Scary behavior caused by Vyvanse?

[Verity]

My son has ADD, Asperger's and has been struggling with some low level anxiety issues that were exacerbated by our recent move. Our new pediatrician initially prescribed Focalin but our insurance didn't cover it so she prescribed Vyvanse 30mg.

My son initially reacted very well, it seemed to make him calm, focused and he seemed happier. However yesterday he had a meltdown of epic proportions. It started with frustration over schoolwork but then escalated. He was yelling, hitting concrete block walls, tried to cut hims arm with a letter opener(thankfully it was an antique and not sharpened and he probably knew that). I tried to calm him several times but being alone seemed to make it worse.

 

Finally he was able to tell me that as the fit continued he was having alot of weird feelings...going from feeling "happy" (described more as hysterical) to angry to sad and back to happy, etc... this went on for about half an hour. The whole fit was probably two hours or more. He finally calmed down and seemed back in his "right mind".

 

During the fit I tried calling his therapist (we had an appointment just that morning and he seemed fine, even euphoric she said) and his pediatrician where I left a message but noone ever called me back.

 

I am discontinuing the Vyvanse at this time until our regularly scheduled follow-up on Tuesday afternoon. I hope that this was caused by the meds and isn't a progression of his issues. At the same time I'm wondering, now what?

 

I recall some people experiencing bad effects from Vyvanse - does this sound at all familiar?

 

Thanks -

[Ottakee]

Yep. Been there, done that.

 

Stimulants can trigger major mood swings in some kids. Those are kids that already tend to have an underlying mood issues but not always.

 

The Euphoria could be a hypomania type thing and the rages, anger/sadness, etc. can be how kids show more depressive symptoms.

 

I have one that has bipolar and that is how her behavior was every day until we got her meds figured out.

 

Did he have any mood concerns before starting the meds? Generally the doctors try to rule out any mood issues before starting stimulants as they can make things much worse. Now on mood stabilizers my daughter does well with a small dose of stimulant (Dexedrine)

[Guest]

Verity, I am sorry for what your child had to go through :( :grouphug:. You might find this quote from Dr. Bock's book helpful when it comes to stimulants prescribed to ASD kids with ADHD.

 

http://www.naturalpedia.com/autism.html

[Verity]

Yep. Been there, done that.

 

Did he have any mood concerns before starting the meds? Generally the doctors try to rule out any mood issues before starting stimulants as they can make things much worse. Now on mood stabilizers my daughter does well with a small dose of stimulant (Dexedrine)

 

He was a bit on the depressed side over the past few years and now at almost 14 I've observed more aggression and anger with his brothers but didn't think that was unusual. However, there was an issue where he was very angry with me and felt that I wasn't listening to him that caused him to get a knife from the kitchen and take it to his room. He says he wasn't going to hurt himself or anyone else, he just wanted to be heard. That action is what caused us to start seeing a therapist immediately.

 

BTW, this son has severely inattentive type ADD...I have one with ADHD and it's totally different.

[Guest]

BTW, this son has severely inattentive type ADD...I have one with ADHD and it's totally different.

 

Not sure if you know this but the ADHD label has now replaced the ADD for both hyperactive and inattentive kids. There is mention of this in Dr. Hallowell's books, that I have seen.

[Ottakee]

You might want to have him evaluated for a mood disorder or other issues before going with more stimulants given his reaction. The anger/aggression/depression and then getting a knife are signs that there is something going on---which is why you got help.

 

Do you have a top notch pediatric psychiatrist prescribing the meds? This stuff is way beyond more pediatricians and primary care doctors.

[Guest]

From "Delivered from Distraction", Introduction/ xxxv.

 

In this book we use the old term, attention deficit disorder, or ADD, because that is the term most people are familiar with. Although the condition has officially been renamed ADHD, for attention deficit hyperactivity disorder, most people still refer to it as ADD. As we use it, the term ADD includes symptoms of both ADD and ADHD, i.e., people who do not have symptoms of hyperactivity as well as people who do.

