View Full Version : Med combo for ADHD/Anxiety in children?


JenSMP
09-08-10, 01:27 PM
I've been discussing the possibility of co-existing anxiety with my son's behavioral-developmental pediatrician. He's already being treated for the ADHD (concerta), but he's still having severe emotional reactions to small things (he's very perfectionistic and hard on himself). He gets frustrated with himself easily and seem petrified to make a mistake. He's started calling himself "stupid" and is afraid to try new things, even at school where he usually excels.

I thought he was having meltdowns to get out of work; turns out he could be having actual anxiety attacks! And this happens multiple times per day. He fits lots of the "criteria" for an anxiety diagnosis and has multiple symptoms. I'm not sure if it's the ADHD that's causing the anxiety or if he truly has both. We've seen the meltdowns since infancy. He's not angry or aggressive, just very frustrated and upset with himself (he looks like he's going to explode he's trying to hard to hold it in). He even does the "almost hyperventilating" type of breathing, has rapid heart rate, gets short of breath, and feels like he's losing control.

Anyway, before I start rambling any more than I already have, does anyone know of a good med combination for comorbid adhd/anxiety in children. My son is 7.

Oh, and we are looking into counseling for him as well.

Thanks.

angora
09-08-10, 11:04 PM
My 12 year old son takes 20 mg fluoxetine for anxiety and concerta. We notice a huge negative difference and increased anxiety when the fluoxetine was discontinued for awhile.

hollywood
09-09-10, 10:03 AM
I kind of have the same issue, but everytime I try an ssri I start making alot of mistakes at work, I can't help but realize that my attitude is better but my over all performance takes a dip. I'm tried cymbalta at night and I just don't think it's going to work, maybe celexa at night? I tried it in the morning and after two weeks I was just like forget about doing anything, I also notice it makes me kind of sick when I take it for some reason? I get more sinus stuff and kind of a sore throat.

JenSMP
09-09-10, 05:12 PM
Does taking an SSRI along with a stimulant seem to help with the emotional meltdowns? Our stimulant alone isn't helping with that. I'm sure that his meltdowns cause anxiety, but I'm not totally convinced that anxiety is what's causing the meltdowns. Does that make sense?

He's not depressed, so is an SSRI really the answer? I know his doctor will be able to tell me more at our appt Tuesday, but I'd like to have as much knowledge as possible prior to our meeting.

My son is going to begin therapy (counseling) next week with someone I really trust. I'm looking forward to seeing if that helps as well.

angora
09-09-10, 05:49 PM
Does taking an SSRI along with a stimulant seem to help with the emotional meltdowns? Our stimulant alone isn't helping with that. I'm sure that his meltdowns cause anxiety, but I'm not totally convinced that anxiety is what's causing the meltdowns. Does that make sense?

He's not depressed, so is an SSRI really the answer? I know his doctor will be able to tell me more at our appt Tuesday, but I'd like to have as much knowledge as possible prior to our meeting.

My son is going to begin therapy (counseling) next week with someone I really trust. I'm looking forward to seeing if that helps as well.

SSRI's are used to treat generalized anxiety and other conditions not just depression. I take citalopram and it helps my anxiety. I only use ativan a couple of times a month (if that even) when I am having a really bad panic attack.

Anxiety might be causing the meltdowns. I don't know which came first with my kids - the anxiety or is the anxiety caused by the inconsistencies and problems with the adhd? If your son doesn't know what to expect or how to react or isn't able to do what is expected of him from time to time, or day to day, I don't think an emotional meltdown is unusual. The fact that some days he probably can do it and some days he can't must be incredibly confusing and anxiety provoking. Does that make sense?

Both my kids see an art therapist through the school and she has done wonders with them. She has helped to educate me about them, if that makes sense. The right therapist can work wonders on some issues and help develop coping skills.

I really don't have much knowledge to offer you, but my oldest's resource teacher directed me to a website today www.anxietybc.com - I have not had a chance to look at it yet but she said there's videos and articles with good, accurate, useful information.

