Hi there, was anyones child misdiagnosed as ADHD when it was depression all along? My son has been irritable since he was a child, and has been described and sullen and disengaged in class 1st -3rd grade. He was diagnosed with ADHD Inattentive type and DMDD 6th grade. He is now in 7th grade, and we have tried ALL the ADHD meds, which work a bit but make him EVEN more irritable after he comes off of them. He has an ULTRA RAPID metabolism, he metabolizes the ER drugs within 2 hours. So this has been quite a challenge. He is focused for those 1-2 hours, then a nightmare. He is off all medication right now except for 1mg Intuniv ER, which we are weaning off of because he can't take that with Prozac. We are suspecting depression, and we need to get his mood in the right place then deal with the ADHD. He has developed extreme avoidance behaviors with school, he is always tired, always irritable, and rarely happy. He has complained of feeling 'droopy' since he was little, I'd say around 1st/2nd grade.
We are also exploring food allergies, celiac, milk, etc. We have tried so many vitamins!
Has anyone had a child like this that was helped with an SSRI? Speficially, we are starting Prozac because based on his genetic testing, that's the only one that's 'green'.
IF your child takes Prozac, do they also take a stimulant? What were the worst side effects of Prozac?
Thank you!
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amewhit
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We have a 13 year old who is extremely anxious and irritable. He has been on Prozac since the spring and it has helped tremendously. We saw a difference in him within days of starting it.
None that we have noticed. He was also on Sertreline in the past. My biggest concern is sexual side effects but that’s hard to quantify…
Question for you: I’m curious about guanfacine/intuniv — in what way do you feel it below with impulse control? I was thinking of asking our dr about it.
He has been on it for over a year. It’s the only thing that has helped him so far with his impulsivity and just thinking before he reacts. He has so much anger and frustration. It helps a little bit calm down that part of his brain. It is also supposed to help with executive function. He did say it helped with focus a little bit but that didn’t last long. I feel that he probably needed to go up to 3 mg because he is a big guy he’s 130 pounds and 5‘8 inches tall at 12. Intuniv is supposed to help with the emotional regulation part of ADHD. Our choice was to go up to 3 mg or start Prozac. So we are weaning off Intuniv and decided to start Prozac. We should get the prescription tomorrow. I think being on both would be beneficial, but we will have to figure out Prozac first.
We had a somewhat similar situation. 10 year old diagnosed with ADHD and stimulants made him more aggressive and irritable. We stopped the stimulant after trying a couple different ones. We then saw a psychiatrist who said it was underlying anxiety and started him on sertraline, once he got to 50mg we started intuniv. Both of those medications have made a big difference. The psychiatrist had us try a stimulant again but it again made him irritable, but also seemed to make him depressed and have suicidal thoughts. So I think our son has more anxiety than ADHD. Hope that helps and good luck.
Thank you! Intuniv helps but they said both and SSRI and Intuniv would make him too tired (he is already so tired but I think that’s the depression). I’d love to add that back in after we stabilize on Prozac because it does help him be less impulsive. What benefits do you see with Intuniv that the SSRI doesn’t help with?
i’ve tried twice to get him off intuniv while on Sertraline just to decrease the amount of medication and to see if he really needs it. My husband and I both noticed that our son is less impulsive, irritable and angry with the intuniv. My son says the intuniv helps him focus in class. If it’s helpful-He’s on 100 mg of sertraline and 1 mg of intuniv. we tried 2 mg of intuniv, but his blood pressure decreased too much and he was so tired and complained of stomach aches so we had to back down to 1 mg.
He's 11yo, 5 feet and 90 lbs. Wow your son is a tall guy!! Mine and my son both have genetically low blood pressure so I wasn't surprised when he coudln't go above 1mg on intuniv.
my husband has taken sertraline and Prozac in the past but over time he became compulsive obsessive and started gambling, speeding, eating too much, and buying lots of stuff we didn’t need. Then he became suicidal and agitated.
Be on the look out for side effects and try a fraction of the dose recommended for a few weeks only gradually increasing if he is ok with them.
I have had my husbands dna genetically tested and results came back that his dopamine and seratonin pathways are compromised hence his problem with these types of drugs. He now has Parkinson’s, probably also related.
Personally I would really avoid anything that interferes with these pathways with young kids.
You say you have tried vitamins? Have you tried multinutrients with natural forms of b vitamins? Some of the vitamins available aren’t in a form that some people can utilise.
