I am a mother of a 7-year-old son diagnosed with ADHD 3 years ago. He just started Adderall this school year. He started with regular Adderall, but it didn’t last long enough and he was easily agitated when it was wearing off. So we started with the 10 mg of the XR version and bumped up to 20 mg, which is working, like a charm.

My problem is during the past week he has developed a dry hacking cough. It comes and goes all day long. It doesn’t bother him during sleep. He was seen in the ER after a coughing spell lasting 4 hours. Chest x-rays were clear and albuterall treatment temporarily stopped the cough. The pediatrician and pulmonary specialist agree it is not asthma but might be a tic caused by the Adderall. I am at my wits end, he needs the medication but not the side effect. Has anyone ever had this type of side effect and if so how did they treat it?

I have an 11-y/o son with what sounds like a similar problem. He doesn't cough for hours at a time, but he has a kind of dry, intermittent cough all the time that really sounds like a nervous cough. I think it probably is a result of his medication--he also seems to blink a lot. He takes 30mg of XR daily and I'm thinking about lowering his dose. However, we don't dose him on the weekends and the cough seems to persist. If you have learned anything else since posting, please let me know.

My son is not yet medicated (mom is researching this to death first). However, when he started a new school this fall he also began to cough and blink his eyes a lot, he also flexed his hands while writing. I thought for sure he had Tourettes. We later figured out with help from our psychologist , and after visiting the eye doctor...that it all had to do with anxiety. He only does these things when he is anxious. And the hand flexing has stopped since we realized he was holding his pencil too tight.

Stimulants can cause tics, and a cough is a kind of tic. I'm not sure how you can differentiate between a ticklish little cough and tic related cough. To complicate the situation stimulants will give you a dry mouth which might also cause a dry cough? You would think that a tic related cough would not persist when off the drug - or the frequency would go way down. If it's anxiety related, the stimulant would generally make it worse, so you'd want to deal with the anxiety as well (and not just because of the cough). I wonder if Strattera might be worth looking at if a stimulant gives coughing spells 4 hours long? It works well in a lot of children and I think it might work for anxiety too, but I am not sure. Sometimes a stimulant is used along with Strattera, but I suspect it might be a lower dose than a stimulant alone? It might be worth asking your pediatrician about?

Thank you all for your input. I thought I should update you on our ongoing med situation.

UPDATE 3/1/04

The doctors decided that his cough was a tic aggravated by the Adderal XR. Now they have put him on Concerta 27 mg. He has only been on it for 4 days but there is no sign of cough. Although already I’m not liking the side effects. He is too quiet now and seems to be “zoned out”. When he starts to come down off the medication he is very quiet and seemingly depressed. At his last basketball game, Sunday 4:30 pm, he didn’t even want to play, he just walked up and down the court for the 2nd period. He sat out the 3rd, sitting on my lap with a “zoned out” stare. I asked him if he were feeling okay, he said yes. When the coach asked him to play the 4th quarter, he started to cry (me too, almost). After the game they had a little party with pizza, juice and cookies. He had certainly come down off the meds, because he ate 3 pieces of pizza, 12 cookies and 2 juicies. He was also running around playing with all the kids, like normal.

I have made a call to the doctor to have his dosage lowered. She lowered it to 18 mg. Now it seems to have no effect at all.


Update 3/15/04

Once again they have changed his meds to metedate 20mg. I'm not sure this is working for him either. He seems to have the same issues with self control and fidgeting. I will give it some more time, but so far I'm not happy with the results.

One thing you might consider is whether your son has some depression as well. Depression and ADD/ADHD are often comorbid. You might want to mention this to the doctor as well, as symptoms of depression and some medication side effects can be very similar.

I did bring up my concerns with the doctor and she seemed to think that the dosage was too high. But now our problem is the dosage at 18 mg of concerta isn't enough. The "specialist" suggested 20 mg of metedate. This doesn't seem to be working as well as the adderall XR. I wonder if he will suggest another medication. I know it takes a long time to get just the right medication and dosage, but this is getting ridiculous.

My 7 year old just started dexedrine, and he is experiencing the exact same cough you describe. We weren't sure if was a cold, or maybe allergies. (he's never had any). Now it sounds as if it is tic related. He was doing so well on the dexedrine otherwise. But that dry, hacking constant cough is too much. I'm glad I found this forum, because I didn't know where to turn for answers.

