Ready to try medications

[ML]

I am a bit nervous as we are seeing a new psychiatrist tomorrow. We got rid of our lousy kaiser insurance that had zero support for difficult child in terms of therapy of any kind.

I want to try a stimulant for the inattentiveness. I realize that it might not work. But more importantly, I'm realizing that because of the anxiety, it could make a difficult situation worse. I'm not ready to try an AP (antipsychotic) at this point. Isn't that what they use for anxiety in these kids? What are some possiblities for our kids on the spectrum (or not) with anxiety and inattentiveness? If we could just get him to engage and focus just a little bit it would make such a difference in terms of school success. I'm worried about him passing third grade and even more worried about how he'll manage 4th. He's smart enough, but concentration is nonexistent. I think with CBT he could learn to manage the anxiety to some extent. I'm scared. I just want to try the stimulant by itself without adding a second medication but thinking it may not be possible. I sure wish there were easier answers.

 

[Big Bad Kitty]

Hiya Michelle,

My daughter was diagnosis's as ADHD/ODD and originally given stims. They did not work AT ALL and we switched to Abilify (atypical antipsychotic). The doctor said we'd treat her as though she were bipolar even though he has not gone as far as dxing her. He did not give that to her for anxiety but to stablize her mood.

The good thing about stims is that they do not stay in your body for a long time, so if they are not working, boom, you can try something else.

As far as kids on the spectrum, I won't answer that because I have no knowledge. there are also many more moms here with better knowledge of medications. I just wanted to give a shout since it was getting late and I didn't want you hanging.

 

[trinityroyal]

Hello Michele,

My difficult child is on the spectrum (Asperger's/ADHD) and a combination of stims and SSRI medications work well for him.

Initially, when we just had him on a stimulant, his focus and control improved tremendously, but anxiety attacks were still a major issue. The SSRI has helped to smooth things out. He's less anxious and better able to get through the day. Before, anxiety would paralyze him.

The downside...in the initial time when he started on the anti-anxiety, him impulse control (limited at best) dropped to nothing. Things did stabilize, but it's something to watch for.

Now that he's settled into a good medications routine, we're planning to add melatonin to address his sleep issues.

Hope this helps.
Trinity

 

[TerryJ2]

Hi Michele,
we reached the same point with-our son, and we started him on Adderal at the same time we held him back to repeat 3rd grade. You won't know precisely which medication works unless you try them separately, so you don't have much of a choice. You obviously start on the lowest dose possible, and I would recommend starting on a weekend so you can watch him.
If he's already got anxiety, a stimulant could make him worse, but then again, the anxiety may be caused by the sheer speed and quantity of thoughts racing through his mind, so you may find that the anxiety is quieted down.
Your child is an individual. We'll all give you our own experiences here but you won't know unless you try. It will be fine ... just as the dr how long the medications stay in the system S/he should be able to answer off the top of her head, especially if you call in advance and tell her why you want the appointment so she's had time to review.

Also, what kinds of allergies does your difficult child have? Could they be causing some of the moods, anxiety, etc, or exacerbating them? Have you discussed that with-an allergist? (Beware: some allergists don't "believe" in the connection.)

been there done that. Try not to stress to much ... we all just keep working on things and supporting one another.

 

[BusynMember]

Some kids on the spectrum take stims. Sometimes they work, sometimes they don't. They made my son aggressive and mean and he's not like that. Rispserdal is more widely used if the child is out-of-control or self-abuses or is destructive. Only half of Autism Spectrum Disorders (ASD) children are on medications. I prefer interventions in school to deal with the inattentiveness and an aide to teach my son how to break down what he learns in school. He has done really well without medications and with school interventions. I think that, if you use therapy at all with an Autism Spectrum Disorders (ASD) kid, CBT is the best idea. These kids don't normally understand abstract thinking. They do better with concrete talk as they are concrete, black and white, thinkers.

 

[Marguerite]

Terry said what I was going to say - it's always possible that the anxiety is being made worse by his inability to stay on task.

Also, BBK pointed out that stims are generally short-acting. If t hey aren't suitable, they will wash out of his system fast.

If the stims are going to work, you will see an improvement within a matter of hours. If the improvement is not spectacular, you may need to rely on non-medication options. But if they DO work - then you have one more tool in the armoury.

