ADHD medication Advice

Discussion in 'General Parenting' started by Janna, Jan 21, 2009.

  1. Janna

    Janna New Member

    Well, we have an appointment with the Partial psychiatrist Friday for Dyl. I haven't kept up to date on all the newest, latest, greatest medications out there for ADHD symptoms - and I'm just lookin' to see if anyone knows anything new or has had luck with something after trying others and having none LOL!

    Dylan has a ton of inattentive issues and alot of hyperactivity issues in school. We've tried Ritalin, Concerta, Metadate, Dexadrine, Strattera, Adderall (the latter 3 are absolute NO GO'S). Clonodine and Tenex (eh, not really interested in those 2 again). Am I missing one? *sigh* I lost track....

    Anywhoo...I need to tackle this issue. At the Residential Treatment Facility (RTF), the psychiatrist (genius he is) says "well, if J is doing so well on Concerta and he and Dylan are brothers, the Concerta should work wonders for Dylan too! (oh yes, he really did say that).

    I thought about it, and thought ok, that sounds dumb, but let's try. He was only on, what I consider to be a small dose (36 mg) for his weight (155 lbs), and it really did nothing. This was toward the tail end of the Residential Treatment Facility (RTF) placement, though, when I just said forget it, I'll find another doctor.

    I've heard that some kids can do better on larger doses, say, of Concerta. I think I read here one child was on over 100 mg of it. Anyone else hear that?

    Keep in mind, we're not really looking at a Bipolar diagnosis anymore (does that matter? I dunno...) - more like, maybe Mood Disorder, sorta - someday? But, Autistic. Does that matter? LOL I dunno.

    Just looking for thoughts on the stims. Not really sure what to throw at this psychiatrist, but it's very, very clear that my son needs help with these issues.

    His current medications are Seroquel (50 mg AM, 175 mg PM, Buspar, 20 mg AM, 10 mg PM). Seroquel doesn't really do anything in the AM - but sure knocks him out cold at night. Buspars been great for anxiety, but didn't help with the ADHD stuff like psychiatrist thought it would.

    Any thoughts, appreciated. Have a great night every1!
  2. TerryJ2

    TerryJ2 Well-Known Member

    Gosh, we've only tried one--Adderall--and it worked immediately.

    But I know others here will say that yes, it does make a diff whether he is bipolar or Aspie. I recall reading that stimulants seem to cause mild mania more often in bipolar kids, so it does pay to have a good diagnosis.

    Others here will come along and help out.
  3. LittleDudesMom

    LittleDudesMom Well-Known Member Staff Member

    Hey Janna,

    My difficult child switched from adderall to vyvanse in December. His issue was that he needed a little something more for focus and the up from 10 to 15 mg in adderall (difficult child has always been able to get by on a low dose) was causing a little lower frustration level. His psychiatrist suggested this medication because it's makeup is different.

    With the adderall he was getting a punch in the morning and then another punch in another punch in the afternoon. The vyvanse delivers a smooth release throughout the day. Another benefit of the adderall is that kids can't smoke or snort it (which my easy child says is a money maker at her school - $5 a pill) because it's wrapped in an amino acid and has to be digested in order to be absorbed by the body. Many of his psychiatrist's teens like the vyvanse because they say it "makes them feel more like themselves".

    It does last longer, which means my difficult child doesn't eat real well until later in the evening. He's a pretty skinny kid, but I do like the medication so far and so does he. He says it doesn't make him feel like such a zombie in the morning like the adderall (I suppose that was the first punch of the medication). He was put on 40 mg which is close to the equivilant of 15 mg of adderall.

    Here's a link to their website so you can look up the chemical make up, studies, etc.

    Good luck!

  4. jal

    jal Member

    Hi Janna,

    My difficult child was diagnosis'd BiPolar (BP) and ADHD by one psychiatrist. None of the medications worked. We tried Ritalin, Metadate, Adderrall, Dexedrine, Vyvanse, Daytrana, a Straterra and Tenex combo...I could go on. Nothing helped and would just set him into aggitation and rages. difficult child was just diagnosis'd with a new psychiatrist as Pervasive Developmental Disorder (PDD) - Aspergers and anxiety. She said it is not ADHD. difficult child is on Seroquel 100mg am and 50mg when he gets home and 50mg before bed. We have added 10 mg of Fluoxetine (Prozac) in the am for the anxiety. We just started so we haven't seen the full effect. Just adding my experience with stims as you mentioned you are no longer looking at BiPolar (BP) but Autism.

    With regards to the dr talking about one medication working for a family member...I have heard that from a few doctors. Typically if one works well for one person it may work for a relation. That is why when our last psychiatrist told us he believed difficult child was 99.9% BiPolar (BP) and he wanted to trial Wellbutrin (Buproprion) to combat the ADHD we said no. husband's Aunt who is BiPolar (BP) used Zyban (Buproprion) to quit smoking and had a psychotic break. We were not going to risk it with a 6 year old. Good luck!
  5. DaisyFace

    DaisyFace Love me...Love me not

    I would take this with a "grain of salt"...