I too was searching for answers and found this forum. It is great to know there are people out there going through the same thing you are. Sometimes they are a little farther along in the process and have valuable information to pass along. AJ is now on Mededate 20 mg and so far, so good. No side effects at all.

Hope you get some answers soon.
Linny

My pediatrician says he's definately sure my son's cough is tic-related. We took him off the dexedrine, and the cough started to subside, but it's still there. Guess the only other option is Strattera, but he has terrible trouble swallowing pills. If one stimulant causes tics, wouldn't they all?

I also thought that all the stimulants would cause the tic. But the "behavioral specialist" explained to me that even though they are all stimulants they target different parts of the brain and have varying side effects. AJ is now on 20 mg of Metedate, a stimulant, and is responding well. Adderall and Metedate can be sprinkled on a spoonful of applesauce if your son can’t take pills. AJ has no trouble with pills, he likes to keep up with his older twin siblings and has to do anything they can do. It did take a week or so before we noticed a difference, but it is there. He is now excelling at school, and is excited to come home and tell me about all the other kids in class getting in trouble for talking and it's not him. What a morale booster for him to be the role model for a change.

This seems to be the right medication and dosage for him. It takes enough of the fidgeting out of him so he can sit and concentrate, but not so much that he sits in a "zombie" state. He also has maintained his appetite too. The first medications we tried, Adderall and Concerta, took away his appetite so much so that he dropped 5 pounds in the first 4 weeks. That had me very concerned, He couldn't afford to loose 10% of his body weight on his small frame. He has since gained it back.

As for the cough, it did take about 2 weeks off all medication before it was completely gone. On the bright side, we now know is only allergic to cats and not the host of thing I thought he was. But we are still not getting him a dog like he wants. (at least not now anyway) He also has a very mild case of asthma. Both good things to know, but not a way we had intended to find out.

My son now looks forward to going to school and learning and being with friends after school and on weekends. He was always social but had a hard time with maintaining friendships. I no longer fear that other parents won’t want him back at their house because of his behavior. As a matter of fact he had his first sleep over last weekend. I was nervous, but we both survived. Hang in there JMOM, it takes a while to find what’s right for your child, but the payoff is so worth it. And keep checking this forum, it is a wealth of information from people like you and me, and their experiences dealing with ADD/ADHD every day.

My 7 yr old son has been on Daytrana (patch) for ADHD for 1 1/2 years. Everything was going great up until 4 months ago. He has been scratching at his bottom excessively (enough to wear holes in his underwear). We took him to a GI doctor who believes it is psycological. We are going through a few other tests this week just to rule out other things though. It wasn't until this evening when my son coughed that I realized that he started having this same dry, hacking cough about the same time the bottom scratching started. It just dawned on me tonight that these symptoms are probably tics. I feel so helpless! I am reading how MPH (active ingredient in ADHD medicine) actually helps with Tourettes. And I can't help but wonder if the Daytrana created the tics. Do I stop with the ADHD medication now? I am very concerned and the information I am finding on the web is contradicting. Just when I thought things were going good. Does anyone have any advice for me??

I find all of this talk on how the coughs or itching must be automatically a tic quite interesting, and actually feel a bit frustrated for the kids that get labeled with yet another symptom and or condition that they actually may not have, and may just be their body responding to the medication. I guess it's just parents and doctors hypothesizing on what must be happening because they typically aren't the ones experiencing what these medications do to your body. (See my post in Ritalin/Coughing section as well) If you think about one of the possible scenarios that may be going on here, in reality it's very basic human-biology, these medications consist of salts, salts that are not usually part of our bodies, at least in these concentrations I would assume, (I am not a doctor or a bioloigist) If your you or your child is coughing his/her sinuses are probably dehydrated as a result, it affects your mucous membranes, in some more than others. As a natural defense to protect your sinuses etc, you're body is going to react by covering them with phlegm, not that pleasant to think about, but true just the same. This causes it to accumulate in the back of your throat and then the natural reaction is to cough, a lot of the time due to post nasal drip or to clear your throat. As I stated in my other post I was able to find temporary relief using a nasal saline spray. It works, but requires me to use it many times an hour. I am thinking of trying Strattera to see if it's possible that dries me out less.ffice:office" /><O:p></O:p>