[Guest]

Sorry, I should have explained! I posted the previous comments about the ADD and ADHD labels in order to explain Dr. Bock's reference to kids with autism and ADHD features in my link. I hope my comments did not come across as rude! I was just trying to make sure that it was clear that Dr. Bock most likely used the ADHD label with the new meaning including both hyper and inattentive kids. My apologies to the OP if my comments came out wrong.

[Verity]

You might want to have him evaluated for a mood disorder or other issues before going with more stimulants given his reaction. The anger/aggression/depression and then getting a knife are signs that there is something going on---which is why you got help.

 

Do you have a top notch pediatric psychiatrist prescribing the meds? This stuff is way beyond more pediatricians and primary care doctors.

 

We just moved to this location in the last two months and have new insurance so we are dealing with all new dr's. My therapist wants us to get in to see a developmental pediatrician which she believes would provide the most help but I agree that it looks like I need to go the extra step and see a pediatric psychiatrist...I've been trying to avoid them as I know that mostly they are an expensive pill distribution system and it's hard to get away from that once you start with them.

[Verity]

Sorry, I should have explained! I posted the previous comments about the ADD and ADHD labels in order to explain Dr. Bock's reference to kids with autism and ADHD features in my link. I hope my comments did not come across as rude! I was just trying to make sure that it was clear that Dr. Bock most likely used the ADHD label with the new meaning including both hyper and inattentive kids. My apologies to the OP if my comments came out wrong.

 

Thanks, I hadn't responded because I am aware of the technical definition changing. I see it as two different expressions of a similar dysfunction. You can call them the same name but they are still very different.

[Ottakee]

Our psychiatrist is not like that at all. Her idea is the LEAST amount of meds for the BEST functioning. She doesn't keep adding meds but rather looks to see what might be side effects, etc.

 

She also checks all blood work once a year and has had the kids have EEGs and EKGs to check for seizures (both my girls have them) and to make sure there are no underlying heart issues before starting meds. Things like blood sugar issues, anemia, thyroid, etc. can be picked up with blood work and might be causing some behavior issues or change which meds are best choices..

[Renee in NC]

We call that the Vyvanse crash here, and it will get better over time. My ds went from doing that every day to more like once a month or so now. It isn't due to a mood disorder, but more from the chemical structure of Vyvanse.

 

ETA: I missed the Asperger's part of the equation. One of my ds has Aspie tendencies, and he did react that way and quit taking it because it made him so aggressive.

[8filltheheart]

I can't remember which drugs caused which reactions, but our Aspie had some incredibly violent reactions to some of the meds we tried. I don't like thinking about his teenage yrs b/c honestly, they were horrific, family altering yrs. But one of the anxiety meds he was taking led to him curling up in a ball carving 666 on his arm. The behaviors you described were amg the ones we witnessed at various pts in his teen yrs.

 

If you both haven't started keeping a med journal, I strongly urge you to do so. Keep a diary of daily med doses and you write down what you observe in his behaviors and have him keep his own w/just a simple sentence or 2 describing how he felt that day. That way you don't have to try and remember what behaviors occurred w/which meds at which doses. You will have a record to keep your thoughts straight b/c it is completely overwhelming to remember what their behaviors were like a few weeks ago when you are in the midst of a crisis. It will be your objective memory for you.

 

(((hugs))) It is rough.

Edited October 7, 2012 by 8FillTheHeart

[Ottakee]

If you both haven't started keeping a med journal, I strongly urge you to do so. Keep a diary of daily med doses and you write down what you observe in his behaviors and have him keep his own w/just a simple sentence or 2 describing how he felt that day. That way you don't have to try and remember what behaviors occurred w/which meds at which doses. You will have a record to keep your thoughts straight b/c it is completely overwhelming to remember what their behaviors were like a few weeks ago when you are in the midst of a crisis. It will be your objective memory for you.

