To Medicate or not!!

[SquarePeg]

Hi guys, I am hoping to receive some opinions from both parents and teenagers if possible.

My 13 son has just been diagnosed ADHD but doesn´t have many behaviour problems. WE moved from the UK to Spain when he was 5 years old. His teachers have never mentioned bad behaviour in the past, only daydreaming and being distracted and not focused and he is ok at home although can be a lively jack in the box but not really a problem. He has the usual problems re organisation, remembering homework and stuff and actually being able to start tasks. His room is a bomb site of course, but since he has banned me from it now, I just ignore it. I have come round to his way of thinking, it is his room and he feels more comfortable with everything out on the floor where he can find it!! He says tidying it up makes me feel better but not him, so that´s me told and I have respect it.

He has had to repeat his last school year (we live in Spain and Spanish is his second language and you have to repeat the whole school year if you do not pass the majority of subjects, although you have a chance to retake failed subjects just before the academic year begins). I suspect his teachers have been a little lenient with him because of the language and they all comment on what a lovely child he is, so happy, well behaved and polite.

We are due to see the doc shortly and I know he will be offered medication and I am desperately trying to weigh up the pros and cons. Whilst I know he does need help with concentration and focus issues, he isn´t badly behaved. From reading a lot of posts here it seems that there are a lot of unwanted side effects and finding the most suitable meds and then fine tuning them seems to be a long and painful process. What upsets me to read is that meds can make children sad and cry for no reason.

He has always been such a happy go lucky child and although immature for his age (as most adhd kids) I have always loved his silliness and immaturity, and counted his zany carefree attitude as a real blessing. He is such a crazy ray of sunshine. It would truly break my heart to give my child medication that caused him to feel, sad, tearful or change his moods in any way, whatever other benefits it may have, I just couldn´t do it.

Another concern which I have read here is that the appetite is suppressed, although this can pass after a few months. He has just hit puberty and has always been underweight and extremely skinny. He is eating well at the moment but really cannot afford to lose any weight at all. He does a lot of sport which he loves, trains hard and uses a lot of energy. Deep down I really can´t find any justification in given him drugs even though I know they may help him at school.

Another thing is that I have spoken to a mum of two boys with adhd and she told me that her youngest has developed a facial tick since taking meds. I have read that tics can remain in 1% of patients that develop them after taking meds, this scares me.

So I am not against drugs, I know many parents reluctantly use them and there are kids who would be unmanageable or very difficult to deal with without them, so please don´t think I am passing judgment in any way. I would just like the opinions of parents with teenage adhd sufferers and also from youngsters themselves, if possible as they are the ones who truly know what it´s like. I would like to know if they feel they are better off on medication and whether it really helps in the long term.

Sorry if the post if a little incoherent, but am beginning to think I may have adhd the more I read about it!!
thanks for reading guys

[sarahsweets]

Yes there are side effects, but at what cost? do you want to set him up fpr sucess or failure?

[Lisa_Mac]

Hi Linda

My son has just turned 14 and was diagnosed towards the end of grade 5 at the age of 11. He was prescribed 36mg Concerta (slow release Methylphenidate)

Like you I was also concerned about the side effects of stimulants but we decided to give it a go. Like your son, there were never any behavioural problems other than talking too much etc. The big problems were that he was constantly forgetting and losing his books, homework, stationary, clothing, etc. And of course the usual attention problems that goes with adhd.

He has always been a bright child, but was slowly slipping more and more behind and just not achieving to his very obvious potential. Homework was awful, and he would take 2 hours to finish something that shouldn't have taken more than a half hour. His handwriting was atrocious.

The difference was unbelievable. He is now one of the top achievers in his grade (about 160 boys) and top in maths. Always does exceptionally well in maths competitions.

There is no way that he would have been able to achieve this if he had not been treated with stimulants.

What the meds do is not make him more intelligent. They just allow him to achieve to his full potential.

