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Failed medications, starting from scratch...
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<blockquote data-quote="smallworld" data-source="post: 53111" data-attributes="member: 2423"><p>A few thoughts about the medications:</p><p></p><p>While the maximum dosage of Daytrana allowed for kids 6 to 12 years old is 60 mg, there is a good chance 40 mg is too high for your difficult child. Stimulants are dosed by clinical response, not by weight or age. So if a kid starts getting jittery, talking too much, acting like he's on crack, that reaction is consistent with too high a dose. It's like when you or I drink too much coffee (another stimulant). We get jittery, high-strung, too talkative. Same kind of response.</p><p></p><p>There are some kids (about 15 percent) who don't respond positively to stimulants, even if they have ADHD. Then there are some kids who don't respond positively because they don't actually have ADHD, but another disorder whose symptoms mimic ADHD. And then there are some kids whose attention increases on stimulants, but whose mood is affected negatively. My own son falls into that latter category, although he has done the best on low doses of Focalin XR, which we use for school days only.</p><p></p><p>In terms of Zoloft, when I recently spoke to the child psychiatrist who is a researcher at NIMH, he said there are three kinds of common negative reactions to SSRIs. First, within days the child becomes impulsive and more active. This reaction is related to the medication and/or dose, and the reaction stops when the medication is discontinued. This reaction is not an indicator of bipolar disorder. Second, within days the child experiences auditory or visual hallucinations, again related to the medication and/or dose. The reaction stops when the medication is discontinued, and again is not an indicator of bipolar disorder or schizophrenia. Third, after weeks (typically 3 when the medication truly kicks in) the child becomes aggressive, violent, in "mission mode" and/or suicidal, and the child rages for hours. Even after the medication is discontinued, the child does not settle down. This psychiatrist believes this latter type of reaction is more indicative of true mania associated with bipolar disorder and treats it as such. My son experienced this type of reaction after taking Zoloft for 3 weeks, and it did not stop for months until he was prescribed a mood stabilizer (Depakote). Although we will not know for certain whether he has bipolar disorder until he gets to the other side of puberty, his psychiatrist is treating him as such because of his symptoms.</p><p></p><p>In your shoes, I would not want to trial new medications until you are more clear about what you're truly dealing with. by the way, a neuropsychologist is what you're looking for, and they are frequently part of the Depatment of Psychiatry or Psychology at large teaching and children's hospitals. They may not be advertised as such, but if you call those departments, the staff there may be able to help you out. </p><p></p><p>Hope you are able to get some answers soon.</p></blockquote><p></p>
[QUOTE="smallworld, post: 53111, member: 2423"] A few thoughts about the medications: While the maximum dosage of Daytrana allowed for kids 6 to 12 years old is 60 mg, there is a good chance 40 mg is too high for your difficult child. Stimulants are dosed by clinical response, not by weight or age. So if a kid starts getting jittery, talking too much, acting like he's on crack, that reaction is consistent with too high a dose. It's like when you or I drink too much coffee (another stimulant). We get jittery, high-strung, too talkative. Same kind of response. There are some kids (about 15 percent) who don't respond positively to stimulants, even if they have ADHD. Then there are some kids who don't respond positively because they don't actually have ADHD, but another disorder whose symptoms mimic ADHD. And then there are some kids whose attention increases on stimulants, but whose mood is affected negatively. My own son falls into that latter category, although he has done the best on low doses of Focalin XR, which we use for school days only. In terms of Zoloft, when I recently spoke to the child psychiatrist who is a researcher at NIMH, he said there are three kinds of common negative reactions to SSRIs. First, within days the child becomes impulsive and more active. This reaction is related to the medication and/or dose, and the reaction stops when the medication is discontinued. This reaction is not an indicator of bipolar disorder. Second, within days the child experiences auditory or visual hallucinations, again related to the medication and/or dose. The reaction stops when the medication is discontinued, and again is not an indicator of bipolar disorder or schizophrenia. Third, after weeks (typically 3 when the medication truly kicks in) the child becomes aggressive, violent, in "mission mode" and/or suicidal, and the child rages for hours. Even after the medication is discontinued, the child does not settle down. This psychiatrist believes this latter type of reaction is more indicative of true mania associated with bipolar disorder and treats it as such. My son experienced this type of reaction after taking Zoloft for 3 weeks, and it did not stop for months until he was prescribed a mood stabilizer (Depakote). Although we will not know for certain whether he has bipolar disorder until he gets to the other side of puberty, his psychiatrist is treating him as such because of his symptoms. In your shoes, I would not want to trial new medications until you are more clear about what you're truly dealing with. by the way, a neuropsychologist is what you're looking for, and they are frequently part of the Depatment of Psychiatry or Psychology at large teaching and children's hospitals. They may not be advertised as such, but if you call those departments, the staff there may be able to help you out. Hope you are able to get some answers soon. [/QUOTE]
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