    I have had bad reactions and am allergic to a number of different Rx medications, as well as over-the-counter remedies--so I have to be really careful about what I take (even for a cold!). However, no one else in my family (neither my parents, nor siblings, nor my children) have ever had any trouble with medication reactions or allergies. So don't limit yourself just because a relative might have had a problem (although I would definitely be cautious...) nor should you assume it will be fine just because this or that relative was fine. Always proceed with caution...

    Just my two cents...

  6. Janna

    Janna New Member

    Thanks, guys. Sharon, I think I heard something about that Vyvanse. Is that a patch or a pill? Daytrana is a patch, right? I don't like the patch idea. I could see him outside, sweating, and it irritating him and him just ripping it off. I have enough PTSD issues LOLOL!

    Terry, he's been diagnosis'ed BiPolar (BP) in the past. First he was ADHD. Then he was Pervasive Developmental Disorder (PDD). Then he was Bipolar. Then he was Pervasive Developmental Disorder (PDD) again. LMAO! He's never had luck with stims, but I am more questioning dosages at this point, and looking for new. Adderall has a side effect of aggression - so I dunno why they'd even trial that with a kid that's aggressive LMAO! I mean, common sense stuff like that is what I've tackled thus far. To my team, the diagnosis is not important. They say Autism, but I could take him elsewhere 2 years from now and they could say BiPolar (BP). Whatever LOL! I'm looking for a weight off Dylan's shoulders. I need some of these ADHD symptoms helped. I don't care if he's BiPolar (BP) or Autistic or whatever - yanno? Doesn't much matter to me at this point. I'm just willing to try whatever - if it works it works. If it doesn't, thank goodness we can take em off right away :)

    I wouldn't ever assume one medication that worked for one child, sib or not, would work for the other. I was being sarcastic LOL! My not so funny sense of humor doesn't come out on a computer screen, I guess :( I'm sorry. I thought the psychiatrist was a dope when he said that to me LOL! You're taking a child, look at my sig, D and comparing him to J? Egad! LMAO! Nope, shouldn't ever think that. EVERY child is DIFFERENT.

    Thanks for the link, Sharon!
  7. smallworld

    smallworld Moderator

    Hi Janna! I'm sorry I haven't officially welcomed you back yet. Glad you made your way back here.

    Actually, our neuro believes that if a parent responds positively to a certain medication, the child has a good chance of responding similarly. It makes some sense given that a parent and a child share 50 percent of their genes. But it's certainly no guarantee.

    In addition to Vyvanse (which is a pill -- Daytrana is a patch), other medications you could consider to treat ADHD symptoms include:

    Provigil: a narcolepsy medication that is used off-label to treat ADHD
    Wellbutrin: a stimulatory AD that is also used off-label to treat ADHD
    Notriptyline: a tricyclic AD that can be helpful for ADHD sx
    Focalin/Focalin XR: refined Ritalin that supposedly has fewer side effects than regular Ritalin

    If 36 mg Concerta did nothing, you could try 54 mg Concerta. I personally would never go higher than 72 mg Concerta, but I'm risk averse.

    Good luck.
  8. totoro

    totoro Mom? What's a GFG?

    Not any help to you! :)
    We did the Strattera, Tenex and Clonidine... I stopped. Buspar did not help her either. I am glad that is helping Dyl.

    I might try Buspar again if she was actually stable on maybe a MS or something.
    For now though I am not doing any ADHD medications or any more AP's. Just not very good for K.
    Personally though for us, when K is a little more stable her Hyperactivity diminishes. She is still hyper, but I can tolerate it a bit more.
    Good luck on your decision. SO much fun, huh?
  9. Janna

    Janna New Member

    Thanks, you guys.
    SW, wasn't your son on Provigil, or is he? Sigs aren't showing up. I think I asked one of our previous psychiatrists about that one. I wrote them down, thank you for those. We did try Wellbutrin in the Residential Treatment Facility (RTF). Really no changes, other than a little moodier than normal. Then we tried Luvox, and that was - well - horrible.
    I'm with you on the dosing. I appreciate that.
    I'm not really looking to help with the "H". I need more of the ADD help at this point. He needs so much redirection and help with staying on task at school that he is to the point of needing a 1:1 JUST to keep him on task. He fidgets, he is staring out the window, you're teaching and he's talking about the car that just drove by LMAO! The hyperactivity part has slowed, some (he's now probably considered NORMAL ADHD instead of the incredible overactive I dunno what he was last year - I mean, that kid was HYPEEEEEEEEE!).