 

(((hugs))) It is rough.

 

This is SOOOO Key. It helps you and the doctors and may even help your child years down the line when they switch doctors, go off on their own, etc. to know that they tried X medication at Y dose and Z was the result.

[Guest]

Thanks, I hadn't responded because I am aware of the technical definition changing. I see it as two different expressions of a similar dysfunction. You can call them the same name but they are still very different.

 

Verity, please let me try again because I feel I have offended you somehow. I posted quickly and this is probably why. First, let me explain the link. It was an FYI for you in case this was the reason that your child was experiencing what you described with Vyvanse. The link does include another drug but I did not link it for you for that. My reasons were strictly what I said before, for you to look into the possibility that the med may be having that reaction on your child because of the ADD/ Asperger's dx.

 

About me, I do not encourage meds but I do not have anything against them because I realize that they are necessary in some cases. Either way, I would not recommend a med to you. My post was strictly an FYI for you to check out.

 

In closing, I totally agree with you about the differences in ADD and ADHD. Since I originally started looking into ADD for my oldest, before switching over to Asperger's when ADD did not seem to fit, I have read and own several of Dr. Hallowell's books. Just like you, I often refer to inattentive as ADD and hyper as ADHD. This is what makes sense to me also. In my follow up comments I was just trying to explain to you that Dr. Bock was most likely referring to ADHD with the new meaning.

 

I hope it is a bit clearer now. I was not trying to offend you in any way and if I have made you feel that way then I apologize.

 

Now I have to get going because this is Thanksgiving weekend for us here in Canada but I felt the need to deal with this now.

[8filltheheart]

This is SOOOO Key. It helps you and the doctors and may even help your child years down the line when they switch doctors, go off on their own, etc. to know that they tried X medication at Y dose and Z was the result.

 

:iagree: And it was advice given to me by you. So, thank you for sharing your wisdom all those yrs ago.

[Verity]

Wow thanks everyone for your responses. I will start keeping the med journal now - it makes so much sense! I guess I need to decide if it will be on the computer or a paper journal and which is easier to keep over time. Suggestions there? :)

 

Marie, You have not offended me. I'm so sorry you took my lack of response that way. I tried the link that you sent to me and got a weird page with lots of quotes from a dr's book and I left it there. I've been busy and dealing with some health issues of my own so I was only responding to experiences that seemed to line up with my own. You didn't do anything wrong so please don't worry another second about it.

 

Med free this weekend my son has been fine, albeit his normal somewhat grumpy teen self but no deep end experiences. I am looking forward to our appointment tomorrow because I'm very interested to see what the dr recommends.

 

I am on the hunt for a developmental pediatrician as recommended by our therapist. I will also see if we have a pediatric psychiatrist available to us. One of those two should be available in the near future - I hope!

[Guest]

Marie, You have not offended me. I'm so sorry you took my lack of response that way. I tried the link that you sent to me and got a weird page with lots of quotes from a dr's book and I left it there. I've been busy and dealing with some health issues of my own so I was only responding to experiences that seemed to line up with my own. You didn't do anything wrong so please don't worry another second about it.

 

Actually it wasn't the fact that you didn't respond. I think I just misunderstood some of your others posts and thought that you misunderstood mine :lol:. Can you tell I over-analyze things :tongue_smilie:! This was the comment I was referring to:

 

This drug is particularly appropriate for the high-dopamine kids, who are often put on the wrong medication. This includes autistic kids with ADHD features, and other kids with severe ADHD, who are often incorrectly prescribed stimulants."

 

I highlighted the part I was referring to but based on his previous comment (the part I did not highlight) it seems he is specifically speaking about high-dopamine kids, even in his comment about "autistic kids with ADHD features" so it must likely does not apply in your case anyway.

 

My apologies for the misunderstanding :)!