difficult child acting no different off his medications??

[rob#30]

Ok, so Ive been taking in everthing thats been said to me about difficult child being on stims and if he is not accurately diagnosis'd (adhd/odd) than stims are actually not helping him. The psychiatrist has told me before that he could go all weekend without the medications if needed ( when he goes to bio dad's because bio doesnt make him take them, dosent recognize that difficult child has a problem, so they werent being taken @ his house anyway). So, I knew it was ok for me to let him go a couple of days without them. difficult child has not taken his medications in 2 days and you know what?? There is really NO difference in his behavior at all! So now what?? Obviously I will have a call in to psychiatrist Mon morning but Im curious what you all think this might mean??

Dont get me wrong, I just caved in & gave him his Xbox back after 2 weeks because I think I may rip my hair out dealing with him for the past 2 days!! I really think maybe I should video him & show the doctor. He NEVER STOPS moving & talking. I took everyones advice about the phone calls @ work and we have specific times he is to call me now. That sems to have worked a little, now Im wondering if I should set up a schedule for him to only ask me questions at scheduled times? I hope that dosent sound mean but I really think I might loose my mind with this kid....

 

[Steely]

in my opinion opinion it means that the medications are not addressing any of the problems whatsoever. He may as well be taking sugar pills. The stims do not help, and you need to move onto something that will.

Excessive talking, lack of impulse control can be a variety of things. Has he had any neuropsychologist testing? Has he tried any other medications, even a medication like Clondine that is not a stimulant, but can help with impulse control?

 

[rob#30]

Steeley, no he has not been tested, yet. I will be addressing that with the psychiatrist this week. He was prescribed Clonidine a few months ago to help him sleep. It didnt seem to help so I discontinued it. I wonder now if he took that alone if it would possibly help? I'll tell you what, I'd love to give him some right now!! Thanks

 

[Steely]

Yea, Clondine might need to be taken 3 times a day to help in a situation like this. It has a pretty short shelf life. For some kids it works wonders, others not so much. For us, however, it has worked well.

There are still days where I want to stuff a sock (or more) in difficult children mouth. But when he was younger - OMG! I thought my head would spin off. I do think setting up times "you are available to talk" is really important. I did this frequently. Just the other night I told him I was done "talking" and he needed to find something else to do. Now that he is older, that works better, but at your kiddos age - uh - not so much.

Hugs.

 

[gcvmom]

If the stimulants aren't working, he probably doesn't have ADHD. The sooner you get a comprehensive evaluation, the better. We thought for a long time that my difficult child 2 had just ADHD. He responded to stimulants for a while, but over time, they lost their effectiveness. That's because another problem was coming to the fore. He cannot take stimulants now at all -- they barely do anything for him and they actuallly make some symptoms worse. The sooner you know exactly what you're dealing with, the sooner you'll be able to help him more effectively.

 

[BusynMember]

I agree with gvcmom. I would think that more is going on than ADHD and I'd want him completely evaluted. Believe it or not Psychiatrists really aren't very good at testing and often miss the real diagnosis. Worse, they often think a change of medications solves things, and if they don't have the right diagnosis. the medications can actually make things worse. I would go for a neuropsychologist evaluation. It is far more intensive than anything your Psychiatrist will do. And I speak from thirty years seeing Psychiatrists and my daughter and son seeing them. They just don't test intensively enough to catch other problems and often decide it has to be a psychiatric problem even if it is a neurological one. And it's always medications, medications, medications. ADHD is not the only disorder that causes extreme hypernness. We have very few parents here with kids who just have ADHD because usually whatever brings us here is more serious than that.
I would go with the neuropsychologist instead of a Psychiatrist. Or I'd have them work together.

 

[Marguerite]

Just a word of caution - there can be two reasons you may not have seen a difference:

1) if the medications really ARE making no difference; or

2) the conditions under which you are observing him do not challenge his ability to stay focussed, on task and with impulsive behaviour controlled.

In other words, if he has his X-Box and has spent the entire weekend playing computer games unchallenged, then medicated or unmedicated, you would probably not see a difference. What can make a BIG difference is how he seems to you in a challenging environment or with a difficult series of tasks to accomplish.

Before you totally dismiss the medications, talk to him about how he feels. If he WAS playing games all day, ask him if he will work with you in a scientific experiment.

Ask him to choose a computer game which is challenging but which he enjoys. Then ask him to choose a complex but stressful game (one with a lot to accomplish in a short time-frame, a game you can't pause at all), then another complex but introspective game (Myst, for example) that he can take his time with and think before he does anything. You need games which have scores that can be monitored - you are going to get him to report on his success (or otherwise).

Next - test him, unmedicated (preferably when he's been unmedicated for several days at least). He needs to play all three games, at three different times of the day:

1) first thing in the morning before breakfast
2) after lunch
3) evening, an hour before bedtime.

You need a chart to show his scores. You also want his opinion on how easy he found it with each game, at each time. Get him to score this at the time he plays, not later on.

Now repeat this test on a day where you medicate him.

And again - on the first unmedicated day after being medicated on previous day(s).

Score each day using the same methods.

If you can, do other tests too, such as take him to a noisy shopping mall on each of these days. See how you cope, see how he copes. Ask him to score how he feels each day as well as how he thinks he is coping. (I've found that often my kids will score themselves as doing great off their medications, it's just that EVERYBODY ELSE is being horrible to them).

If you're right and the medications really are making no difference, this test will show it. Besides, it will not only give him an excuse to play games, it will involve him in a positive way in investigating his own symptoms. He needs to learn to be a part of this.

Testing him this way does not replace getting him properly assessed, but it IS something you can do yourself in the meantime.

The reason I suggest this - it was only this evening that difficult child 3 said to me that he is increasingly aware that he doesn't do as well when his medications have been missed or when they've worn off. He has actually measured this himself by testing how well he can score on his computer games.

OK, it's maybe not standard testing in any textbooks, but I think this is certainly a valid way of trying to empirically determine the effectiveness (or not) of medications.

If the medications really aren't making any difference, then there's no point persisting. But talk to the doctor about it before you stop. (any evidence you have gathered to back this up could speed up the process of finding out exactly what IS the problem).

We talk about the WOW factor. You really should see something that makes you sit up and take notice. And it mightn't be that stims in general don't work, it could be just THAT one.

Good luck and have fun!

Marg

 

[TerryJ2]

Marg has some good points.
If he's just playing Xbox, it's not really testing him.
In fact, many video games can make his issues worse.

Still, it looks like you're planning to do testing and you'll know more then.
It's so hard to guess when it's just a weekend.

My son exhibits such a huge difference on his Adderal that there is no question in my mind there is an affect. He can be off of it for a day or two but eventually he gets so hyperactive and agitated, he's got to go back on them. I just give him a break now and then so he'll eat. A lot.

Wish I knew more.