new and looking for medication advice

grayday

New Member
Just discovered this site. Our child has a diagnosis of ADHD, Anxiety, Depression and ODD. He is on Prozac and Strattera. His doctor mentioned adding Intuniv. Does anyone have experience with combining Strattera and Intuniv?
 
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HaoZi

Guest
I'd be wondering why psychiatrist wants him on two different ADHD medications. Strikes me as overkill.
 

seriously

New Member
Can you tell us a little more about your child? Age, gender, behaviors that have gotten him that string of diagnosis?

Is there a family history of mental illness?

What are the results of any assessments that have been done?

Sorry for bombarding you with questions but it's hard to share personal experiences about medications without more information about the overall situation to see if the situation is actually similar or not.

Has his anxiety responded well to the Prozac? If not, then the behavior problems may be at least partly due to anxiety.

Is he in therapy to help with the mood issues?

Glad you found us - sorry you need to be here.
 

BusynMember

Well-Known Member
Hi and welcome to the board. We don't have a lot of information from you. I'm going to ask a few questions that will help us help you :)

1/Who diagnosed him? Has he ever seen a neuropsychologist? How old is he and what are his symptoms?

2/How was his early development? Speech? Eye contact? Cuddly? Any quirks or obsessions? Motor skills? Does he know how to hold a give and take conversation? How does he get along with his same age peers? Can he transition well from one activity to another? How are his school grades?

3/Are there any psychiatric problems or substance abuse on either side of his genetic family tree?

My opinion of his medications are that whoever is choosing them is throwing way too much stimulating stuff at him of the same type of medication. He is on two antidepressants (Prozac and Straterra). I have depression problems and two antidepressants would be way too much for me to handle. Do you see any good things from these medications or is he the same or worse? Are you comfortable with the diagnoses? I am wondering if t his doctor has a good handle on what is going on. The fact that he wants to add yet another medication, may indicate that your child is not doing well so he is throwing yet another drug at your child. Is your son in therapy too?

You may want to do a signature like I did below.
 

grayday

New Member
I'd be wondering why psychiatrist wants him on two different ADHD medications. Strikes me as overkill.



The doctor talked about Intuniv possibly helping with his anger and impulsivity, since the Strattera may be addressing focus but not the others.
 
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HaoZi

Guest
I've learned to be wary of adding medications to Straterra, it didn't work very well for my kid. Everyone reacts differently, though.
 

grayday

New Member
Sorry to be so vague. I am new to this and need your guidance. Here is some background: My son is 11. His IQ is above normal. He is creative and musically talented. He is quite immature for his age. He weighs 65 pounds and is super skinny.His main struggles are with anger and impulsivity, but he is also very unorganized, anxious, forgetful, and fidgety. Prozac has helped address his depression. School seems to see some benefit from the Strattera in terms of his focus in the classroom. We had considered changing to Intuniv since we weren't seeing much benefit at home and were not sure how much it was truly benefiting him at school. That is when the doctor mentioned combining the two. The doctor talked about Intuniv possibly helping with his anger and impulsivity, since the Strattera may be addressing focus but not the others. We are comfortable with his diagnosis. He never responded well on stimulants (tried several) and had many very bad experiences -- they made him very agitated and volatile. Strattera had been our last hope until we heard about Intuniv. We hate the idea of making him try new medications, but we are frustrated that we have never really seen any measurable improvement on ADHD medications. He is in between therapists at the moment, but will be back in therapy soon. Hope this info helps! Thanks so much for responding!
 

grayday

New Member
If I responded to one above, will you see that info? Or do I need to include in all my responses? Sorry I am so new to all this.
Can you tell us a little more about your child? Age, gender, behaviors that have gotten him that string of diagnosis?

Is there a family history of mental illness?

What are the results of any assessments that have been done?

Sorry for bombarding you with questions but it's hard to share personal experiences about medications without more information about the overall situation to see if the situation is actually similar or not.

Has his anxiety responded well to the Prozac? If not, then the behavior problems may be at least partly due to anxiety.

Is he in therapy to help with the mood issues?

Glad you found us - sorry you need to be here.
 
H

HaoZi

Guest
My gut reaction is that if he doesn't respond to so many ADHD medications, it may well not be ADHD. There are other things that can exhibit with similar symptoms, from forms of autism to allergies. Has he been tested by a neuropsychologist as well as getting allergy tested?
 

grayday

New Member
Was rereading your questions. I forgot to mention that he doesn't transition well. He has an IEP at school and receives EBD services.

Hi and welcome to the board. We don't have a lot of information from you. I'm going to ask a few questions that will help us help you :)

1/Who diagnosed him? Has he ever seen a neuropsychologist? How old is he and what are his symptoms?

2/How was his early development? Speech? Eye contact? Cuddly? Any quirks or obsessions? Motor skills? Does he know how to hold a give and take conversation? How does he get along with his same age peers? Can he transition well from one activity to another? How are his school grades?

3/Are there any psychiatric problems or substance abuse on either side of his genetic family tree?

My opinion of his medications are that whoever is choosing them is throwing way too much stimulating stuff at him of the same type of medication. He is on two antidepressants (Prozac and Straterra). I have depression problems and two antidepressants would be way too much for me to handle. Do you see any good things from these medications or is he the same or worse? Are you comfortable with the diagnoses? I am wondering if t his doctor has a good handle on what is going on. The fact that he wants to add yet another medication, may indicate that your child is not doing well so he is throwing yet another drug at your child. Is your son in therapy too?

