Appt about ADHD meds tomorrow

[Beaniemom]

So DS finally has his appt with the psychiatrist tomorrow. It is our first appointment with her and it is to discuss medication for his ADHD. We already are doing behavorial therapy. I'm suddenly feeling anxious about this appointment. Any helpful suggestions? Been there/done thats?

Ds already is on thyroid medication and has trouble gaining weight so I worry about side effects of medication making that a bigger struggle for him.

[Butter]

Adrian went on Adderall a bit over a year ago when he was 7.  The doctor prescribed the sustained release in a pretty low dose (5mg) and a few months later doubled it to 10mg.  She told me to make sure to feed him a nice, big breakfast before giving it to him just in case he lost his appetite until it wore off.  He takes it between 8 and 9 depending on when he gets up in the morning and it wears off between 4 and 5.  He actually had no side effects and it doesn't affect his appetite whatsoever.  Within a week of going on the medication, he went from only being able to focus to read a sentence or two to reading a whole childrens book or a whole chapter.  His math improved rapidly, too.  School in general started taking less time because I didn't have to keep refocusing him constantly.

[nature girl]

I think the most important thing to keep in mind is that it's only temporary, if you're not happy with side effects, as soon as the med is out of his system, 4-10 hours, those side effects are gone. We've been lucky not to have side effects, but for kids who have trouble maintaining weight, make sure they have a good breakfast before taking the med, and have him snack throughout the day whenever he feels hungry enough. You can also give treats during the day too, like ice cream, which are high calorie and easy to eat. Then as soon as the med wears off (usually by late afternoon for an extended release) you can fill him up again. Some people instead give two doses of short-acting, so the first wears off in time for lunch.

 

From everything I've read, the methylphenidates (Ritalin, Concerta, Focalin) are less harsh for younger kids and kids just starting than the amphetamines, so you might want to keep that in mind when he gives you options. You might also want to consider Intunive, which actually has been known to lead to weight gain rather than loss. It doesn't work quite as well as stimulants, but it's another option.

 

It's not a decision anyone wants to have to make, it IS scary, and I always question myself (until I see my daughter on non-med days, and realize how much happier and more well-adjusted she is while medicated.) But keep in mind that the majority of parents who have made this decision (and there are millions) feel it was the right choice, and many actually wish they'd started sooner! Wishing you the very best of luck! Let us know how it goes! :)

[WoolC]

We went through this last week and I posted about it. We tried quillavant xr (it's a liquid extended release version of Ritalin basically). My son was calmer in the sense that he was no longer running around constantly and he did focus much better during school. We saw lots of side effects though and stopped after 4 days. My son experienced extreme irritablity, rigidness, flushed red cheeks, excessive sweating, trouble falling asleep and loss of appetite. I don't tell you this to say don't try it or to scare you but to say listen to your mom gut and watch closely.

 

I've been reading A.D.H.D. Nation by Alan Schwarz over the past few days and it says 1 in 5 kids can react like my son to Ritalin. Like nature girl said, once we stopped the meds the side effects left as quickly as they came. I'm glad we tried it but we're looking at non-med options right now. I hope that either way the meds go for your son that you will have clarity and peace in the decision. I think that the stress and second guessing over all of these decisions with our kiddos can be as stressful as dealing with the behaviors themselves.

[OneStepAtATime]

Hang in there.  And keep in mind that sometimes it takes trying 2-3 different meds before you find one that works well for your child.  My friends who have reluctantly tried meds frequently had to try out more than one before finding one that worked.  Not all went that route but for those that did, it took time.

 

 

[sbgrace]

I don't have btdt with pyschiatrists as we're coming up on our first appt as well, but I do have experience with ADHD meds.

 

I agree with pp that it seems to take a while to find the right medication. For us, non-stimulants have significant side effects--but I'm sure we're in the minority.

We use a short acting Ritalin. It makes a huge difference. It can be nice to start with something like that--the med is in and out quickly if it isn't a good fit. 

[Beaniemom]

Thanks everyone for the encouragment. The appointment went really well. DH was actually able to come which I think is a first. The doctor was very warm and welcoming and really took the time to ask questions about ds and explain things to us. We ended up at a low dose of short acting generic Ritalin. This way he can take 1 after breakfast and then if it does impact his appetitite it should be out of his system by lunch and he takes another dose after. We already have a follow up scheduled at the end of the month and are armed with phone numbers to reach the nurse who will ccontact the doctor if we have any questions. They also gave us information on a feeding clinic that might be of use to us to help expand the number of foods ds will each. It was a mentally and emotionally exhausting day but thankfully dh and I are on the same page. Bonus: I got to spend some time this afternoon with my friend who was keeping my two girls.

[PeterPan]

Sounds like you had a good appt! Has he been to an OT for sensory and reflex work?

[Beaniemom]

Has he been to an OT for sensory and reflex work?

Yes. We are working with an OT and have been since ds was 3. His needs have changed and they have been freat at making sure he is working on present needs. He really has made great progress over the years. Hopefully meds in addition to all the therapy and work we are doing at home will help him. He has begun to realize how different from his sisters he is and it frustrates him.