta, mounds of fruit. He's still growing (his jeans are getting too short at a pretty good clip), he does great with gymnastics, and like TeDo said: he can slow down enough and keep the impulsiveness at bay long enough to LEARN SOME COPING AND REASONING SKILLS. Yes, I shouted that because that, above all else, has made him proud of himself and given him some confidence.

    He takes the pill when he gets up, eats a huge breakfast and eats a later dinner after the pill has worn off. Mom and Dad, and Grandpa and me, let him eat until bedtime if he wants to. The drugs are gone by then, sometimes a rebound, sometimes not, and he sleeps great. Did we want him on drugs? Absolutely not. What is it the one thing that we threw into the mix that made a drastic difference? medications. It worked for him, but I know it doesn't for everyone. He seems a little anxious and tic-ey at times, which we hate, but you have to look at the big picture, talk to lots of people, do lots of research, and make your decision. It's so hard, I know it is. And I know that stimulants are disastrous for some kids. We were pretty sure we were dealing with a straight-up case of ADHD, so we felt that the risk was worth taking. He started at a lower dose and we didn't see any difference. He's now at 37 mg.

    He has a one-on-one aide at school, but she hasn't had to do anything for him this year and they are thinking of fading her by the winter break. And the day we'll really celebrate is when he can stop using the medications. But, it may never happen, who knows?

    There's lots of advice on here about this that gives both sides. But when my grandson's first grade teacher brought us in a week or so ago, she asked "What has made the biggest difference in his behavior?" Mom and I both hesitated because we really didn't want say "The medications," and hadn't really thought of it that way, but I think in his case, it's true. It's given his brain the time to slow down, process, and learn to solve his own problems with all of the other tools we've been using.
     
  8. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I'll give you my three experiences with people in my family, including me, that were diagnosed at one time with ADHD. Please understand...it is very hard for parents to do the diagnosing. And learning disabilities are still there with or without medication.

    1/Myself: Ritalin gave me a speed reaction. First I was flying then it started wearing off and I got very depressed. The depression lasted a long time. I tried it one other time, maybe at a different dose (I often forget about this second attempt) and it literally put me to sleep. Yes, I fell asleep at work...lol. I did not see it helping my concentration. I'm sure that, along with all my other "stuff", ADHD is in there somewhere.

    2/Sonic took every stimulant that exists. Each one made him mean and aggressive. The worst offender was Adderrall. I would be very leery of Adderrall. Adderrall is the ADHD drug that is most abused by teenagers who are looking for an ADHD stimulant to snort. We had to take Sonic off the stims. They were horrible for him. And he was on low doses to high doses. It was all the same...mean and aggressive, which he's not.

    3/My sixteeen year old daughter Jumper who has diagnosed ADD (shse was quite extensively tested) asked me if she could go back on Vyvanese this year because she has a very hard schedule and struggles with concentration and memory. She is been on a small dose since the beginning of the year. So far, so good. No side affects on the low dose and says school has been ok (meaning her classes). Now Jumper has ADD without the hyperactivity and she isn't an impulsive kid. We don't see a difference in her at home.

    4/My grandson is probably ADHD. Nothing else fits him so far, except possibly some sensory issues. He does not appear to be Autism Spectrum Disorders (ASD). So far it is a NO WAY for medications from both Dad and Mom. I don't really want to see him on medications either at only four. He is bright and can learn...I suspect it won't even come up until he is in kindergarten, and that's only if t he teacher brings up problems.

    You are right to go slow. You need to explore possible other problems that J could have (he could have an ADHD mimicker) or the stims may make things even worse. But, say, Ritalin is worth a try. it is fast in, fast out so if you don't like how he is on it, you can just quit giving it to him.
     
  9. Anxworrier

    Anxworrier New Member

    Energetic grandma...I wish I had your energy! My difficult child son is almost 13 and I have had ups and downs with him since he was two or three. When he was about five his explosiveness got bad and I started researching inflexible explosive information from dr Greene. We tried therapy which I don't think did much. We tried an anti dep for a very brief time and he started refusing to take it. Now in seventh grade he is really difficult regarding homework. Lots of missing assignments and lying about whether he has homework. I have a mtg at school Tomorrow morning I'm terrified about because he will get defensive and lie to them. I'm sick with worry all the time. I want the school to start some testing but am afraid to have him refuse to cooperate. ANd I feel like if I try to take him somewhere for testing he will be so mad and defensive that it'd be useless. I sometimes wonder why I didn't try add medicine earlier when I still had some control over him. I fel like now that he is preteen, kinda helpless. If I had a kid who would cooperate, I would gladly give it a go.
     
  10. bigbear11

    bigbear11 Guest

    Medicating is a tough decision. It was hard for us and I work for a Pharma company and actually work with physicians regarding mental health medications including ADHD medications. So I knew ALOT about them, the safety, etc. But still... when you are talking about your child...that is a totally different decision. The ADHD medications didn't bother me very much (because I knew she needed them)... but the first time we gave TRex something more ... I cried.

    That being said... I think everything is a matter of degrees. TRex had to have medications (she is on Strattera, Kapvay and Lexapro). She is VERY ADHD. We tried during a summer a few years ago to see if she could go without. Suffice it to say the answer was a resounding NO! She couldn't even concentrate long enough to write her name on her Grandad's birthday card. It was sad really... she knew something was wrong. Other kids are less severe and may be able to function better. In that case, I guess it does become more of a "should I or shouldn't I type of scenario". To me the main thing is what you said in your post and what others have said...it is about "quality of life". TRex knew she was different (in a negative way) and being on medications has really helped her self esteem... that makes it worth it for us.