Let us know what your doctor says.

APSJ
09-09-10, 07:20 PM
I had anxiety as a child, and was ultimately prescribed clonazepam, but a number of other medications were tried first, mostly antidepressants, and I think I was in jr. high by the time I started. It worked extremely well, and I can remember the sense of relief it provided.

I still take clonazepam, and more recently added propranolol, a beta blocker, which addresses more of the physical side of anxiety, primarily the racing heart and general 'fight of flight' feeling. My understanding is that propranolol is pretty innocuous, but I have no idea if that holds true in children.

hollywood
09-09-10, 07:38 PM
How well does celexa work for generalized anxiety, that's what I am battling, I just cannot handle many mental dips? I think cymbalta works well but I feel nothing on it

may74
09-16-10, 11:05 PM
My 9 y.o. daughter has expressed Anxiety since she was 3. She was diagnosed w/ ADD in 1st grade. We started her on Focalin short term 5mg in the morning and then 2.5mg in the afternoon. She did wonderful on Focalin w/ her grades, but she lost 10lbs. Considering she is only 65lbs today, it is scary! We take her off of it in the summer, and the weekends to play catch up w/ eating. This summer her Anxiety was controlling her everyday habitats, Separation Anxiety. We talked to her Dr. and he suggested Zoloft. We were told that there really is not just an anxiety med for children, you have a few Anti-Dep to chose from that help w/ anxiety that are approved. We chose Zoloft and started her on 25mg. It takes a month to get in their system, but I have noticed a big difference in her. She can get over things a lot quicker and not dwell on stuff. The Zoloft has made our familys life alot easier.

hollywood
09-17-10, 08:39 AM
does taking celexa cause the adhd meds to be less effective, I'm on celexa and have trialed cymbalta and celexa with my stims and am uncertain which one is better. I feel as though cymbalta causes a bit more somnelence in the beginning , but is less sedating to a degree... Not sure.

mimi'sdreaming
09-17-10, 09:53 AM
does taking celexa cause the adhd meds to be less effective, I'm on celexa and have trialed cymbalta and celexa with my stims and am uncertain which one is better. I feel as though cymbalta causes a bit more somnelence in the beginning , but is less sedating to a degree... Not sure.

I'm not sure, hollywood. I take Cymbalta and Vyvanse. It almost seems like Vyvanse makes me feel better, especially in the mornings.

I can't really tell if Cymbalta is doing anything!

mimi'sdreaming
09-17-10, 10:03 AM
My six year old son was diagnosed with primary anxiety and ADHD. I had major anxiety as a child (I still do at times).

Like May74, summer seemed to almost make his anxiety worse! That's when I realized how important structure was. We started him on Zoloft 12.5 for one month, then added Vyvanse 20mg (right before school started). After that, we titrated to 25mg of Zoloft. We all (teachers included) have seen a huge difference in his anxiety since adding Zoloft. :)

We also talk about "The Anxiety Monster" and what to do when he appears. I make it funny and he loves it! There's also a great book we have (I'll have to find it) :rolleyes: that talks to younger children about anxiety and how to cope. It was given to me by my husband's cousin who is a counselor for K-3rd grade children. She swears by this book!

If it helps, I did extensive research before choosing Zoloft for my son. I was leary of giving him any SSRI.

Good Luck!

hollywood
09-17-10, 02:06 PM
zoloft is the only med I've ever been allergic to, I broke out in hives all over my body, not good. I don't know about this celexa, I keep forgetting everything that I do daily. Weird. Cymbalta may have been less with the sedation. Not sure, I felt that I had tried intuniv in combo soley with my stims and that really helped , ie ( I could focus alot better ) yet on tenex I was more inconsistent? I'm really not certain which route to take. I feel as though if I'm better focused it's good, but it's wasteful if I'm wasting it with generalized learned anxiety thoughts. That would make being sedating and more stupid with the celexa added more beneficial. I guess right now it's good to be stupid.