ADHD and Panic Attacks

[Mandylubug]

So, my DS has never had a panic attack before. Well, until recently. It has happened twice within 6 to 8 weeks. It is anxiety triggered and when he is coming down off his meds. He has had them with two different types of meds. The first attack was while he was on Vyvanse. Second attack was off a low dose of Adderal. 

 

He is now anxious about taking ANY meds for ADHD. I understand. He was hyperventilating, sweating, freaking out and had weird hard cry/hard laugh episodes last night. He told he felt he went crazy during that time period. However, his meds make him able to finish his school work. If he doesn't take meds, he works for HOURS and HOURS on just math. 

 

Any btdt advice? He is inattentive type so we were told that stimulants are the way to go for his form of ADHD.

[Ottakee]

Whonis prescribing the meds? You really want a pediatric psychiatrist to get you going. What did the doctor say about this reaction?

[Mandylubug]

Whonis prescribing the meds? You really want a pediatric psychiatrist to get you going. What did the doctor say about this reaction?

 

They've just suggested we decide if the benefits out weigh the cons for him. They seem to think this is the only med that will help his inattentiveness and that a non-stimulant med will be a waste of time for him. We have self medicated with caffiene prior to meds but he out grew that. Caffiene does calm him but just not enough to focus on things that require concentration and his full attention.

 

He is our family doctor and is willing to do whatever we wish. We haven't seen a pediatric psychiatrist or neuro psychologist with this child because the meds did have such a profound difference in his day.

[Ottakee]

There are SOOO many other stimulants you could try that might not have this effect.  A pediatric psychiatrist would be better able to help you figure out which one is best for him and if there are any other underlying issues to look at.  Simple things like blood sugar, thyroid, vit B and D levels, etc. can all affect how meds work/don't work, side effects, etc.

 

We use Dexedrine with our girls and it has been great.  Some of the other stimulants were a disaster.

[Mandylubug]

I should add that he is currently putting himself in an environment that he WANTS to be in but he does have anxiety before going. It is the first extracurricular (Civil Air Patrol) that he is going in alone, without a friend or sibling and participating in because it is his interest alone. He is very excited about it and enjoys it but it has an aspect to it that can potentially bring humilitation and attention to him if he isn't wearing his uniform correctly or not paying attention. I am prone to anxiety and usually get sick before interviews, new social environments where I know NO ONE, etc. So, I think his feelings of anxiety are normal but I think the meds are exaggerating them. 

[Mandylubug]

Should also note, the days these attacks were triggered, he was also exhausted from a night of insomnia the night prior. They always happen around 5pm. Meds are taken around 8am

[drjuliadc]

This is going to sound a lot like my answer to the ADD and Anger thread.  Low magnesium is extremely common in general but almost universal in any child with a learning, neurological or behavioral disorder.  Don't bother testing for it, just do a trial of it and don't use Magnesium Oxide.  Magnesium is calming and low mag is common with anxiety.  It isn't the whole issue in most, but can be the whole issue in some.  It will cure insomnia in many cases.

 

When mag doesn't work by itself, there is either low serotonin, or low GABA, or both in anxiety.  Try amino acids and natural things before drugs to raise those neurotransmitters.  See Dan Amen, Billie Jay Sahley and Eric Braverman's books.  Amen and Braverman are M.D.s and I think Sahley is a nurse, but medical people rarely know about these alternatives.

 

The only downside of the natural alternatives is that they are not little pills.  They are more like foods in that they need to be taken in greater quantity than drugs.

[PeterPan]

Ottakee, not to rabbit trail too much, but how does one find a p-doc who would be appropriate for this, and how does one decide if they want to use the ped or the p-doc for it?  Frankly, the process the ped office uses just bugs me.  A ped is NOT a specialist on this to have a stinkin' clue, but they want you to pay for all these visits (before, during, monthly, blah blah).  How long is p-doc the appropriate way to handle it?  They're radically more expensive, right?  Do they provide other services or benefits as well? 

