Medication changes

[Sy5636]

Hi I am new to this community. I have a 7yo boy who was diagnosed in end of Kindergarten (he is now in 2nd grade). He recently had a big change in his mood and attitude. He was doing well with medication alone and some behavioral modification. I am only seeing a neurologist and I am currently seeking a psychiatrist but there's issues with insurance not being covered by many pediatric pyschiatrist. Anyways, he was first taking 5mg Adderall XR in 1st grade then upped his dose to 10mg XR. He did ok on it but developed tics when 2nd grade started and noticed it was lasting longer.

Not sure why there was this change. He didn't take it during the summer between grades maybe something changed from that break?

The begging of 2nd grade he started using 7.5mg regular Adderall. He was doing great not impulsive and straight A's. But recently maybe a month ago his grades is dropping, more impulsive, more outburst, etc. Also a new change I have noticed in him is his attitude with myself, grandparents, teachers. He'll throw tantrums no matter where when he doesn't get what he wants sometimes even get combative and aggressive. He doesn't like going to school anymore.

I don't know what has change. What did you guys do if you experienced something like this?

[Onthemove1971]

Sy5636-

Welcome to the group we are here for you whenever. Thanks for reaching out, we all learn from each other.

A few thoughts.. Does he have a 504 plan or IEP to support him in that environment? It is very helpful to assist him with the challenges he has and also, not sure what state you live in but in CA we have state testing and it would be very helpful if he can have accommodations for that( it has to be written into the educational plan to get it. Also is he getting any therapy/behavior training either at school or privately? Many children need a place to go and talk with someone about what is going on with them and help them with their struggles. It also takes the pressure of you guys so he doesn't blame you guys for things.

If I was in your shoes I would request a change in dose or medication. Many times a combination of two different medications is very helpful 1 medication helps to decrease the impulses and the 2nd help with focus.

It would be great to get to a child psychiatrist because they are the most experienced in helping you with these issues. From my experience you will need them for a long time, not just now. As our son has grown he has needed a change in dose.

Hope this helps, there are lots of posts about educational plans on the blog if you need help writing one.

Take care

[Luluisaac15]

Hey there

Currently experiencing some similarities here. My son is 7 years old and in first grade. He developed vocal tics about two weeks ago , and is more irritable lately. We had an appointment yesterday with behavioral and development NP. She prescribed Cotempla XR and intuniv . He was taking Metadate 10 mg. I am hopefully this will work! I’ve communicated all of this to his teacher, and if needed we will make changes to his current 504 plan. I’m also looking into parent coaching for my self . We’ve tried behavioral therapy twice before, and nothing came out of that. His NP informed us that a lot of kids, especially younger ones don’t really respond to behavioral therapy until they are a little bit older .

[anirush]

I would definitely contact your doctor. Sudden growth can make medication suddenly not work. Stimulant medications next some children angry. Neither of my boys can be on them. Intuniv has been a godsend for both of them.

Some kids have problems with depression which makes them irritable and a mood stabilizer added to the ADHD medication is sometimes needed. Talk to your doctor about all of this.

[Pennywink]

Tics are increasingly likely to develop as kids (especially boys) get closer to the tween years. Our prescribing physician said stimulants can unmask tics earlier in a child already prone to developing them.

Have they been happening all year? Tics typically tend to fade in/out, especially during times of stress / excitement (start of school year, vacation, etc. My son seems most effected in May, then nothing all summer.)

A dosage change or adding guanfacine (Intuniv) or clonidine to the medication treatment should help until the child is old enough for Habit Reversal Therapy, or until the tics fade away.

[Hidden]

I have a second grade boy too and it has been rough for us. I would discuss meds with dr. Mine can't be on stimulants as they make him angry.

Son has also developed severe anxiety regarding school and that also makes him unpredictable. It stems from poor management and response of his ADHD at school. He hears only negatives so now wants nothing to do with school.

He sees a therapist for the anxiety and we are making a school change, but also regularly monitor his meds.

I also think season changes cause us issues. Not sure why but we do see regular spikes during the year that seem to mesh with seasons.

[sonicpixie]

We are in the same boat too - and feeling lost. We recently increased medication in hopes that would ease some of the troubles at school - but it did not help AND he developed a tic. My son is 8 and in 2nd grade. He is under the care of psychiatrist to prescribe the medicine. We have since backed the rx back down and the tic has lessened. The biggest trouble is now in the afternoon so I assume he'll need a booster dose at school. I am feeling isolated and lost - the (private) school does not seem to understand how ADHD works and cannot make my child fit in the their box (thank god!). I feel for you and your son. Kids do well if they can. It is a shame that some teacher cannot understand this - and instead our children are shamed. I fear that this year will make a mark on my otherwise bright and sensitive boy - and he will start to believe he is nothing more than a problem.

We have set up an appointment with a psychologist and I am hopeful that he can help my son - and us - understand the gifts of adhd, as well as the obstacle. Hang in there and keep loving!

[MacRN10 in reply to sonicpixie]

We are having the same issue with the school. My son is in a public school system, and I asked for a reading tutor at the end of first 9 weeks at parent teacher conference....nothing. Then at the 2nd parent teacher conference, I asked why he did not have a reading tutor? The answer was basically I didn't know he needed one, yet he is falling farther behind. Then the teacher continued to bad mouth his behaviors, and how he just doesn't want to do his work, how he was up constantly. This was after he started his medicine. (Dad is not supportive and took him off of it for the summer!) So...3rd parent teacher conference I insisted that I had the guidance counselor with me, and proceeded to ask why no reading tutor? Why was his 504B not being followed AT ALL! Basically she continued to put it that she didn't know how to handle him, and she has three boys in the class that have the same issues and she is too busy to work with him. So, I went to the counselor we have been using that comes to our home, and asked for a meeting to discuss the 504B. She saw the same reactions I was getting, frustration from the teacher and negativity. So, I filed a complaint with the US Dept of Education. He is not being accommodated as we were promised, and no one wants to deal with it, so I will the the Dept of Education jump on them, because I am sick and tired of my son "being a problem" to a teacher who has NO CLUE what she is doing. Our kids have rights! That 504B plan should be followed, and I am going to fight to get this school district in check.

[Onthemove1971 in reply to MacRN10]

So frustrating! I am sorry he is not getting the support he needs. Do you think the Director of Sp. Ed. could be contacted and have the school psychologist support you guys. They really need to get this teacher the help she needs.

Hope you get the help your son needs there is so much that can be done with tutoring, online reading programs..

Thanks for sharing.

[MacRN10 in reply to Onthemove1971]

It is a smaller school district. So only one Guidance counselor for the building. No psychiatrist. And no director of Special Ed. The Guidance Counselor handles all of it. I feel like I am educating them whenever I tell them what they SHOULD be doing. They act like he is the first with a 504b plan. When I went to the Principal...he said his kids were both on a 504b plan “if that is what you want to call it”. So....no one is on board here. I’m fighting a losing battle but I swear we (my son and I) are going to turn this school around if it is the last thing I do! I’m a nurse and I deal with some of the pediatric patients that are part of the school system and I vow we will make it good for all. I’m not backing down. They have already tried to tell me that they didn’t say this to my son or do that. They are punishing him when they should be redirecting and allowing him to have extra time. I will get it changed.