With regard to appetite. He has a good breakfast. I try and encourage him to eat something during the day, but he normally doesn't. He has a good evening meal. He is not underweight. On the contrary, he is actually well padded. All children are different though in this regard, as my son would rather play chess than rugby, but the only thing that he doesn't like about the concerta is that in the evening when it's starting to wear off, he becomes a bit grumpy and irritable. Once he's eaten something, he feels better, so it could be low blood sugar.

He has just switched to a lower dose (27mg) so that we can see if it has the same effect as the 36mg. (would rather be a lower dose if possible)

I take ritalin and I have really got no problems with side effects. (yip, he got it from me. )

Hope this helps you to make a decision.

Lx

[T-Rex65]

Not only does your son have ADHD, he also has a language barrier to deal with. So he has two obstacles to mastering the material. If his teachers are passing him out of kindness, then you and your son may not even realize how far behind he has fallen until it is too late.

If medication is offered, why don't you and your son try them for a while to see if they help him concentrate in school. If they don't work that well, or if the side effects are intolerable, you can always stop. But if you don't try them, you will never know how much they might help your son. As for the appetite suppression, I believe there are several threads on the board about that, with lots of good advice.

I'm wondering about the language thing. You moved to Spain when he was five, and he is now thirteen? That is a full eight years of being immersed in his new language. It is generally much easier for a child to learn a new language than it is for adults. So, I'm wondering why your son is having trouble with Spanish. Does he have Spanish speaking friends to hang out with? Or does he spend most of his non-school time interacting in English? Or...did he have to repeat the last year because he fell behind when he was younger, and he just never fully caught up?

[Flory]

medication is the best treatment in addition to behavioural therapies for adhd that we have at the minute...side affects aside , untreated adhd can get harder and harder as time goes by as well as the complex comorbidities like depression and anxiety that can come out of it...its most definitely worth trying the drugs if the specialist is suggesting it, they wouldnt make a decision like that lightly ! best of luck

[SquarePeg]

Originally Posted by Lisa_Mac

Hi Linda

My son has just turned 14 and was diagnosed towards the end of grade 5 at the age of 11. He was prescribed 36mg Concerta (slow release Methylphenidate)

Like you I was also concerned about the side effects of stimulants but we decided to give it a go. Like your son, there were never any behavioural problems other than talking too much etc. The big problems were that he was constantly forgetting and losing his books, homework, stationary, clothing, etc. And of course the usual attention problems that goes with adhd.

He has always been a bright child, but was slowly slipping more and more behind and just not achieving to his very obvious potential. Homework was awful, and he would take 2 hours to finish something that shouldn't have taken more than a half hour. His handwriting was atrocious.

The difference was unbelievable. He is now one of the top achievers in his grade (about 160 boys) and top in maths. Always does exceptionally well in maths competitions.

There is no way that he would have been able to achieve this if he had not been treated with stimulants.

What the meds do is not make him more intelligent. They just allow him to achieve to his full potential.

With regard to appetite. He has a good breakfast. I try and encourage him to eat something during the day, but he normally doesn't. He has a good evening meal. He is not underweight. On the contrary, he is actually well padded. All children are different though in this regard, as my son would rather play chess than rugby, but the only thing that he doesn't like about the concerta is that in the evening when it's starting to wear off, he becomes a bit grumpy and irritable. Once he's eaten something, he feels better, so it could be low blood sugar.

He has just switched to a lower dose (27mg) so that we can see if it has the same effect as the 36mg. (would rather be a lower dose if possible)

I take ritalin and I have really got no problems with side effects. (yip, he got it from me. )

Hope this helps you to make a decision.

Lx

Thanks for taking the time to reply, Your post is encouraging and I´m glad that your son is doing well. I suppose I will have to at least give it a try.

[ConcertaParent]

I'm also a parent of an adolescent with ADHD and my spouse refused to try medication for almost a decade. Here are a couple of helpful links:
- 5 Questions to Ask Before Starting Your Child on ADHD Medication
- Medication for ADHD podcast.

[Ms. Mango]

I had a lot of thoughts going around in my head when I read your post. I'm just going to type them all out in no particular order.