    The stims are either a godsend or failure, very seldom in the middle. They have been around a very long time and have a very clean safety profile in healthy kids. They are in and out... you will know within a few days if one is going to work or not. The ones we tried didn't work for us as we had pretty significant rebound. However, we are going to try again since we have the Lexapro and Kapvay onboard. Maybe they will help even things out for her becuase she still struggles to pay attention in school (at least we have the hyper piece finally under control!)

    You have to make the decision but if J really NEEDS something then the right medication can make all the difference in the world for him.
     
  11. Steely

    Steely Active Member

    Hugs malika, was just thinking about you today....I have faith and confidence you will do what is the very best for him. I know it is really hard. Email me....
    Hugs
    A.
     
  12. Californiablonde

    Californiablonde Well-Known Member

    I was very hesitant about giving my son any medications at all for his ADHD. I finally did so as a last resort. In school he was failing several subjects and his teacher reported spending most of her class time having to redirect his attention because he was usually staring off into space and biting his nails till his fingers bled. This year on Focalin he has done a huge turnaround. All of his teachers say he is hardworking and eager to learn. They say they don't see a problem with focusing for him at all. He is getting straight A's. He is so proud of himself. In the end I am very glad we chose to medicate because he is doing so much better and has much higher self esteem this year. I understand you being hesitant to medicate your very young child but honestly it could be a godsend. In the end the choice is yours. I know it's a tough choice to make, but I'm sure if you follow your heart you will make the right one.
     
  13. Malika

    Malika Well-Known Member

    Thank you for all your views and comments. In France, only three medications are available for ADHD, and no non-stimulants: Ritalin, Concerta and something marketed here as Quasym, all varieties of the Ritalin molecule.
    The benefits could be undoubted. The hesitation is to do with putting a heavy-duty medication with all sorts of unknown side effects into a developing young body. We would have to try it to see what happened, of course.
     
  14. I have been through what most of you have been through regarding medications and have felt exactly like the statement above. I hate that we are all in the position of having to make the excruciatingly hard choice to medicate or not...only extreme circumstances would ever cause most of us to consider these drugs for our children. We are all so desperate to help them. Although medications do help many, many, kids and turn some lives around, most our medicated kids continue to struggle (not that we are expecting miracles) and also experience side-effects from the medications. I think this last fact contributes to making the decision to medicate or not so difficult. We know that there is no perfect drug and there are risks with all of them.
     
  15. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Ritalin has been around for over 40 years now and it isnt considered a heavy duty medication that doctors no nothing about anymore. It has been studied over and over and the patients that were first put on it in the first place are now at least in their 50's and 60's. Both my younger two boys were on ritalin when they were younger and in fact that was the only medication Jamie ever took. It did nothing harmful to him such as stunt his growth. It did cause him to be a bit on the thinner side as a child but not skin and bones. He ate well. He just had a high metabolism.

    Jamie wasnt a good student when he was your son's age either. He simply couldnt sit still even with his ritalin on board and he hated book work. It took him until halfway through 2nd grade (when he was 7 and a half) at which time he came home beaming telling me he had finally figured out why kids went to school. He started doing very well from that point on. Before that he couldnt memorize his spelling words or reading or even math concepts. He just wanted to be outside playing and really didnt get why anyone would expect little boys to be inside all day...lol.
     
  16. Malika

    Malika Well-Known Member

    Well, now, a retired child psychiatrist with whom I am in correspondence (mainly about another subject but recently we have talked about J and the should I/shouldn't medicate dilemma) and here is what he says - I reproduce it here for general interest and possibly debate :)

    "Surely you must realize you are attempting to control your child's behaviour so others don't become irritated. Ask yourself, the teachers and others. Why his flapping about, shouting etc. makes them so anxious and angry. At one time my wife and I had a foster child that was the worst of deprivation and hyperactivity. So I know what is like to live with a child who grabbed his dinner in both hands and ate so fast, he vomited it all back onto the table and was so uncontrollably wild he had to be on a tether when walking near dangerous places and yet by God's great wisdom and patience, he was normalized to a great extent before he was adopted by another family. We had applied but were considered too old. The hard route is almost always better in the long run. I have treated hundreds of 'hyperactive' children and very seldom have I seen a child who really needed medication."
     
  17. whatamess

    whatamess New Member

    I think the dr. sounds biased to his belief system instead of evidence based information.
     
  18. InsaneCdn

    InsaneCdn Well-Known Member

    I'd love to know his definition of "hyperactive"... because I've seen at least a couple dozen different definitions.

    I will agree on this point, though... the H is harder to medicate successfully than the ADD is, if you Know what I mean?.

    The impact of medications on attention is well known and (if you can tolerate the medications) very successful IF the problem is "attention management". Hyperactive... not so much. It "helps" hyper, but not nearly as well. Dealing with hyper is about learning skills. Why medicate at all, then, for hyperactivity? in my opinion... for safety, and to make it possible to learn the skills. If the medications don't address at least one of those two benefits, and the biggest issue is hyperactivity, then medications are not going to be the answer.
     
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