Combining ADHD and Anxiety meds for inattentive type? Please share your experience...

[kaf2022]

Hello, my 16 year old son was diagnosed with anxiety in 3rd grade but with ADHD, inattentive this past summer at age 16. He still suffers with anxiety, mostly social anxiety. His lack of executive functioning seems to be the biggest issue right now with some impulsivity. He had already been on Paxil for 6 months when he was evaluated for ADHD and we began seeing a child psychiatrist. Psy left him on Paxil and upped the dose a little at first - didn’t help ADHD symptoms. Next he started him on 5mg Focalin XR, went to 10 mg after a few days of no negative symptoms. Went up to 15 mg after a few weeks of no negative symptoms but also not much help with ADHD symptoms. A few days on the 15 mg he reported feeling shaky, anxious and irritable all day. We backed off to 10 mg. Now the last few nights have been awful - angry outbursts when med worn off, lots of missing school assignments again, won’t study at all, conflict, etc.

I’m thinking stimulant might not work well for him and have been reading about Clonidine helping those with Anxiety. The Paxil seems to help so we don’t want to take him off of that.

Anyone have experience with teen taking an SSRI like Paxil along with a med like Clonidine or Intuniv?

[Elijah1]

Clonidine and Intuniv can sometimes help. Ask the doctor about stopping the Focalin XR and see if the evening behaviors stop.

[kaf2022 in reply to Elijah1]

I did that - no meds yesterday and today except Paxil. But we are on vacation and it’s hard to tell if it’s truly rebound or all the other stressors that caused his behavior. It was definitely worse than previous. I just want to find the right combo!!

[kaf2022 in reply to Elijah1]

Have you heard of taking both SSRI and Betablocker like Clonidine?

[Elijah1 in reply to kaf2022]

Yes

[Elijah1 in reply to kaf2022]

And clonidine is an alpha adrenergic agonist and not a beta blocker (propranolol fits into the latter category).

[bdhb96]

My 18 yr old sounds similar, but won’t swallow pills so the ADHD med options are quite limited. That said, of the ones tried over the last 4 yrs nothing seemed to make any difference for the inattentiveness.

The thing that has made a huge difference was getting the anxiety under control with fluoxetine (generic Prozac). Other SSRI were tried over the last 6 yrs but fluoxetine was the most effective. Wish we’d found it sooner or switched to a different prescriber nurse/doc sooner to find a better solution.

In retrospect, I’m not sure the ADHD meds made any difference for our child so I probably would have not even started. Perhaps if pill swallowing was possible...

[anirush]

My 34 year old daughter had ADHD all through school and also suffers from severe anxiety. It was managed with meds when she was younger but now she just wants to handle it on her own.

I am helping to raise her 2 sons. Both have the same problems except the younger one is probably bipolar which his dad is. They are both on Intuniv for the ADHD. The younger one also has to take Straterra and Risperdone to manage symptoms. The older teen is on Seroquel and Welbutrin. Besides the above he has depression, too. Both do pretty well managing life but have flareups as does their mother.

Nothing is easy but most days are ok.

[nurse_nelly]

Try a short acting stimulant twice daily. It sucks taking one in the am and then again at lunch time but It has helped my son so much. He was on long acting for years and we had the same issue - angry , irritable, moody.. Then changed to short acting 2 years ago and WHAT a difference it has made... Good luck.