Discussion in 'General Parenting' started by Bugsy, Feb 14, 2007.

  1. Bugsy

    Bugsy New Member

    It has a been a long while. My son is almost 6 and has been diagnosis with a mood disorder. After 2 1/2 years we have gotten him more stable using seroqel. Now we are trying to address some attention issues. We started Focalin (2.5am, 2.5noon). So far I think the only effect is he seems more active. He has not seemed quite this energetic in a while. Has anyone experienced this causing more energy?

    Noone can seem to decide if he is ADD/ADHD or not. He can attend well to stories being read, while the class is doing an activity, walking in the hall, basically all structured activities. The problem is he can not do ANY task by himself even though he is cognitively very bright (IQ 132). He can not play puzzles, build blocks, watch tv, color...NOTHING. He needs the teacher close by him to help him complete a task. He talks constantly, walks around looking for stuff, cannot settle down to play anything.

    Any thoughts appreciated.
    Bugsy's Mom (my signature has not been updated)
  2. smallworld

    smallworld Moderator

    When a child has a mood disorder, stimulants like Focalin can rev him up rather than help him attend. The "inattention" you're seeing may be part of the mood disorder instead of true ADHD. You might want to ask the psychiatrist instead about a first-line mood stabilizer (Lithium, Lamictal, Depakote, Tegretol, Trileptal).
  3. Liahona

    Liahona Active Member

    Focalin sent my difficult child over the top MANIC. He was so hyper I stopped it after 3 days without consulting the doctor first. Normally I like to talk to him before stopping or starting medications.
  4. Bugsy

    Bugsy New Member

    Thank you,
    I did forget to write that he is on Lamictal too. We have been titrating it very slowly. His medications are:
    AM: 150 seroquel
    32.5 lamictal

    After Lunch: 200 seroquel

    Bed: 325 seroquel
    25 lamictal

    My gut feeling is the lack of ability to attend is much more due to the mood disorder. I have been in the field for many years as a teacher, consultant and advocate but it is way different when it is your own child. His inability to focus does not resemble any of the MANY children that I have been with over the past 20 years that have a diagnosis of ADD/ADHD.

    I am not giving the Focalin to him tomorrow. I still would appreciate any other thoughts.

    Thanks and Happy V-Day to all.
  5. SRL

    SRL Active Member

    Has a private Occupational Therapist (OT) evaluation been done to rule out sensory issues? Sometimes kids with Sensory Integration Disorder (SID) are in high gear all the time as they seek out various sensory stimuli.
  6. smallworld

    smallworld Moderator

    That Lamictal dose is not high enough to offset any of the bad side effects a stimulant could cause. Although my difficult child 1 is older and bigger, he is successfully taking 200 mg Lamictal with 10 mg Focalin XR. My difficult child 2, who weighs 55 pounds, takes 125 mg Lamictal. Like you, we titrated their doses very slowly over the period of several months.
  7. Bugsy

    Bugsy New Member

    He has been going to Occupational Therapist (OT) for 2 years and at first sensory was very much considered an issue but he does not seem to show much of the signs any more. No problem any more with sounds, textures, touches, crowds, etc. He used to need to swing in his swing a lot but not much any more. He presents like a typical 5+ year old but when looked at closer he does not function well. In fact most Occupational Therapist (OT) would sign him out because his fine motor is good enough ( poor coloring, but yet good enough; no sensory stuff and doing okay with other skills) He does not qualify in a school district. Our Occupational Therapist (OT) is so great she gets that he is not functioning well enough and is trying to help get him to work more independently.

    People that have more experience with Lamictal, do you think he may settle down more when the Lamictal is around 200mg? I know that the doctor's goal is to get it up around 150-200.

    Thanks again,
  8. jannie

    jannie trying to survive....