Also with diet have you tried removing all additives , sugar, seed oils and gluten? Maybe dairy? And adding many nuts and seeds, beans, and leafy greens? And exercise, minimise screen time and get enough sleep and morning sunlight.
We changed our diet dramatically and hubby is off the antidepressants and his depression has gone and his Parkinson’s symptoms progression seem to have slowed.
I’ve been doing a lot of research on mental health and diet and the typical diet we all eat has very little nutritional value. Watch this clip from Julia Rucklidge , clinical psychiatrist and lecturer in psychology at Canterbury university New Zealand.
Thank you - we are definitely aware of food and have had him tested for celiac among other things. Three different pediatricians maintain food is not the issue, however we keep away from food dye and dairy seems to upset his tummy every now and then. He also has the MTFR gene so we do methylated B vitamins, folate, Vitamin D, and starting Omega's.
Sounds like you are doing all the right things. In our experience the specialists ( psychiatrist and neurologist) aren't always up to date on latest research and our ones at least don't want to hear about genetic tests or nutrients . My husband also has has the MTHFR and others that mean he processes pharmaceuticals very slowly hence all his overreaction to drugs. I think people can be sensitive to gluten but not celiac. Have you tried Hardy's daily essential nutrients with added vitamers? They helped my husband and son who also struggles with ADHD symptoms. Is he exercising? For my son going to the gym, doing a walk first thing in the morning and playing football plus avoiding screen time as much as possible and going to bed on time really help. He is at uni doing pyschology now so is finally listening to advice as he hears it there too. It's hard when they are teens to get them to help themselves.
So true - sometimes I don't trust the professionals. My son's genetics are really wacky - he has the MTHFR. Then it shows he has the ultrarapid metabolism (3% of the population). The one he has is CYP2D6 Ultra Rapid Metabolizer, which metabolizes a lot of drugs. He also has the COMT Met/Met gene, which means he has reduced COMT enzyme activity with an increase in dopamine (basically his body doesn't get rid of the excess) so he may have less improvement from dopaminergic stimulants. From what I read about COMT, he has a hard time getting rid of toxins (me too!). So when we add toxins (meds), he is great for like 2-3 days then it's a disaster. We did the Genomind test, it was really interesting.
Yes, we did the opus23 one for hubby. I’m assuming our son has the same problems. I’ve had run ins with 3 psychiatrists who want to keep giving him SSRIs even after 3 episodes of suicidal intentions. The genetic make it clear why this is happening. They get angry and say there isn’t enough science yet and want to prescribe more similar drugs.
They work by trial and error one size fits all scattergun approach. But you have prior information which should eliminate some drugs yet they refuse to take that into account. From what you say he will metabolise the drugs fast so will get high rapid spike in his blood which I would expect to cause many of the adverse side effects listed on the drugs webpage. At least this happen to my husband. For him I now trial at 1/4 dose of anything for at least a few weeks then 1/2 if I don’t see any change. He doesn’t need as much of anything as a normal person to experience every side effect. He has a very fast dopamine beta hydroxylase which according to the genetics has bad outcomes. No kidding 😢.
With my husbands dopamine drugs for Parkinson’s he has to take half as much as the lowest normal dose but closer together as it spikes quickly then drops off too fast.
He has found low dose clonazapam relieves anxiety and calms him. He has 0.5mg tablet cut in quarters spread over the day. That and the Hardys den has meant he is better mentally than he has been for years.
The doctors don’t like clonazapam though as it is addictive and has a black market but it works for hubby as it works on the GABA pathway which helps him, not his dopamine and seratonin which are completely blocked.
I hate to sound like a broken record on this board and of course may be totally wrong. I would also be sure everyone feels there are no additional diagnoses that haven’t been recognized eg autism. Mostly because sometimes that’s a missing piece of the puzzle for some kids who are chronically unhappy, irritable, have executive functioning difficulties, and don’t tolerate stimulants despite multiple attempts at trials.
I really appreciate you mentioning this, I have mentioned autism to his speech and language therapist, OT, psychologists, pediatrician, and psychiatrist. The ALL say no. Stimulants do work, it's just that because of his incredibly fast drug metabolism they don't last as long as they should, and then the comedown is horrific. He is chronically sullen, disengaged, tired, irritable, and annoyed. But he can also be happy when he is dong preferred activities. He is a sweet boy, with empathy, kindness, and has an abundance of good in him, he wants to access that part of him all the time but it appears he just can't? I think in boys, anxiety and depression (anxiety first) can present this way (anger and defiance). We have ruled out autism for now - but it's always in the back of my mind.
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