ADHD: meds or not?

[AnnieW625]

And--have the child psychiatrist manage this NOT your pediatrician!!! We see lots of issues in mental health and my DH sees them in the ED when you have pediatricians managing these meds.

Yes I am starting to realize we need to do this as well. I need to do more research on this because at least in our current area Kaiser Permanente uses “developmental” pediatricians for this service. I am happy with Kaiser otherwise, but now that we are moving to a new area I am hoping that also starting with the fact that I would like Dd2 to go to some counseling and have her evaluated for potentially having anxiety as well I am hoping maybe that will get her the right physician.

If anyone is with Kaiser and has their child seeing a psychologist for their needs please send me a PM.


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[KpbS]

So what have you found that helps him instead?

Well since they truly are not an option for us, we’ve had to manage with implementing lots of organizational strategies like list making, keeping a clean workspace, keeping books and materials organized, minimize distractions, taking breaks to move your body, redirecting, trying to give just one or two tasks at a time (eg put your dishes in the sink, then go get started), and generally being patient while he outgrows some of it. My DC all have some level of ADD, but none are severe. We homeschool and my kids go to school 1-2 days a week. It’s easier to stay focused one on one than in a classroom filled with distractions. They work in separate rooms also which has helped a lot.

[jse107]

DS (16) has been on Zoloft since 3rd grade and Concerta since 4th. They have been a positive life-changer in every way for him and for us. He talks about his life "before meds" and "after meds." We did therapy for 18 months prior to a full psychological evaluation and then starting meds. ADHD and GAD run in our family, so there was no surprise about the results. Additionally, we had already seen an OT for moderate SPD.

I am a school counselor and school psychologist and have seen what a huge difference meds can make for kids when they are prescribed and monitored correctly. I agree with everyone who has said that parents and family need to be on board. We've made a it a totally normal, non-stigmatized thing in our house. DS knows how to monitor himself and how to let us and the psychiatrist know when things are off. He's lucky in that he doesn't experience any negative side effects and his appetite is just fine. Meds shouldn't be the first or only line of intervention, but they can have their place.

Professionally, I often use the example of high blood pressure with parents. After diagnosis, doctors will ask for change in diet and adding exercise to see if that will be enough to get it to a safe level (think behavioral interventions, coaching, teaching strategies). If that's enough--great! If not, medication may need to be added--starting at a low dose and increasing until efficacy. That doesn't mean one can go out and eat high-fat, high-sodium foods everyday while sitting on the couch. One still needs to eat in a more healthy way and get exercise. The meds are just a tool to help.

[gatorsmom]

We've since switched to Concerta XR and she's on a much more even emotional keel. Concerta doesn't seem to have the same appetite-suppressant impacts that Adderall did, but YMMV.

I just wanted to comment that everyone's experience really does vary. DS3 is taking Concerta XR and it completely suppresses his hunger as well as his thirst. To keep his calories up, we feed him nutritious high-calorie foods. He loves chocolate milk so in the morning and at night when he would normally drink it, I add heavy whipping cream to it. It's DELICIOUS and he loves it. I have to keep an eye on how much he's drinking too, because he avoids it (he says drinking or eating during the day make him nauseous). He gets dehydrated and constipated easily if I don't stay on top of this. After trying 6 different medications, Concerta has the least bad side effects so we just deal with the suppressed appetite.

We medicated DS in first grade for anxiety. It helped a ton. DH refused to medicate for ADD at that time. Finally, by 4th grade, we just had to. The poor kid could not concentrate enough to complete one long division problem! It has made a huge difference. We don't have him take his meds on the weekends or in the summer. He eats more then. I have a friend whose daughter gained weight on her meds because she could actually concentrate enough to eat. She even did better on her eye exam because she could concentrate enough to look at the letters.

As for an ongoing issue, kids in middle school and high school often self-medicate with drugs in their search to calm their minds. And yes, if you have anxiety and ADD, you need to medicate both or the ADD meds make the anxiety worse. Yes, kids do need to learn coping skills-make lists, etc. I think there is a book--Late, Scattered, and Unprepared--that has good tips in it. But if you don't medicate and the kid can't concentrate it only gets worse as they get older. There is a big leap in 4th grade and kids need to be able to read to learn by that age so they have to concentrate.

Give it a try. See what he thinks/how he feels.

Our behavioral psychologist has said more than once that most kids cannot feel a physical difference between when they have taken their medication or not. Their body and mind feels the same either way. We have found this to be true with our DS3. He doesn't notice that he's more focused or calmer with the medication. When I point it out, however, he will admit that without his medication he isn't getting his homework finished, he is making his siblings annoyed with him and fighting more with them. He notices that he's making more people angry with him. I've been working on pointing out to him how different his atmosphere is and other people's reactions to him without his medicine. Hopefully that will help him realize how important this medicine is for him.

Yes I am starting to realize we need to do this as well.

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I just wanted to point out that in some areas of the country it is nearly impossible to schedule an appointment with a psychiatrist. We had 2-3 meetings with the psychiatrist but then transferred DS3's care to his pediatrician for maintenance after struggling to get more appointments with the psychiatrist. It's been fine for us but we also get some input from the behavioral psychologist.