[wapiti]

FWIW, OhE, our ped refers out to a ped psychiatrist for meds - the ped hands out cards for their preferred psych providers.  There is a wait time to get in of at least a month, it then takes a lot of time to trial meds, etc.  I checked out the website of the one our ped referred us to, and the website specifically said they don't deal with ASD stuff, so naturally that is something to look for.  I too would not be inclined to seek these types of meds from a ped, but would see a doc with more specific expertise if at all possible.  (That's all I got, as we are still pursuing other avenues.)

[Ottakee]

UGGG>  I just wrote out a long post and LOST it right before I hit post.

 

Anyway, a pdoc would do more testing and rule out other issues and then provide contact every 2-4 weeks in the beginning to help get the right med, dose, time, etc.  Over time though, they might give the prescribing back to the primary care doctor and just consult once a year or so.

 

I wonder if the anxiety attack came due to low blood sugar if it was before dinner and if he doesn't eat as much at lunch when he takes the meds.

 

Your insurance might have a list of psychiatrists in your area to call.  www.bpkids.org has a link to "find a doctor".  I know that you aren't dealing with bipolar but these doctors tend to be some of the best and have a lot of training with kids/teens.

[Mandylubug]

UGGG>  I just wrote out a long post and LOST it right before I hit post.

 

Anyway, a pdoc would do more testing and rule out other issues and then provide contact every 2-4 weeks in the beginning to help get the right med, dose, time, etc.  Over time though, they might give the prescribing back to the primary care doctor and just consult once a year or so.

 

I wonder if the anxiety attack came due to low blood sugar if it was before dinner and if he doesn't eat as much at lunch when he takes the meds.

 

Your insurance might have a list of psychiatrists in your area to call.  www.bpkids.org has a link to "find a doctor".  I know that you aren't dealing with bipolar but these doctors tend to be some of the best and have a lot of training with kids/teens.

 

It definitely could be low blood sugar. We actually made him attempt to eat while in the middle of the attack. While on meds, he can be a booger to eat but yesterday he actually ate as if he didn't medicate for breakfast and lunch. For breakfast he had an omelette and he asked for two grilled cheese sandwiches at lunch and a cup of milk. 

 

I called his Dr. and left a message. Waiting to have someone call me back. 

[Mandylubug]

The Dr called us back and suggested we try Gaba

[drjuliadc]

Shocking and encouraging and somewhat impressive that your doctor knows about GABA.  It will help if your son has a leaky blood brain barrier, which many kids with issues have.  GABA is too large a molecule to cross an intact blood brain barrier, so if it doesn't work, it doesn't mean your son wouldn't benefit from increasing GABA with something like Apex Energetic's Gabatone, which is a combination of calming herbs that raise GABA.

 

You can use GABA to determine if someone has a leaky blood brain barrier.  If it calms them, that is diagnostic for leaky BBB. It doesn't hurt to try it either way.

 

Gluten intolerance, common in ADD, ADHD and spectrum kids, will cause a leaky gut and leaky brain.

[Mandylubug]

Shocking and encouraging and somewhat impressive that your doctor knows about GABA. It will help if your son has a leaky blood brain barrier, which many kids with issues have. GABA is too large a molecule to cross an intact blood brain barrier, so if it doesn't work, it doesn't mean your son wouldn't benefit from increasing GABA with something like Apex Energetic's Gabatone, which is a combination of calming herbs that raise GABA.

 

You can use GABA to determine if someone has a leaky blood brain barrier. If it calms them, that is diagnostic for leaky BBB. It doesn't hurt to try it either way.

 

Gluten intolerance, common in ADD, ADHD and spectrum kids, will cause a leaky gut and leaky brain.

Yes! We are very pleased with our Dr. He is open to discuss essential oils, supplements etc. His office even uses castille soap and more natural substances. He's always discussing his garden, etc. He's a good hybrid in my opinion.

[kbutton]

We use short-acting Ritalin (generic), and we have night and day differences if we use a different generic. The other generic causes anxiety.

 

I would definitely make sure he eats more. It is also valid to adjust doses and try different meds. They are all different.