You may want to do a signature like I did below.
 

grayday

New Member
How do I arrange to have him tested by a neuropsychologist and what type of testing will they do?
I am convinced it is ADHD. I have been attempting to educate myself about ADHD and truly feel that ADHD has a number of "types." (see Dr. Amen brain scans) There is one segment that doesn't respond well to stimulants and I believe he falls in this category.
My gut reaction is that if he doesn't respond to so many ADHD medications, it may well not be ADHD. There are other things that can exhibit with similar symptoms, from forms of autism to allergies. Has he been tested by a neuropsychologist as well as getting allergy tested?
 

BusynMember

Well-Known Member
Hi again.
I had trouble figuring out how to navigate the site too at first. I think you hit "profile" to do the signature.

Did your son ever have any speech delays or problems? Does he socialize well with him same age peers? Does he have any obsessions or quirks or both? Is he sensitive to any foods or fabrics or scents or loud noise? His combination of diagnoses may actually be just one disorder. I would also suggest going to a neuropsychologist. You can find them in childrens and university hospitals as well as in certain clinics. They do every kind of testing you could imagine and tend to flush out stuff that other tests miss. Their diagnoses in my opinion are the most accurate and focused so that your child can get more help.

in my opinion (and of course I'm no doctor) it sounds like more is going on than ADHD...and that's really all he's being treated for right now. It may not be ADHD at all. It could be a mimicker. There are many. I'm sure you know this, but most clinicians do not believe in Dr. Amen's work. I don't either so if you are a big fan of his just disregard my post...lol. I think you'd be better off with a neuropsychologist than an expensive brain scan that most doctors disregard as inaccurate. At the very least, it can't hurt to get a more mainstreamed opinion. Better to be safe than sorry.
 

pepperidge

New Member
One medication you might want to research is Lamictal--it might help with the depression--Prozac can actually hurt focus as it can be disinhibiting. Maybe with Lamictal you might find that a stimulant would work. Also Strattera can alter mood.
 

seriously

New Member
Hi -

You go into Settings - you can find that at the top right side of the page - and chose edit signature then you enter the info you want to include. Do not include real names - even first names - or other identifying information.

You can choose to quote someone if you want to but you don't have to. Everyone can see every post so you don't have to answer the same questions over and over.

I can't say whether there's more going on than ADHD but it can be very difficult to tease things out when you have a kid who is bright and has multiple difficult behaviors. That's when it's a good idea to look into getting a thorough assessment done by a neuropsychologist.

A neuropsychologist evaluation usually takes 10 to 12 hours and can often produce new understanding and treatment/accommodation recommendations. If possible you would get it paid for by your health insurance. Given the number of diagnoses your son has and the poor response to ADHD medications I would think you could get your insurance to cover it.

You can ask the psychiatrist about it and/or your son's pediatrician.

The assessments a neuropsychologist does generally start with an IQ test - or the equivalent assessment of intellectual ability. What comes next is often determined by the observations the neuropsychologist has made during that testing along with the information you provided during the pre-assessment interview and/or written information from places like school. The goal is to develop an in-depth picture of your child's strengths and weaknesses that will provide enough information to be able to make diagnoses and treatment plans with more precision and greater confidence. In comparison to testing done by the school it is much, much more accurate and comprehensive. Neuropsychs are either PhD's or MD's with special training in neuropsychology. There is no equivalent training in psychiatry.

I'm glad your son is getting services at school. Are those helpful? Is he making progress academically?
 

grayday

New Member
Thanks so much for your reply! My son did have an evaluation/assessment done by a psychologist, but it didn't last 10-12 hours. It lasted a couple hours. She gathered info from school and us and did test him. He had a previous IQ test. She is the one who gave us the diagnosis of ADHD, Anxiety, Depression and ODD. Not sure this is the equivalent of a neuropsychologist evaluation?? Services were helpful in elementary but have proved more challenging in Middle School. (Different school/different teachers/different case worker.) He is capable of getting very good grades, but doesn't apply himself. Forgetfulness and disorganization also contribute negatively. We are more concerned with his struggles with social interactions. Thanks so much for all your help walking me thru how to do things!!!
 

grayday

New Member
He does play with straws (self-created fidget) -- they soothe him and he carries them daily. He uses them when he is feeling stressed. No sensitivities. He had normal early development - no delays. Socially he is immature now. Not a fan of Amen, just was another thing I came across when trying to educate myself. I do believe that ADHD does have different types -- I work in the school system and see it daily. Too often we latch onto one stereotype. I appreciate all your feedback. I would be curious what mimickers you are suggesting?
 
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HaoZi

Guest
My daughter also started with a simple ADHD diagnosis. As she got older and more complex things were expected from her, behavior got worse. More labels started getting applied - ODD, Obsessive Compulsive Disorder (OCD) (in some ways, in others she's totally disorganized), Generalized Anxiety Disorder (GAD), then after a bad medication reaction bi-polar got tacked on (not so sure on that one, but the medications are only covered under that diagnosis), and eventually led us to the Aspie diagnosis, which includes or can be co-morbid with Obsessive Compulsive Disorder (OCD), ADHD, etc. Her IQ is in the gifted range, and way back when other parents were asking me if she'd been tested for autism my reaction was "No way, how could anyone think that?" because I was thinking "classic autism" and she didn't have those signs. No problem with eye contact, she's very high-functioning. I've since come to learn that my mini-me is autistic - and so am I. Most Autism Spectrum Disorders (ASD) people have atypical reactions to medications across several classes of medications.

I'm not saying your kid has any or all of these additional issues, this is just an example I've lived of something that can mimic ADHD when they're younger and gradually out itself in different ways as more complex social expectations are forced on them.
 
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