Medication choices

[dhdb97]

My 9yo son was diagnosed in Dec 2012 with ADHD type 1 combined. We started him on medication trials in Feb 2012. So far he has taken Adderol 5mg, 10mg, and 15mg. No positive changes were noted. He had recently started taking Concerta 14mg, and now he is taking 28mgs. Again, no positive changes have been noted. He has lost 3lbs in the last 2 months. His pediatrician is a bit unsure of what to do next. It seems most children have responded in some sort of positive way by now. It has become frustrating for us at this point. Like all parents, I just want what is best for my child. Am I ecpecting too much too soon with the medication? Has anyone else experienced anything similar? Thank you for your assistance. Dan N.

[sarahsweets]

Have you taken him to see a adhd psych dr that specializes in children?

[CrazyLazyGal]

Your doctor is correct, the vast majority of patients do respond to at least one of those medications, and the positive change is usually pretty apparent within a few weeks.

Two suggestions. First, you may want to give a non-stimulant medication such as Intuniv or Strattera a try. Statistically, they work on a fewer percent of ADHDers compared to stimulants, but your son clearly isn't a statistically typical case.

Second, how was the diagnosis made? If he's not responding to anything, it could be a misdiagnosis and/or something else going on in addition to ADHD.

[Ms. Mango]

One other possibility to throw out there: these doses may be too low. When my DS started on Adderall his Dr. told me I could go up to 20mg. I'm not really familiar with the dosing for Concerta, but I think even a child could safely take more than 28mg/day if need be.

It's good that your son's doctor had him start at the lowest dose, but he may need more.

This would be a good time to find a specialist because your son's case may be more complex than his primary care physician's level of expertise.

[dhdb97]

Originally Posted by sarahsweets

Have you taken him to see a adhd psych dr that specializes in children?

We have not yet. His pediatrician did state they she would probably have us go see a specialist after this latest medication trial.

[dhdb97]

Originally Posted by CrazyLazyGal

Your doctor is correct, the vast majority of patients do respond to at least one of those medications, and the positive change is usually pretty apparent within a few weeks.

Two suggestions. First, you may want to give a non-stimulant medication such as Intuniv or Strattera a try. Statistically, they work on a fewer percent of ADHDers compared to stimulants, but your son clearly isn't a statistically typical case.

Second, how was the diagnosis made? If he's not responding to anything, it could be a misdiagnosis and/or something else going on in addition to ADHD.

We had a private Dr (Neuro-Psychologist) conduct an evaluation of my son. We also had the school system conduct an evaluation. Both had almost identical conclusions.
With the latest medication (concerta) we have seen small improvements in his school work. But he still is having attention issues and is losing a bit of weight.

[happytexas]

My ds started on 18mg of Concerta with no effect; we upped it to 36mg. When we tried to up it again to 54mg (36mg was no longer working well enough) it worsened his symptoms so we switched to Vyvanse.

I second seeing a child psychiatrist with more experience in ADHD and ADHD medication in children.

You may also want to consider an interdisciplinary evaluation led by a developmental-behavioral ped and includes educational testing. The symptoms of ADHD overlap with other things, so there may be a misdiagnosis or missed diagnosis of a co-morbid issue.

[ccom5100]

Have you looked into dietary changes? Studies have shown that some children are sensitive to food additives containing petro-chemicals, such as artificial coloring, artificial flavoring, and certain preservatives, which can cause or increase the symptoms of adhd. My ds was diagnosed with ADHD by two different specialists; yet eliminating those additives from his diet has helped us manage his adhd symptoms. He also takes a small dosage of a non-stimulant (Tenex, which is the short-acting version of Intuniv), which helps with impulse control. We also supplement with a good multi-vitamin, an Omega 3 and extra magnesium.

You might find these articles of interest:

http://www.sciencedaily.com/releases...0522210010.htm

http://www.additudemag.com/adhd/article/2991.htm

[the3rubys]

I agree, dietary and the right supplements may help. This has helped our 9 year old son. We have struggled years to find something that would help. Diet changes did make a difference but not quite enough so we searched for supplements and with th right ones we have now been able to take Austin off his meds and doing great. Our problem with the meds were the side effects. We started him on Aderall then switched to Concerta before we and Austin could not do it anymore.