:) I can't tell you how happy I am that I found this forum!!!! I have an 11 year old girl that has had a cough on and off for about 4 years. It seems worse during the school year and disappears in the summer. At first I thought it was season related. Then it hit me that I take her off her adderall xr during summer and any other time when she is not in school. Her Psychiatrist told me that I shouldn't do that because the poor kid cant sit still and it's better than people crabbing at her for something she can't help. You know what ? The constant movement doesn't bother her and I'm used to it. I only give it to her so she does well in school . She can't focus without it. I asked about the coughing and he said that it could cause tics but he didn't think thats what it is. Doctors tried to treat the symptoms , (cough syrup, singulair, inhalers)
This is the first place that I have seen where anyone acknowledges the fact that adderall is associated with a cronic cough. I even took her to an allergist. No allergies !! One even told me it was an asthma.
Inhalers dont help and she has no breathing problems, and she doesn't cough at night. I switched to a medication called "vyvanse" and she used it for a month and the coughing stopped. I went to fill the prescription again and my insurance said that it isn't in their formulary, so they wont pay for it unless I try all the other adhd meds that are in their approved list. Tomorrow I am taking to a new psychiatrist at foote hospital in jackson . Hopefully this Doctor will get it :confused:!! One other thing I learned by taking her off the medicines whenever possible, she would grow!! She was not growing when I kept her on it year round. She is starting to catch up now. People need to keep an eye on their weight and growth. You always need to keep and eye out for problems because no one knows better than you if something is not right. Just because they are Doctors doesn't mean that they know everything.:rolleyes:

We had the same issue with Straterra and throat clearing. It was every 2 seconds. It took 6+ weeks to go away after discontinuing the med. It came back on day 1 on daytrana lowest dose.

My son was on adderall for about 6 months and about 3 months ago also started with a cough that just did not go away. Tons of phlegm, dr tried 2-3 antibiotics and nothing worked. Finally switched to another dr. and he put him on 2 inhalers (which only worked for a short time) then sent him some med (can't remember the name) which he took for 5 days and he says would get rid of the cough entirely (it was a steroid of some type). This same dr. also switched the adderall to Focalin XR and the cough has completely disappeared. Understand that even with all this different meds for the cough, you could always hear the phlegm in his chest (like a rumbling) and now even that's gone. I find it so incredible how many people any responding with the same probs more or less. The adderall would make my son extremely anxious and would last 4-5 hours tops, very moody and it was very inconsistent (not to mention the lack of appetite). The Focalin has been a god send. He is always eating (he's skinny so I'll take it!), has very little rebound and lasts 7-8. Finding the right meds is truly the key. Good luck.

My 9 year old son has been on Adderall XR (varying doses) for 5 years.

*He develops "tic like" behavior periodically
*These medication tics have always come and gone
*Tics usually last 1-3 months

Tics have been:
-clearing throat
-picking nose or touching nose area as if something is there
-sniffing nose and then swallowing air and making a gulping sound
-picking lip (current behavior)

At first I was scared and alarmed; his child psy. assured me the tics would come and go. And so far....always have.

I hope this helps those who are worried about their current situation. :)

My 9 year old son has been on Adderall XR (varying doses) for 5 years.

*He develops "tic like" behavior periodically
*These medication tics have always come and gone
*Tics usually last 1-3 months

Tics have been:
-clearing throat
-picking nose or touching nose area as if something is there
-sniffing nose and then swallowing air and making a gulping sound
-picking lip (current behavior)

At first I was scared and alarmed; his child psy. assured me the tics would come and go. And so far....always have.

I hope this helps those who are worried about their current situation. :)


Thank you for this. I am exteremly worried, I started a thread about adderall xr related tics to which I've received thus far zero replies.

My eight year old took the 5mg dose for only five days when he developed a head rolling and a light cough tic. The light cough vanished as soon as we stopped the adderall, but the head roll has not gone away. I'm petrified that it wont go away and the doctor isn't really being clear about. He said that once you stop the meds the tics should be gone within 72 hours, but I'm reading so many mixed reviews, some even suggest that sometimes they don't go away.

I'm worried sick. He didn't have any of these tics prior to the medicine, I wish that I never started him, what was I thinking? :(

I'm so sorry that you are going thru this.:(

It is not your fault......try not to blame yourself. You were only trying to help him-not hurt him. Putting your child on medication can be a difficult decision....but a choice.

Is there another Dr. in your area that may be able to help you?

My son started with Ritalin at the age of 4 (it increased his rage); then we switched to Strattera and later added Adderall. He has never been taken off the stimulant to see if the "tic like" behavior subsided. We chose to "wait it out" and it has always worked to our advantage.

