On to drug #2: We’ve consistently upped... - CHADD's ADHD Pare...

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On to drug #2


We’ve consistently upped Adderall for our grade 1 son with quite severe symptoms of adhd up to 25mg and as we went up so did his touchiness and temper/extreme anger. We weren’t seeing the attentiveness and focus at school and he become zombie-like so we quickly decided to switch from Adderall last week. Now we are starting at 18mg of concerta and are seeing more energy/in-attentiveness and he’s more “himself” again. Although that is great he’s still unable to function at school. We are waiting to get in to a pediatrician and/or psychologist and I recently read this on an internet article and I’m wondering if any of you have any knowledge/thoughts on combining these drugs?

“ stimulants improve day to day performance for a person with adhd, helping him get things done. They are not effective at calming the internal hyperarousal that many with adhd have. For these symptoms, the majority of people will benefit by adding one of the alpha agonist medications (guanfacjne/intuvniv) to the stimulant”

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Could he have anxiety or sensory processing disorder? Anxiety can affect concentration. So can sensory issues. We had the same prob with our girls.

I’m not sure, he was only diagnosed with adhd at the time however it’s possible? We definitely see positive changes with the stimulant medication and great strides at home it just isn’t getting to the point where he can learn at school. I’ll have to read more into sensory processing disorder.. I don’t believe he has anxiety but it can be sneaky I’m sure.

What did you do for your girls? Our son we just had to pull from the school.

Play this video by Dr Barkely

I am currently talking to my doctor about adding Intuniv to my childs stimulant to help with the EF . Called adjunct threapy.

Thank you for the video!

This is what our son takes and it has been amazing!

That was very helpful. Thank you for posting!

Our son is on Adderall. We upped it but it didn't make a difference because he's overwhelmed with anxiety at his current school. We increased the zoloft he is on but we literally just had to pull him from the school because he was having /is having scary meltdowns similar to what he had last spring break when we took him to Disney and he didn't want to leave the hotel room and was saying that he wished he was dead. We're not letting him get like that again. He's dangerously close to that again. We're homeschooling until we can get him mentally healthy again. It's amazing the soul crushing one school can do I'm only a month and a half. Our son also has a spd. But when he's not overwhelmed with stress, not all, but a lot of his sensory seeking goes away. Now that he's under tremendous anxiety, he can't think straight, can't focus, rolling around on the carpet at school etc. Teachers constantly scolding him for things he does sensory seeking. When he was evaluated by OT at the school she said she didn't see his sensory seeking. We are also are on Intuniv but doesn't seem to make any difference.

in reply to ADHDmetoo

That school sounds terrible. Many of our kids thrive on positive behavioral interventions and supports and require them at school in order to get by. What you described is the opposite and would definitely provoke anxiety and defiance in my child. Have you seen a pediatric neuropsychologist? Perhaps they'd be better at getting to the root of things. In the meantime, have you checked out the Tilt parenting website/podcasts? It's different then typical diagnosis geared websites in that it is focused on parenting and connection and acceptance while also loaded with good info. You feel as though you have found your tribe. Check it out : )

Interesting... and I’m sorry to hear you are having these issues. They are so scary especially when they start questioning their self worth and happiness is affected. we noticed the anger almost immediately went away when we stopped giving adderal, not sure if it was too high of a dose or if they were side effects. His school and especially his teacher happen to be great with him and work with me but he still has 26 students in his class. I guess a lot of the behaviour could still be caused by overwhelm and anxiety.. and I hadn’t really been confident on that connection before. It could for sure be sensory issues maybe too. I hope your son feels happier for the time being while at home with you.. ❤️

He is. We're nursing him back to health mentally. He was really in a bad state,still is but seeing some improvement. He had a semi traumatic experience Saturday where a couple of parents in our cul de sac yelled at him (mostly to watch out) as he was driving his little car. He cried and cried for awhile but recovered better than a few days earlier when similar incidents occurred and he was inconsolable saying he wished he weren't alive etc.

There are other settings that might fit his needs better when and if you decide to return to school.

Most school want the best and "least restrictive" setting for a child and therefore they end up in classrooms with higher numbers.

Is he also seeing a therapist to help him deal with all of these emotions?

Our son takes both guanfacine (intuniv) and dexmethylphenidate (Focalin). Adding guanfacine made a huge positive difference for my son. Our doctor did say that the degree of benefit we reported was not typical, however. The guanfacine took the edge off the stimulant. Our son became more relaxed, playful, and joking and ate better. It allowed us to decrease the stimulant slightly. If you go this route, be aware that although it can make kids sleepy (we give in evening) doses above 1 mg can interfere with rem sleep ( night waking) at least initially.

You may want to look at dexmethylphenidate instead of methylphenidate or amphetamines if you’re seeing touchiness or aggression. Supposedly the single isomer causes less side effects.

What behaviors is your child exhibiting at school?

That’s fantastic you found a combination that works well. I don’t see a column for dexmethylphenidates On the Canadian adhd medication guide but maybe My doctor has an old one. Definitely going to try and get a psychiatrist. Once we switched to the low

Dose of concerta, the anger is pretty much gone. Even at the high dose of adderal he was unable to focus and transition and couldn’t work without one on one support. Also he was really sensory the higher we went with the adderal where normally he isn’t bothered at all by noises, it was almost unbearable for him to be in a loud class setting.

(These were the school behaviours) we did see progress with the stimulants though, so they definitely work)

Dexmethylphenidate is not available in Canada. Intuniv is approved as adjunct therapy if stimulant response is sub-optimal.

Thank yoy

I would highly recommend you seek out help with a child psychiatrist vs a pediatrician. They are more skilled in helping to determine the right medicine to help your son. It took us trying 7 different ADHD meds for my son because we couldn’t find one that would help him focus and control his impulses at the same time. Some meds also caused him more anxiety. Focalin has been the only one that has helped my son and he’s been on it for 7 years now. We tried several non-stimulant as well and none of them worked. Don’t give up and just keep trying different ones with the help of a child psychiatrist.

Thank you for the good tips. 7 different meds, wow what a battle. Focalin seems to be a common one that works with severe symptoms? Do you figure the psychiatrist needs to specialize in children to know adhd and drugs?

I thank God everyday for Focalin! You definitely need a psychiatrist that specializes in ADHD and preferably one that treats children. Finding the right medicine is definitely a journey. It took us 3 years and 3 different doctors before we found the right medicine. There are so many different types of medicine so if one doesn’t work, don’t waste time and move on. Keep a list of meds tried and list the pros/cons. Good luck.

yes we have tried the intuniv but so far its not helping with the ADHD or aggression/violence. We also added sertraline and I'm hopeful this will help with the aggression.

We did Vyvanse and Guanfacine. Barely any affect. Switched over to Focalin and Hydroxyzine and it has worked miracles. He takes Focalin (15mg) in morning along with a Hydroxyzine (25mg). When he comes home around 5pm, i give him a second 25mg of Hydroxyzine along with melatonin and he passes out around 8pm and sleeps through the night.

Note , as always, take this with a grain of salt - every kid reacts differently.

But ultimately in our situation - the adjunctive (stimulant with non-stimulant) has really worked wonders with my little ones impulsivity.

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