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Children's Diagnosis & Treatment This forums is for parents to discuss issues related to diagnosis and treament of children with AD/HD

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Old 04-19-17, 10:41 PM
Shellfish76 Shellfish76 is offline
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Which Medication?

Hi All,

I'm new to this forum and looking for any advise regarding our son (10).
He has a diagnosis of High Functioning Autism (Aspergers) and In-attentive ADHD.
Basically, he has a high IQ (according to tests) but struggles at school for several reasons but not least of all, the inability to focus and attend. We started with ritalin however, after some time the medication stopped being effective and he developed terrible anxiety and some OCD, which didn't stop even after the ritalin was ceased. Our paediatrician recommended Strattera to help with anxiety and attention issues. I wasn't too hopeful after reading the reviews but we were willing to give it a try.
The Strattera was horrendous initially and he had horrible side effects included self-harm ideation however we persevered as he has threatened self harm in past with no medication.

Basically, the Strattera didn't really helped with either the anxiety or the concentration but he in general he was a much happier child in himself with fewer meltdowns and aggressive mood swings.
Then the tics began - so rubbing his face raw and biting his mouth until he got ulcers. Our paed recommended a very small dose of risperidone (an anti-psychotic) for a few months to help get the tics under control, which it did.
We were due to come off the risperidone when my husband was transferred to a new job interstate. The paed recommended not changing medication because of the stress for our son being in a new town, new school etc.

We have begun the withdrawal process of the risperidone finally (pretty bad, so we are taking it slow) but the tics have now resurfaced.
We refuse to keep him on the risperidone long term (I really feel like we are taking a gun to a knife fight here) and have decided that Strattera is not effective enough to justify the tics.

Sooo, any advise on what to try? Anyone recommend a stimulant that isn't too bad for anxiety or alternatively, has anyone tried a stimulant and anti-anxiety med simultaneously? We are in Australia and so have fewer choices unfortunately.

We are going to slowly withdraw from these two meds and give our boy a break but long term, we need an alternative.

TIA
Michelle
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Old 04-20-17, 12:14 AM
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Re: Which Medication?

My daughter has severe anxiety and lexapro works very well for that. There are also amphetamines like dexedrine and adderall that can work well. Dexedrine IMO would be a better choice because adderall contains levoamphetamine which can cause excess PNS stimulation, which wouldnt be good for your son.
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Old 04-20-17, 09:43 PM
maple17 maple17 is offline
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Re: Which Medication?

My daughter (12) has ADHD and suspected ASD as well. Her pysch and paed have both mentioned she's likely on the spectrum, so we're pursuing that diagnosis. She has anxiety related to the ADHD and ASD but not to the extent that we need a separate med for it. We're also in Australia, in Melbourne.

She's been on Vyvanse for almost 7 months now and it's really benefitted her and made a huge positive change. Meds are so individual though and even though it works fine for her, there have been so many others who had negative experiences with it. I can say though that for her, it has reduced her anxiety. Her paed recommended it as the first trial med.

She's had a mouth tic the past two years as well, pre- any meds. The Vyvanse seems to reduce it somewhat but then it comes back after it wears off. I've read that Vyvanse can improve tics or make them worse. Sometimes it makes no difference.

Good luck. I hope you can find something that works for him.
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Old 04-21-17, 04:09 AM
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Re: Which Medication?

Quote:
Originally Posted by Shellfish76 View Post
Hi All,

I'm new to this forum and looking for any advise regarding our son (10).
He has a diagnosis of High Functioning Autism (Aspergers) and In-attentive ADHD.
Basically, he has a high IQ (according to tests) but struggles at school for several reasons but not least of all, the inability to focus and attend. We started with ritalin however, after some time the medication stopped being effective and he developed terrible anxiety and some OCD, which didn't stop even after the ritalin was ceased. Our paediatrician recommended Strattera to help with anxiety and attention issues. I wasn't too hopeful after reading the reviews but we were willing to give it a try.
My sister is 29 now but was diagnosed with Aspergers when it was actually a ground breaking thing before it was included in the Autism Spectrum. She used to take Luvox for the OCD/rigid behaviors. I know a lot of kids who do well with certain atypical antipsychotics like risperdal and also old school-like depression medications like Remeron.



Quote:
Basically, the Strattera didn't really helped with either the anxiety or the concentration but he in general he was a much happier child in himself with fewer meltdowns and aggressive mood swings.
Then the tics began - so rubbing his face raw and biting his mouth until he got ulcers. Our paed recommended a very small dose of risperidone (an anti-psychotic) for a few months to help get the tics under control, which it did.
Did you know that Strattera was first studied as an antidepressant? Thats sort of part of the class of drugs that it is. It was almost an accident that during the clinical trials it was discovered that it worked for adhd. When the company realized the lucrative market that adhd was turning out to be, and because they couldnt quite get the FDA behind them on the anti-D front, they started pursuing it specifically for adhd. Just some interesting info. And because of that, its sometimes, if not many times, not recommended for people on the sprectrum because of the kinds of side effects these types of medications can have.

Quote:
We were due to come off the risperidone when my husband was transferred to a new job interstate. The paed recommended not changing medication because of the stress for our son being in a new town, new school etc.
When you say 'due to come of risperdone' what do you mean?


Quote:
We have begun the withdrawal process of the risperidone finally (pretty bad, so we are taking it slow) but the tics have now resurfaced.
We refuse to keep him on the risperidone long term (I really feel like we are taking a gun to a knife fight here) and have decided that Strattera is not effective enough to justify the tics.
Why are you concerened about risperdone?(just curious). The tics resurfacing makes a lot of sense and risperdol can help with that although I dont know the specific mechanism of action.

Quote:
Sooo, any advise on what to try? Anyone recommend a stimulant that isn't too bad for anxiety or alternatively, has anyone tried a stimulant and anti-anxiety med simultaneously? We are in Australia and so have fewer choices unfortunately.

We are going to slowly withdraw from these two meds and give our boy a break but long term, we need an alternative.

TIA
Michelle
I am curious as to why you think he needs a break from all meds? Autism, like adhd is very difficult and legit, and medication is considered a first line treatment for management of the symptoms.
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