Talk to me about adult ADHD and prescriptions

[Lady Florida.]

This is not a question about whether or not to use meds. We've been down that road and ds takes medication for his ADHD. 

 

 

I think we're in new territory with ds as an adult with adhd. He's 18.  Although he's had counseling on and off since his dx, it's always been his pediatrician who prescribed his meds. He can stay with the pedi until he's 21, but decided he might as well find a doctor he likes who treats adults, and switch now. Many doctors tell you upfront they do not prescribe controlled medications, which is the category where adhd meds fall. Finding a new doc has not been easy.

 

Ds has accommodations at college and can't afford to lose them. He needed a doctor who would both accept his diagnosis and prescribe his meds - his current dose works well. He found one who said he would and had an appointment last week. Now the doctor is saying he should try not taking them. He did that and basically lost his entire 9th grade year. College doesn't seem to be the best time to experiment with this. The doctor also made it sound like he's not going to be happy prescribing controlled medication. Grrrr! Why did he say he would BEFORE ds sent his records there? 

 

So, I started wondering if ds is going to have to see a psychiatrist for his adhd (psychologists can't prescribe meds in my state).  Does anyone have experience with this, either as an adult with adhd, or a child with adhd who had to make changes at adulthood? 

 

This is so frustrating for me and for ds. ADHD doesn't magically go away. He needs medication and accommodations. Why can't he find a doctor who understands this? 

[maize]

Could a Nurse Practitioner prescribe it for him? Since he already knows the medication and dose that works for him, this should be fairly straightforward. For some reason the NP's I have worked with have sometimes been more willing to listen to the patient and believe they know what they are talking about.

 

Finding a psychiatrist would be a good thing of course, but I know how hard they can be to get in to see.

[Lady Florida.]

Could a Nurse Practitioner prescribe it for him? Since he already knows the medication and dose that works for him, this should be fairly straightforward. For some reason the NP's I have worked with have sometimes been more willing to listen to the patient and believe they know what they are talking about.

 

Finding a psychiatrist would be a good thing of course, but I know how hard they can be to get in to see.

 

Unfortunately Florida is one of a handful of states where a NP cannot prescribe controlled medications.

[maize]

Unfortunately Florida is one of a handful of states where a NP cannot prescribe controlled medications.

 

Ah, I see :(

[TechWife]

If the pediatrician will see him through college, then do it. The last year he is in college, he should ask the pediatrician for a referral to a psychiatrist. He needs to make an appointment well in advance of when he will need a refill as there way be a wait and he could get one several months out. Most psychiatrists see patients for maintainance meds and have 30 min appointments available after the initial intake appointment. Be glad the doctors are telling him they won't prescribe, it means they either don't understand ADHD or don't know how to prescribe the meds. Either way, they don't need to be prescribing for your son.

[Anne in CA]

Just wanted to say that it sounds maddening.

[Catalytic]

I used a psychiatrist when I was on meds for adult ADHD.  I didn't even bother with a GP.

[Pink and Green Mom]

I would have him see a psychiatrist for meds.  Usually (and I live in FL) they want to see you once for about an hour - a session which is sort of like a therapy session.  Subsequent meetings every three months (I think that is the longest they can go without laying eyes on the patient) were 15 minutes and consisted of "is this medication working?  Great, here is another prescription see you in 3 months." 

 

Good luck. 

[Carrie12345]

Did he at least write the script this time?

 

Lots of potential options, but what does your son want?  He clearly knows he could stay with the ped for a few more years.  He could start looking for psychs now, or another GP.  Or he could stand his ground and advocate for himself with this new doctor.  What is he most comfortable with?

 

I was fortunate that my GP respected my research, wishes, and experience.  Unfortunately, we never found a med or dose that worked without unacceptable (to me) side effects.  Blah.

[zoobie]

In our state, the prescription has to be written monthly. I don't have the time to mess with that right now, so I'm ODing on caffeine. DH was seeing a psychiatrist for it, but it was so expensive. Over $150/mo for 5 minutes of face time. A friend of his referred him to her GP who prescribed it for her. He was nice but initially suggested a change of job before trying meds. :rofl: Sure, at 40, after 16 years of practicing law and with 4 kids to support, let's try a new career where we don't have to focus. He laughed too fortunately and has been great. Anyway, all that to say, stick with the ped for now. Unless you have really great insurance and the time for monthly med visits. DH still has to pick up the script in person, which is a pain bc the doc is in a huge hospital building with a $$ parking deck.

[Lady Florida.]

Thank you all for the replies so far. 

 

I would have him see a psychiatrist for meds.  Usually (and I live in FL) they want to see you once for about an hour - a session which is sort of like a therapy session.  Subsequent meetings every three months (I think that is the longest they can go without laying eyes on the patient) were 15 minutes and consisted of "is this medication working?  Great, here is another prescription see you in 3 months." 

 

Good luck. 

 

That's how it's been with his pedi and we were hoping to find a GP who would do it that way. This pedi practice has been involved in a number of national studies on adhd, so we've probably been spoiled by their knowledge of the condition and its treatment options.

 

Did he at least write the script this time?

 

Lots of potential options, but what does your son want?  He clearly knows he could stay with the ped for a few more years.  He could start looking for psychs now, or another GP.  Or he could stand his ground and advocate for himself with this new doctor.  What is he most comfortable with?

 

I was fortunate that my GP respected my research, wishes, and experience.  Unfortunately, we never found a med or dose that worked without unacceptable (to me) side effects.  Blah.

 

He did write the script while complaining. And then he suggested trying to stop taking them. I told him we are probably going to have to come up with a plan either to go back to the ped or find a psychiatrist he's comfortable with. 

 

I don't think ds knows what he's comfortable with yet. He's still trying to get used to handling this himself and keeps giving them permission to discuss it all with me. I OTOH, am trying to help him while also pushing him towards more independence in decisions like this. As I said, totally new territory for both of us. 

In our state, the prescription has to be written monthly. I don't have the time to mess with that right now, so I'm ODing on caffeine. DH was seeing a psychiatrist for it, but it was so expensive. Over $150/mo for 5 minutes of face time. A friend of his referred him to her GP who prescribed it for her. He was nice but initially suggested a change of job before trying meds. :rofl: Sure, at 40, after 16 years of practicing law and with 4 kids to support, let's try a new career where we don't have to focus. He laughed too fortunately and has been great. Anyway, all that to say, stick with the ped for now. Unless you have really great insurance and the time for monthly med visits. DH still has to pick up the script in person, which is a pain bc the doc is in a huge hospital building with a $$ parking deck.

 

They have to be written monthly here too, but the doctor can do that without an office visit as long as you've been seen within 90 days. The ped has been giving 3 months worth of prescriptions but post dating them. So, monthly prescriptions, office visit every 3 months. I think the doctors who handle adults with adhd often require monthly visits even though the state doesn't. 

 

Our insurance will cover a psych as a specialist, which carries a $40 copay, so we're okay there.