Teens and ADHD medication

[bnme]

DS is a high school junior who has been on focalin since late elementary school. He wanted to take a break over the summer and he did amazingly well. Had some issues at first, but he seemed to be able learn to adjust/deal with them and he said he overall feels better without taking it. I think remote learning ( we are hybrid now) has made it easier in the sense he can work more at his pace and I can help refocus him ( mainly talk to him about how to plan his day. He gets very overwhelmed and tends to shut down when he has a lot of tasks on his to-do list)

Now that school has started, he is facing some challenges, especially on longer, test loaded days. We have a doctors appointment next week to discuss options, but I am wondering what others do. He really does not want to continue his meds because he feels he doesn’t need them most of the time, and he feels better off them. But there are certain situations he has to be in that he still has a really hard time without. Wondering what others have done in this situation. How do you know if it’s time to transition off or change meds, or if you really should continue?

[bisous]

DS1 is a junior and wants to continue taking meds. He feels that he needs them. I really do think it would be hard to "make" an older teen continue with something like ADHD meds. I know it is a medication but I do feel like it is different than some other meds. I feel like I have an interesting perspective on this because DS1 also has type 1 diabetes. And yes I would FORCE him to take insulin. I feel like ADHD meds were and are so necessary for us. But people can and do go without meds. There are side effects that can be unpleasant. I would say that probably the best thing you can do is go to that appointment and have the doctor talk about the pros and cons candidly. Your DS might do better listening to the doctor present the case for meds than if he's getting the argument directly from you.

[Gracemom]

My dd is 17 and takes Vyvanse. She does not take it on weekends or during the summer. She has a good relationship with her psychiatrist and can ask questions, talk about her concerns, etc. I would encourage your son to write down his questions and concerns and talk with the doctor. It’s so important for them to own their health care and figure out what works for them.

[lizzywednesday]

... He really does not want to continue his meds because he feels he doesn’t need them most of the time, and he feels better off them. But there are certain situations he has to be in that he still has a really hard time without. Wondering what others have done in this situation. How do you know if it’s time to transition off or change meds, or if you really should continue?

I haven't faced this with a child, but DH was diagnosed with ADHD as an older teenager/young adult. He does not take stimulant medication currently, but he has in the past. He also didn't like how he felt on the meds.

The things that work for him include a daily (diet) cola (caffeine is a stimulant, he responds to stimulant medications for focus) and checklists.

What your DS, his doctor, and you need to figure out is how to build that executive function/organizational scaffold so that he can stay focused on self-directed days without you nudging him, otherwise, he really should continue taking the medication, especially on those days when he needs the focus boost.

[gatorsmom]

DS is a high school junior who has been on focalin since late elementary school. He wanted to take a break over the summer and he did amazingly well. Had some issues at first, but he seemed to be able learn to adjust/deal with them and he said he overall feels better without taking it. I think remote learning ( we are hybrid now) has made it easier in the sense he can work more at his pace and I can help refocus him ( mainly talk to him about how to plan his day. He gets very overwhelmed and tends to shut down when he has a lot of tasks on his to-do list)

Now that school has started, he is facing some challenges, especially on longer, test loaded days. We have a doctors appointment next week to discuss options, but I am wondering what others do. He really does not want to continue his meds because he feels he doesn’t need them most of the time, and he feels better off them. But there are certain situations he has to be in that he still has a really hard time without. Wondering what others have done in this situation. How do you know if it’s time to transition off or change meds, or if you really should continue?

Can he take them only in the days he needs them? Like, if he knows the day will be extra long or have several tests he needs to focus on, can he take the meds on those days but not the quieter days?

Also just a thought, it’s not unusual for kids with ADHD to also have anxiety. They often go together. Would your ds be less likely to freeze up if he were on an antidepressant? I’m only asking because that is EXACTLY the behavior of my sons when they are afraid of something. They freeze up and then avoid whatever makes them nervous. The my both take Prozac (which is very well tolerated in our family) and it takes helps them dig in without being fearful. It almost looks like a burst of confidence. Our plan with the Prozac (and by that I mean our psychiatrists and behavioral therapist) is to create new patterns of behavior which, once they are entrenched and become the regular response, is to stop the Prozac. For example, our DS3 was very afraid of all bugs and wouldn’t go outside. He refused to ride his bike or go for walks in the neighborhood and even avoided using the pool. On Prozac he started venturing out and is now in the habit of going out to skateboard and bike with his brother. He still doesn’t like bugs but they don’t stop him from going outside. When we wean him off the meds one day, we hope he’ll have enough experience doing the things he enjoys to no longer freeze up and avoid them. Something like that might work well for your ds.

[bnme]

This is very helpful and giving me a lot to consider. I agree, he really needs to discuss how he feels and what his options are with his doctor. Bisous, I have always felt it was a need, like insulin would be. But now that time has passed, he has changed, and I have seen him off it, that level of need may have changed for him.

Gatorsmom, anxiety is a factor for him so this is an interesting thing to consider as well. Lizzy, I do feel him being off is his helping him learn how to do some of these things “on his own”. In the past, it was just not possible, even if I nudged. It is hard to tell how much is just related to the pandemic and less pressure in someways from school and social situations.

His appointment is next week so we will see what happens. Thanks again for all the insight.