[daisyd]

Professionally, I often use the example of high blood pressure with parents. After diagnosis, doctors will ask for change in diet and adding exercise to see if that will be enough to get it to a safe level (think behavioral interventions, coaching, teaching strategies). If that's enough--great! If not, medication may need to be added--starting at a low dose and increasing until efficacy. That doesn't mean one can go out and eat high-fat, high-sodium foods everyday while sitting on the couch. One still needs to eat in a more healthy way and get exercise. The meds are just a tool to help.

I love this explanation. It's a useful way of looking at it.

[mom2binsd]

DD started meds in 4th grade, and it was life changing, her teachers said it was like night and day the day she started, and the few times she forgot to take them it was very very noticeable. She is now a senior, with a 4.8 gpa and very independent study skills, that would not be possible without her medication. DS was also the exact same and we held off until 4th grade and the change was amazing, even DS could tell the difference. We have an excellent pediatrician and have been fortunate that they both responded well to methelphenidate/XR. DS took a break two years ago, it was ok for school, but his hockey coaches could really tell a difference. They are seen every 3 months for a med check and both have not had any serious side effects. DS needs a much lower dose than DD, although I have a feeling freshman year may prove a different story.

As a SLP who was in the schools, I can tell you the amazing differences I saw in kids who were on medication/vs when they weren't . It can truly be life changing.

[AnnieW625]

DD started meds in 4th grade, and it was life changing, her teachers said it was like night and day the day she started, and the few times she forgot to take them it was very very noticeable. She is now a senior, with a 4.8 gpa and very independent study skills, that would not be possible without her medication. DS was also the exact same and we held off until 4th grade and the change was amazing, even DS could tell the difference. We have an excellent pediatrician and have been fortunate that they both responded well to methelphenidate/XR. DS took a break two years ago, it was ok for school, but his hockey coaches could really tell a difference. They are seen every 3 months for a med check and both have not had any serious side effects. DS needs a much lower dose than DD, although I have a feeling freshman year may prove a different story.

As a SLP who was in the schools, I can tell you the amazing differences I saw in kids who were on medication/vs when they weren't . It can truly be life changing.

That is awesome! I am hoping for similar results with my Dd2 because I know how smart she is, but it is frustrating because I know she isn’t getting the help she needs to perform her best.


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[StantonHyde]

My son can absolutely tell the difference when he is on Concerta and when he is not. He can't tell the difference if he misses his anxiety meds for a few days--he gets angry, is really rigid, and is not nice to be around when he is anxious. But he knows when he can focus and when he can't. For some kids, they just know that their bodies are not as wiggly or they realize they don't get in trouble as much at school. And he will absolutely let you know when he feels off or even the least bit uncomfortable. (he is the drama king in the family!)

[gatorsmom]

I quoted a few people up above but I never really commented on our situation. DS3 was difficult from birth. After already having 3 other babies, I could tell he was definitely different. When we finally found a diagnostic center to figure out what was going on, he was 8yo. I was uncomfortable with the idea of medication but frankly, we had tried everything in the 8 years before that. He was going to OT for SPD, we used weighted blankets for him, eliminated food coloring, etc. Nothing ever did much for him. So when he was diagnosed, we agreed we should try meds. It has been a life changer for DS3. Looking back, I"m so glad we did. There are the obvious reasons- he has lots of friends now, he gets straight A's and his confidence is through the roof. But it's also for the bullets we dodged. His siblings used to say, "mom, DS3 is bothering me!" or, "quit bugging me and go away!" Now he hears none of that. His siblings ask him frequently to join them playing. I wouldn't want my child to grow up hearing, "stop bugging me! Go away!" several times per day. What would that do to their self-esteem? Also, alcoholism runs in my dh's family along with ADHD. Is it because those relatives with ADHD were self- medicating? If we didn't help DS3 with safe medications, would he be likely to end up an alcoholic like his father, grandmother and great grandfather?

He's taking Concerta XR and Prozac. The Concerta causes him to pick his skin and lose his appetite and sense of thirst. The others we tried caused terrible stomach-aches (Adderall), bursts of uncontrollable rage (Focalin and Vyvanse) and extreme sleepiness (Guanfacine). A couple of them did nothing at all (can't remember their names). Concerta helped him focus the best with no rage so we we work around the appetite and picking issues. We have noticed over the past 4 years that over time, when he stops picking and he starts looking for snacks throughout the day, his attention starts to slip and his grades slip too. Then we know it's time to increase his medication.

I'm so glad we put him on meds!

[belovedgandp]

DS2 has shown ADD signs since 1st grade. But we've always managed with strong routines, timers, and great teachers. He's now 13 and going into 8th grade. Being home in March and April brought out how much he really needs routine. Middle school was harder with more to keep track of. He would be fine for a month then slide for a month or two but able to catch back up. We're just starting the evaluation process to medicate.

I want him to have a better handle before starting high school. From being home with him doing this school work, I can truly see that he was only hearing about 25% of what was being said in class. But he's stinking brilliant and can pull low A's easily.