Behavior is an external manifestation of an internal disorder: what exactly is a behavior problem? I think what most people are referring to is hyperactivity, acting out, tantrums, and other behaviors associated with children being perceived as "bad" or "naughty". A child who is inattentive or spacy often flies under the radar because they aren't causing problems for adults or teachers. But any child who cannot organize himself, focus, take in, remember or retrieve information has a problem--whether it manifests itself as hyperactivity, anxiety, or inattention. You don't consider your son to have many problem behaviors, but his inattention is so severe that it has caused him to be retained in school. That, by any measure, is quite a problem.

My son has had behavior problems. As bad as they were, I didn't decide to medicate solely because of that. He was also struggling in school with academics. This was a child who tested very high academically on psychological tests but couldn't read at the end of first grade and couldn't sit still long enough to make it through a simple addition worksheet even through he demonstrated the ability to add two digit numbers in his head in kindergarten. There was a huge mismatch between what he was able to show his teachers academically and what I knew he could do. Was your DS's output last year on par with what you believe his ability to be?

Language issues: This is puzzling. Your son has lived in Spain long enough that he should be fluent. Even though you probably speak English at home he should be immersed in Spanish at school, on his sports teams and hanging out with other kids. It sounds like the teachers were using that as an explanation as to his poor performance rather than trying to see if there was a deeper issue.

I know several people who came to the US as kids or were born to parents who spoke a language other than English in the home. In at least two cases the children lived in neighborhoods of predominanatly immigrant families and had almost no exposure to English until school (so, your son's age when you first moved to Spain). In almost all cases those children did well in school. When they didn't, there was another cause behind it--in one case a receptive language disorder and in another an auditory processing disorder (CAPD). These disorders can be co-morbid with ADHD; have they--or any other disorder--been ruled out in your son's case? ADHD meds will not address or remedy co-morbid disorders.

Medication: Medication should not turn your son into a zombie or make him overly emotional. If it does, it's either the wrong medication or the wrong dose.

ADHD medications treat a chemical imbalance in the brain. They are not dosed based on age/weight/height. Because your son has never been on ADHD medications before he should be prescribed the lowest dose to start.

Many kids respond well to the first medication they're given. Some don't. My son was one who didn't. It was still worth it to keep at it until we found a med combination that worked. My son--the one who couldn't read or do simple math problems in first grade--was retested in January of this year (mid-third grade) at an eighth grade level in both reading and math.

Choosing to medicate your child: This is ultimately your decision. Consider your son--since he's not a little kid he may be old enough to have some input. Have you asked or considered how he feels?

How do you think your son feels about being retained? I can remember being that age, I'd want to curl up and die if everyone knew I wasn't going on to the next grade--how would I explain that? Would people ridicule me? What if my parents could do something to help me and just chose not to because I wasn't considered a problem?

[SquarePeg]

Thanks for your reply. I agree his teachers weren´t helping him by being lenient with him, but a lot of his teachers were really old school and up for retirement and didn´t seem to know much about learning difficulties. It was only during his last few years of primary that the staff were more switched on that realised that he had a problem. As for the language, well he doesn´t have any English speaking friends so day to day Spanish is not a problem, but as he doesn´t live in a Spanish speaking family, he isn´t exposed to as much new vocab as others of his age. In a Spanish household kids would talk to parents, uncles, aunts, grandparents and watch tv in Spanish. Reading is a great way of expanding vocab but, of course, he absolutely hates reading. It´s not so much of a language issue (he has the same difficulities in English as well) it´s that his teachers couldn´t understand why he sometimes couldn´t follow simple instructions. I must admit until I learnt about ADHD I couldn´t understand either why he sometimes had difficulties in following instructions.