    Hi Bugsy--
    Glad to see you--

    I don't have any advice regarding focalin because difficult child was only on it for one day-one dosage. difficult child began having tics within 45 minutes of trialing it-

    Sounds like difficult child is showing improvements-

    How many days was he on the focalin? Sorry this medication doesn't seem to be working.
  9. Sara PA

    Sara PA New Member

    Have you had his eyes checked for convergence? If both eyes can't focus on the same point he may not be able to do seat work or watch TV comfortably, causing him to want to move around.
  10. ForeverSpring

    ForeverSpring Well-Known Member

    Has he seen a neuropsychologist for possible high functioning autism? He has a lot of the signs--Sensory Integration Disorder (SID), high IQ but trouble applying it, ADHD symptoms that don't respond to ADHD medications. How does he relate to his peers?
  11. Bugsy

    Bugsy New Member

    Yes to the neuropsychologist. The signs you mentioned do not present like an autistic child. He can apply the knowledge but verbally and the Sensory Integration Disorder (SID) has really gone. The dr. attributes it to the high aggitation level from the mood disorder. He relates well to his peers (more so that the mood medications are helping). He is very social, can be so charming, and cracks people up with his sense of humor. More and more it seems like a very clear case of a mood disorder. He is functioning in Kindergarten but the concern is being able to work without someone being with him. It is has if he has so much going on in his head that talking with someone, having an interaction of some sort helps him to keep on task.
    I spoke with the dr. and we are going to try to be patient and keep titrating the Lamictal up and see if that helps. I am running short on patience.

  12. SRL

    SRL Active Member

    There's so many kids and parents coming through here that I can't keep many straight in terms of evaluations/specialists/diagnosis so there may be something major here that I missed. This is my opinion so take that for what it's worth--

    When children are this young and doctors start talking about adding a third medication I get very, very nervous and if it were me I would be stepping back and getting second opinions on the evaluations and treatment recommendations. I also think it's in the child's best interest to step back and re-evaluate all the medications instead of keeping adding on to fix this problem and that problem. Please understand I'm not totally anti-medication here but if he can't do any task without the teacher are non-medication solutions such as getting a 1:1 aide being considered? I worked with my daughter's class yesterday and the by far brightest kid in the class got half of what everyone else did because he could not stay on task so it's a very legitimate option. The aide provides the "structure" that the classroom teacher doesn't have time to do.

    The other thought I have for you to research is I have known parents of a few children report that their child's over the top distractability was sensory seeking but not in the way that we would typically associate it with. These kids literally needed the stimulus of the physical environment to what I can best describe as orient themselves in space or in a particular environment. The result is the same as ADD/ADHD in that the child can't attend but it has a different feel to it. They are finding out that sensory is far bigger than just Sensory Integration Disorder (SID) and the new term is Sensory Processing Disorder if that helps any. I'll try and remember where I saw parents post about it and dig up more info if I can.
  13. SRL

    SRL Active Member

  14. Bugsy

    Bugsy New Member

    Thank you very much. Very interesting. Ihave been discussing Executive Functioning for a long time has a professional and have explained to many educators and parents as a problem for many children around 2-4th grade and beyond. I never read as Executive Dysfunction and it being a possible diagnosis. I will look into further and bring it up to the dr.

  15. jannie

    jannie trying to survive....

    In regards to Executive child just had nuerupsych testing at a local Children's Hosptial and basically the results of the evaluation were difficulties with EXECUTIVE FUNCTIONING....I thought I would get more information, but they just kept referring to his breakdowns as functions of "frontal lobe looping issues"--they said his issues...mood regulation...anxiety...sensory overload....tics....word retreaval...etc are weaknesses realted to executive functioning.

    There is a thread in General archives on this topic.
  16. SRL

    SRL Active Member

    difficult child saw a doctor who used the Executive Function Disorder as a diagnosis but said it was evolving. Our school district is behind in understanding and addressing it even though we live in a pretty on top of things district. I think it's gaining more acceptance. Don't know the status in the DSM IV- text revision which is what is currently being used criteria wise.