The medications were almost miraculous in our case. All three of my younger kids have improved dramatically on stims. The dose needed could be small or large - the amount of improvement is still spectacular. difficult child 3 is on quite a high dose, easy child 2/difficult child 2 on a very low dose. But we sure do notice if she misses her medications.

difficult child 3 still has anxiety problems. I don't think the medications make it worse - I'm reluctant to take him off the medications, since they make such a huge difference for him. If the medications ARE making his anxiety worse, then in his case we need to find another way to deal with the anxiety, OTHER than taking him off stims.

Every child is different, you just have to find what works. But if you make the decision to use stims, and you find they help a lot, have the courage to stick it out in the face of people telling you that "drugging your child into submission" is not a good idea. You WILL encounter people who think they know your child better and who would rather have us all living on 10 acre farms each, in teepees painted like rainbows, each with our very own tree to hug. I don't mean to offend anyone with that statement, I consider myself an environmentalist and grow my own fresh herbs, but I'm fed up to the back teeth with people who haven't had to deal with what we have had to, telling us we are harming our child by giving him prescribed medication. difficult child 3's best friend's mother is easily bullied by people like this; one 'bully' (the one I just quoted) talked her out of giving her son the prescribed medication and instead sold her (very expensive) Goji juice. That woman's husband is a pharmacist who even had a go at me once when he was standing in for our local pharmacist. As he handed over the stims, he accused me of being brainwashed by conventional medicine and not looking after my kids properly; "Give them these special supplements instead, you can buy them from my wife." (Saying this to me under these circumstances was not only unethical, it was illegal)
You need to be strong to stand up to these people.

And if you are now thinking, "Hey, Goji juice might be worth trying," I was re-reading a report today from "Choice", an Australian consumer watchdog magazine, which tested all these "super-juices" to measure their antioxidant level, and also examined the claims they were making in their advertising. They found that the super-juice highest in antioxidant had about the same amount as an apple (per dose). And at $80 a bottle, vs $8 a case for apples, I'd rather be getting the fibre and the other vitamins as well, from the apple.

Good luck with it, I hope you find something that makes a difference.

Marg

 

[PersonalEnigma]

My difficult child is on Strattera, which is to help with his inattentiveness. The advantage is that it does not have anxiety as a side effect (unlike stims). The disadvantage is that it take 4-6 weeks to see a noticeable difference. It does seem to be helping difficult child though and he really likes having the medications to help.

 

[Calista]

We have been on the medication merry-go-round for 8 years now. We have had every conceivable diagnosis. I have had Pediatricians refuse to medicate my difficult child because of the multitude of symptoms. I have had psychiatrists get stuck in a rut and not know what to do next. We were on a VERY effective reigimen of medications; however, one of them, Trileptal, causes my difficult child to puke for 24 hours every 14 days (that is ow long it takes to reach therapuetic level). Now we are Guinea Pigs, AGAIN! We have lowered the Trileptal to an ineffective level and have added Risperdal which is doing nothing that I can tell. This is why the school called me today tp ipick him up. The medication merry-go round ! No medications at all even more. You may notice that my difficult child is on the spectrum. He CANNOT tolerate a stimulant so his 135 IQ is unfocsed and wasted. Not to mention the IMPULSIVITY! He is now at the onset of puberty which may or may not help.

Good Luck and stick with it. It's a long road.

 

[ML]

We just came back from the new psychiatrist. She doesn't think he even has adhd! Based upon the questionnaire, he scored out of balance only on the seretonin symptoms, but very low on the dopamine one (which is involved with adhd I guess). So my guess is that his daydreaming is probably *just* from spectrum stuff. AND, the fact that he is on: QVAR, Clariton, Albueterol and flonase caused her jaw to drop a little. Oh well, one other really good thing that happened this week is that I interviewed a therapist who will work with difficult child on his anxiety (CBT) and he's actually happy about going.


What she said was that he seemed to be doing better at night and in the morning but during the day he struggled more and that I need to break up the Celexa into morning and night doses. So we'll see what that does.

Thank you all for sharing your thoughts. I feel exactly like you do, Marg. I mean on the part where other people who don't walk in our shoes think they get to weigh in on our treatment protocols. My mom was upset with me for considering a stimulant. I had to nicely tell her that she had to trust my judgement and let me handle it. These people who want to tell us how to treat our kids don't seem to be signing up for homework duty, now do they?

Hugs,
MicheleL