[SquarePeg]

Hi, thanks for your reply. Yes you are quite right regarding behaviour. Behaviours that are a problem for the teacher and classmates are usually noticed first and dealt with and because my son was always "well" behaved, his problem was harder to spot in class. I suppose what I am saying is that there are kids who, without medication, are very difficult to "manage" and can be very disruptive. A friend has a son with ADHD and, before medication would do things like take a pair of scissors, spread his hand palm downwards on a table and stab the space between his fingers very quickly with the scissors, and ending up stabbing his hand and hurting himself quite badly. So yes his ADHD is a problem but I don´t have the added worry of disruptive or dangerous behaviour.

Regarding the language problem, well of course he did have a problem with the language at first and school was difficult for both him and his sister so the teachers had to try to assess how much of his grades were due to learning a new language. It´s a small village school and they had very little experience with non Spanish speaking children and most of his teachers had never had an English pupil, so for many of them my son presented new challenges. 99% of his friends have always been Spanish so he has a lot of exposure but not the same as his Spanish friends, who learn new vocab by talking to adult or older family members, reading books (which he absolutely hates doing as he finds it so hard) and watching Spanish TV (not kids stuff). He has the same problems with oral comprehension in both English and Spanish, so understanding and processing oral instructions presents a problem. We have yet to see a neurologist or psychiatrist, which is the next step. So far we have the assessment from the psychologist and Educational psychologists which points to ADHD and possibly dyslexia.
I know meds can be adjusted but sometimes this can be a long process. I´m glad to hear your son has found the right one. His friend, who is on concerta, still suffers insomnia and has been on various different medications for the past 7 years. My son has spoken to his psychologist and he says he would rather not take medication but try and work harder at school but I will wait to see what the psychiatrist says. So far he isn´t too bothered about having to repeat a year but wouldn´t want to repeat another year. However, he can´t really "see" the next few weeks, he doesn´t think of the future, he lives in the moment.
well we have to take one step at a time, next week he retakes his four exams that he has failed so things are very stressed at the moment. He has had help from a private tutor during the summer so I really hope it will make a difference. If it hasn´t made much of a difference then I know that I will really have to consider meds. thanks again for your valuable input.

[walkjog25]

i'd say get him enrolled in spanish classes and if anything at all give him an Instant Release med that only lasts for a few hours. He shouldn't need extended release if he doesn't have behavior problems, in my opinion. If it's just a learning thing, give him some IR to learn spanish for a few hours. Don't let him tell you that he wants more just to have a mood upper. It's only supposed to help him focus/learn. If the main problem is that he doesn't know spanish, get him spanish tutoring lessons (maybe they could go over his class vocabulary/help him with his homework) and during this time maybe he could be on meds. if sleeping is a problem... maybe he shouldn't take them. If the main problem is the language barrier... I would just consider that that is one of the main problems, and it's that on top of add. Try to solve the language barrier and then see if add is still a problem for him at this point in his life. (later in life, like college you might want to reconsider everything.)


it sounds like tutoring/extra help could be a better treatment for him. maybe try that before medicating. mental dependency is an issue with some meds. unforseen issues can/have come with meds, deceptively, short term and long term.

[SquarePeg]

thanks for your input, I think I didn´t explain myself very well in my first post. His teachers thought he may have a problem with the language but he doesn´t have any problems with Spanish although of course it was an issue when we first came here and it must have held him back initially. He has had extra tutoring for the past 3 months to retake 4 exams which he did today. If he gets good results then I will continue with extra tutoring even though its quite expensive. If he doesn´t get good results despite the extra help then I will have to consider meds. I do worry about addiction problems, 3 of his uncles are/were drug addicts but I don´t really know if people can have addictive personalities or why they became addicted. thanks again

[JenE]

I've seen research that indicates medicated ADHDers are LESS likely to become addicts.

[Ms. Mango]

Originally Posted by LindaGreen

I do worry about addiction problems, 3 of his uncles are/were drug addicts but I don´t really know if people can have addictive personalities or why they became addicted. thanks again

ADHD is a very heritable disorder. Maybe they also have ADHD or some other disorder and are/were self-medicating.

[JANAE]

My son is four and his behavior was off the charts. He has ADHD and ODD. So we decided to try meds. He is on a NON-Stimulant and so far it has been a major improvement.