Try not to blame yourself.....parenting ADD/ADHD children is not easy!!! I hope things go better real soon.;)

I'm so sorry that you are going thru this.:(

It is not your fault......try not to blame yourself. You were only trying to help him-not hurt him. Putting your child on medication can be a difficult decision....but a choice.

Is there another Dr. in your area that may be able to help you?

My son started with Ritalin at the age of 4 (it increased his rage); then we switched to Strattera and later added Adderall. He has never been taken off the stimulant to see if the "tic like" behavior subsided. We chose to "wait it out" and it has always worked to our advantage.

Try not to blame yourself.....parenting ADD/ADHD children is not easy!!! I hope things go better real soon.;)


Thank you again for replying, it's tough to keep going, particularly when you question every step because you aren't familiar with this, even tougher when you stand in front of a wall and no one is offering any explanations.

I'm incredibly confused and have no idea if a pediatrician can diagnose based on what we tell him. All we did is walk into the peditricians office, told him about the complaints that we've received from various teachers in the past 3 years and his response was "Yup, sounds like ADHD".

I've combed this forum upside down seeking information, answers, tips, clues, ideas, and still not sure where to begin.

You see, my eight year old was born on the cusp, in the beginning of October, so he is really a year younger than most of his classmates, and acts it. We had the option of starting him a year later (in first grade), but I pushed and felt that he'd be able to keep up with the rest of his classmates. He's a very friendly and outgoing boy, but his grades are average, he isn't failing, understands his material, but as with other ADHD children, he takes hours to complete simple assignments, often material that he is completely knowledgable in and displayed no problems one day, will sit in front of and struggle for hours the following day. He reads incredibly well, but does not retain the information, so if you'd ask him what he just finished reading more often than not, he'll stare at you as if a deer caught in headlights. He doesn't get antsy, has no problems sitting through meals or through any situations that require a long time to sit still. He doesn't do the running away and the unmanagable issues that I read about. And that's why I'm so puzzled about the diagnosis.

Can a peditrician based on what we told him make such a diagnosis?
Or is there a specific set of tests that my boy should undergo?

Will these tics go away? :(

And how do I stop myself from feeling as if my heart is shattering in a million different pieces?

My 9 year old was diagnosed two years ago with ADHD. And it's been a struggle to find a good combination of meds for him (which we haven't found yet). Adderall worked fine for a while, until he developed tics (eye blink and head nod). The tics did go away after a week or so off the Adderall, but then we had to start from scratch on the meds! We found out about Tenex, which is supposed to help with impulsivity, but it also is used to relieve tics in Tourette's patients - so we are going to start the Adderall again with the Tenex and keep our fingers crossed.

Our experience has been that we need to figure everything out by reading books and the internet. The doctors really don't know how to help with medication!

To Myperfectchild: I would recommend that you take your child to someone who is "qualified' to diagnose ADHD. It's worth the extra step, because it may be something else. There are non-invasive tests that can give a better indication of whether or not it is ADHD. Good Luck.

A couple of things I thought of about testing: Try asking a local private school for "gifted" kids who they might reccomend. Also see if there is a local psychiatrist that specializes in kids - they often do testing. One other avenue is if there is a major University nearby - they might have a child psych department or clinic that will diagnose. If you can avoid it - don't go through the school, it's better to get a completely independent diagnosis. Your insurance may cover testing, it's worth asking about.

I have a question. When you all say *testing for ADHD*. What do you mean by that. Is there a specific set of tests that one must undergo in order to be diagnosed with this condition?

Our pediatrician gave a diagnosis based on our descriptions of the complaints that we receive/d from various teachers, no testing of any kind.

-M

Usually the Psych. will at least administer the WISC (IV) test. I can't remember exactly what the letters stand for but it is an intellegence/cognative ability test. My son did so poorly on this timed test that the diagnosing Psych would not release his "unmedicated" score for fear that the school would label him learning disabled, which he is clearly not. But there are other game-like tests that they can administer to test attention level. Where say the "average" child will score 75-100% and the ADHD child will score more like 50% (on one of these my son scored 35%!).
Your son's teachers and pediatrician may very well be correct, but ADHD often comes with other conditions or other things LOOK like ADHD on the surface. Even though (looking back) my son is an absolutely classic, textbook case of ADHD - it took a Psych. from a local ADD testing center to diagnose him and explain to us what that meant.

I have much more information to share and am happy to discuss more with you if you want to email me. Let me know and I will share my email address with you. I've been where you are and it's very confusing and it seems like nobody can give you a straight answer about what is going on and what to do next. -B