    You would think with his placement (he's in a partial program, there's a teacher, an aide, like 3 kids in the room!) they'd be helping more with that, but it doesn't seem so by his comments and points he comes home with. We've tried so many things to help him stay on task (you should see these cool stress balls I just got him from Office Playground - they're scary faces with "blood" and "guts" LMAO) and it works, for a minute, then it's gone.

    I'm gonna print up the thread and use it for my notes to psychiatrist Friday.

    T, it's no fun LOL! Dyl is loaded up with anxiety, which is probably why the medication is helping. I've been asking for a "chill pill" for him for 9 years and they finally woke up and gave him one. I think if this hadn't worked, they were thinking Ativan (?) or something of that nature. But, I've read that it's so addictive, so I'm thankful it worked. I hope you find something that works for K. It is very frustrating.

    Thanks everyone, it's appreciated.
  10. Marguerite

    Marguerite Active Member

    Where does dexamphetamine fit into the range of options? I note that it's not listed - do you have it available as a brand name over there?

    We have dex prescribed, then privately compounded into long-acting formulation. It costs us about $1 a pill for this, but it's worth the fuss.

    I do agree with you, Janna, about how stupid it is for a doctor to assume that what works for one sibling should be OK for another - our two boys (difficult child 1 & difficult child 3) have similar issues, but very different responses to medications.

    If the diagnosis is autism, medications won't necessarily work. In our boys, the medications help with the ADHD component of the problem. However, even ADHD doesn't always rspond, it just MOSTLY responds to medications.

    We know now, that for our sons here, ritalin won't work, they get bad rebound. That means Concerta will also be a problem (only difficult child 3 has tried Concerta - yes, he had problems too). Only difficult child 3 has tried Strattera, but difficult child 1 refuses to try anything else, because he claims he can do better as he is, why muddle with what's working? For him, there is too much at stake if he plays around with his medications.

    If part of Dylan's trouble is connected to his Obsessive Compulsive Disorder (OCD) part of his autism, then the medications for ADHD will have limited value. However, anxiety can make them more obsessive, so often finding a medication that hoses down the anxiety, can find a way to help yor child focus better. However, a highly distracting environment then becomes the barrier - we dealt with that in the classroom with difficult child 3, by making sure he had somewhere to go to remove himself from distraction, to do actual schoolwork. First difficult child 3 would sit with the class while the teacher talked about the task to be done, then the sheets were handed out and kids began working. At that point difficult child 3 was moved to his desk on the veranda, where all he had to look at was the corner of the timber walls. He put on his headphones with "easy listening" music (no lyrics, so he wouldn't sing along) and then his aide would stay with him to try to keep him on task. Not easy.
    At home, difficult child 3 chooses where he wants to work, and whether to put his music on. Lyrics no longer matter. He also can continue working on the topic of his choice until it is completed or until he wants to change. Usually he keeps going until it's completed. He works more efficiently, and is much happier with himself. We were able to reduce his medications a bit when he came home but as he has grown we've had to increase it again.

    We're currently looking for a good "chill pill" for difficult child 3, but one that isn't going to clash with dexamphetamine. Antidepressants are off the list, he reacts to them badly. At least, all the ones he's ben given so far. Meanwhile difficult child 2 has been on Zoloft for yers now and does really well on it. Again, you can't automatically apply to one siblnig what you want to apply to the other.

    I hope you can find something helpful here.

  11. Janna

    Janna New Member

    I think the brand name is Dexadrine. And, we did try that while Dylan was in the Residential Treatment Facility (RTF). He was very weepy on that medication. Moreso than normal. I don't want to say depressed, but short fused, which would lead to abnormal amounts of crying. Anyway, we took him off.

    The "chill pill" Dylan was given - Buspar - is anti anxiety. Not sure about interactions with Dexamphetamine, but may be worth looking into. Dylan was given this to help with (just like you said!) his Obsessive Compulsive Disorder (OCD)/Asperger type thinking. The obsessive, it's going to kill me I just can't let it go thinking was making him mad. It was to the point he was all but eating his clothing (chewing) due to the anxiety. The Buspar smooshed it LOL! But, we also hoped it would help with ADHD and hasn't. Oh well. He is calmer, but I'm sure partly due to the Seroquel. I want to talk to psychiatrist about trying to tirate down, then off the Seroquel and replace it with something for ADHD. I know they aren't the same type of medication, but I'm so uneasy with giving him an AP.

