View Full Version : Overall update and questions

07-03-15, 02:28 PM
Hi all. It's been a while since I've posted. Quick background and update. Our 8.5yr old son L was diagnosed at 5 with the hyper-impulsive type of ADHD, at 6.5yrs he was also diagnosed with Tourette's. The Tourette's is 95% controlled with 1.5mg of Tenex a day. The ADHD is very atypical as L is extremely organized, focuses well at school etc. He certainly does has issues with impulse control, and social issues where he is super competitive, has to be in charge, and is "difficult" overall. He does not have tantrums or aggression but we have issues with not listening, feeling like he's always right, and some hyperactivity.

We have been considering behavioral therapy or maybe trying stimulants again (Tourette's makes me hesitate and I'm not sure they could help his issues). I'd love any thoughts on either of those options.

Here's my other question and its a weird one. L is a bed wetter. We were just away for the last month visiting family so the doctor prescribed Desmopressin for night time wetting. It worked great but more surprisingly we saw an immediate, unexpected, drastic behavior change for the better. The impulse control, overall attitude, and even competitiveness issues were hugely improved. And yes, we experimented by taking him off (completely safe to do) and putting him back on it and it's definitely a result of the medication. I can find nothing online about this. I'm not sure if I should even approach his pediatrician about using it for the long term because I'm pretty sure she's going to think I'm nuts. Does anyone have any thoughts on this at all?

07-03-15, 02:34 PM
Have you thought about having him checked for Enuresis? Its a conditon that can make bed wetting hard to break. As far as meds go, if there is no long term issues with taking the bedwetting med, then maybe its not a bad idea? Sometimes off label use of meds can be a real life saver. As far as stimulants go, with the tenex it could work now so its worth considering.

07-03-15, 03:17 PM
Has the bed-wetting affected his sleep -- does he wake up afterward? Sleep deprivation can exacerbate any impulse control / bossiness / not listening issues that are already there (and sometimes cause them).

If the medication has reduced bed-wetting and thus allowed him to get more uninterrupted sleep, I could see that as being a possible contributor to the improvement you've seen in behavior. Likewise, if the bed-wetting was causing him anxiety that he expressed by needing to be in control, etc., I could imagine that reducing the wetting would lead to reduced anxiety and a mellowing of his behavior.

If it's not either of those things, and it's some other physiologic response, hooray anyway, for treating two issues with one med.

I could only find a couple of papers discussing the relationship between desmopressin response and cognitive/behavioral variables, neither of which seemed directly relevant to your son's case, but it does appear there are certain neurological predictors of response, which could perhaps hint at neurological effects of treatment. But that's speculative.

I don't know enough about the long-term safety of desmopressin to make any useful comments -- and I'm not a doctor, and don't even play one on TV -- so that's something to ask the pros. I do know that the medication affects a number of systems related to fluid balance in the body, and thus can affect blood pressure and kidney function, especially if water intake isn't carefully managed. Again, I don't know if this is anything you need to be concerned about, but I would guess that it could potentially have implications if your son is into sports or outdoor activities where hydration (enough, but not too much) might be a concern.

Also, you may find that some of your son's symptoms will decrease with time / cognitive / behavioral therapy, so you may not need to continue the desmopressin indefinitely.

In any case, glad you've stumbled onto a treatment regimen that's helping so much!

07-03-15, 05:58 PM
Well it looks like I may not be crazy after all!