    His diagnosis is definately, without a doubt, Autism. Depending on who you ask, it varies (of course), but it's all Autism. The neuropsychologist says Pervasive Developmental Disorder (PDD)-not otherwise specified. The psychiatrist says Pervasive Developmental Disorder (PDD)-not otherwise specified with an Outrule of Aspergers. The Masters Level therapist that comes here says Aspergers, Mild - Pervasive Developmental Disorder (PDD)-not otherwise specified, Clinical. Of course, (as if I'd be surprised) the psychologist that works with the therapist says the same LMAO! But, they all concur, which is nice - because they're all from different places and now everyone's saying about the same thing. We're gearing up for a very thorough (one last time if I have any say) neuropsychological evaluation with a center here that is specifically for Autistic children and children with Developmental Disabilities, where we're hoping for an Asperger diagnosis, finally. I don't know if he'll turn out to be Bipolar. It's one of those things that's hanging on as a Mood Disorder and maybe over time it'll turn into something and maybe it won't. I could really care less about that component right now.

    Hey, thanks for the info! It'll be nice to go see psychiatrist with some info Fri.
  12. jannie

    jannie trying to survive....

    Hi Janna

    Vyvanse has worked really well for my difficult child 2. He is on a really low dosage (only 20 mg)...The combo of lamictal and vyanse have really seemed to make a big difference for him. Has Dylan ever taken lamictal?

    There is child I know who is Asperger with a vareity of other issues and he seems to be doing really well right now with a combination of daytrana patch and focalin . His mom puts the patch on at home and he takes the focalin in the health room when he gets to school....

    The other High-Functioning Autism (HFA) child I know takes risperdal, focalin and prozac....

    It's such a crazy thing...trying to improve attention....and decrease impulsivity...

    And in the spring I hear tenex is coming out with a long acting medication that is supposed to really help with impulsivity and attention. My psychiatrist is really looking forward to seeing how kiddos respond on this medication.
  13. MyHrt31

    MyHrt31 New Member

    My son has been on most of those medications but none of them seemed to help. In fact, they made him even more irritable. Finding the right medication is so hard! We've been trying for the past 7 years and we are still looking. I've heard good things about Vyvanse for most kids. My son is on it and although he is irritable, it has affected him the least out of all his medications in the past. Of course, now that they've added lithium and abilify to his medications, he seems even more irritable... but that's another story, lol. Good luck to you! Its not easy but you just hang in there. These ladies here are tough and they give terrific advice :)
  14. Woofens

    Woofens New Member

    4 months ago we started non difficult child S on Focalin. I'm not sure which medication this is close to, but I do know it is a stimulant. It has helped her so much it isn't funny. She went from failing school 1st 9 weeks to honor roll 2nd 9 weeks.

  15. pepperidge

    pepperidge New Member


    I have one child who has done really well on Adderall small dose, though the cocktail of Lamictal and Risperdal has taken away much of the anxiety and irritability which didn't do so well with the Adderall mix.

    My youngest has been on just about every drug out there --he is totally disorganized, very distractible, not so hyper, can't tolerate stims because they increase the perseveration to an anxiety pitch. Has been on strattera, tenex, wellbutrin, focalin, adderall, ritalin....
    Only thing that seems to help some is Abilify--but he can only tolerate 2.5 mg dose due to side effects. But even that dose seems to help some. I remember you were up to a really high dose of Abilify at one point. We have taken my son off it, only to restart it several weeks later because we saw the difference. It acts on dopamine so it may indeed have some positive impacts on executive functioning.

    We are also trialing a low dose 5 htp supplement to some apparent good effects--seems to work better than zoloft.

    I don't thinkwe are ever going to lick this one. structure is going to be the name of the game.
  16. Janna

    Janna New Member

    Hey, Chris, we tried the 5 HTP! I was so hopeful, too! How are you making out with that? It didn't do a darn thing for Dylan, but it was worth a try. I was really hopeful with that, being natural. He was on Abilify, several different times over several years. It's one of those things where it just kept pooping out. The Seroquel now seems to be doing that. The AP's work great in him at first, then you need to go up, up, up, up and then, there's nothing else to do but d/c. D was up to 30 mg. Abilify, then he was drooling, slurring, etc. But, even then, it didn't do anything for the ADD part. Just the H LOL.

    I think I'm gonna talk to the psychiatrist about the Vyvanse and the Focalin. See what she thinks about the others, too. Jannie, we haven't tried Lamictal. The current psychiatrist chose to trial Tegretol instead, first - but we didn't have a good reaction to it (Dylan was dizzy, felt horrible, complained alot - he's not a medication complainer, so we stopped). When I was sitting at the table with the team, we discussed them together (Tegretol vs Lamictal). I'd have to look back thru notes, but that's what we decided. I dunno that we're gonna do another M.S. Just don't know.

    Hey, MyHrt, give the Lithium some time. Dylan took it, but it took about 8 weeks to get in his system. It really cut his raging down, alot, for a long time (about 12 months!). Make sure you have blood work done. Do you know Lithium can trigger hypothyroidism? That could be making mood changes - I'd make sure his thyroid levels are good.