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My irritable son
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dino12 posted:
My son (9) had been taking Adderall XL 30 mgs. I felt it was too much because my son was like depressed, so my pedriatician changed it to 20mgs and told me to try it for 15 days to see how it worked out. Today I gave him the last pill. I told the pedriatician that my son was very irritable. Almost always in a bad mood. Now, he wants me to give him 25mgs, He says that my son feels this way because 20mgs is too low for him. I wonder if he is right. My son started out fine with the 20mgs. He arrived from school doing his homework very diligently. He was always quiet. At times he seemed sad. These past 6 days, he seems more irritable, does not want to do his homework, and is more "noisy." Seems as if he has not been taking anything. Why did the 20mgs of Adderall work well in the beginning only?
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ADDComputerGEEK responded:
I am new to the board and your post caught my eye I am 39 and taken medication for my ADD about 3 years ago I also have taken Adderall XR which works great but my concern is the amount he is taken I was taken 30 mg I am 6'0 245 that seems very high amount for a 9 year I am no doctor but I started off with 25 and was increased to 30mg.
 
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momuv4girls responded:
Hi,

It is not uncommon for medications to work......then become ineffective. A doctor will usually then try to bump the dose and see what happens. Sometimes the 'bump' will work out, or sometimes the side-effects become too much of a problem, and the med needs to be changed.

When a child has been diagnosed/treated for AD(H)D, it is extremely important to have a Doctor who is a specialist - - one who know about a child's developing brain, side-effects, and the different medications, and most often this Doctor is a Child Psychiatrist. I would not see a 'typical' pediatrician for this, but rather a "brain specialist".

As you see, it is not a 'one fix' med thing. A child needs to be constantly monitored, and the meds adjusted and/or changed.
A child psychiatrist is the most equipped to do this type of treating.

As for the other posters thoughts on the med being a high dose..........Children metabolize a lot more quickly than adults, and often times need higher doses - this is part of the puzzle when meds seem to just 'stop' working.

So, my suggestion would be to find a qualified, well known child psychiatrist, take your son in for an evaluation and start building a lasting relationship with a doctor you can trust.

Take care,
-Kathleen
 
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dino12 replied to momuv4girls's response:
I have always been very concerned because I have always felt that I am giving my son too many miligrams. I feel it is too much, but the doctor says that this is what he needs for his weight which is about 90lbs. I have tried making an appointment with the only pedriatic neurologist there is, but the pedriatrician has to make the appointment. I am scared of telling my ped. because he can get offended and angry. He has always told me that I don't trust him because I tell him I feel that it is too many milligrams. I don't know what to do. My son is always angry with me. Everything bothers him. I am desperate. Today, I started the 25mg. I don't see any positive effect, but I know it is too early to notice. Help
 
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dino12 replied to ADDComputerGEEK's response:
I am worried about this too, but the pedriatician says this is what he needs. I don't trust him too much. My son just got diagnosed with ADHD. He has been having trouble in school since he was in K-5. I never wanted to admit he had a problem. Until I got so frustrated because he just could not learn. I made some exams and he came out positive for ADHD. Now that I have learned many things about ADHD, I am sure that I have ADD also. It is hard to accept it, but now I realize why I never remember things, why I don't listen when they call me, why I don't remember the names of my friends, etc... I have never been too social, but I always feel that nobody likes me too much. I feel it is because , when I see someone I know, I just turn my head instead of saying hi. Then I remember that I know them. Maybe they feel I am arrogant or something. I don't do it on purpose. Now that I am 42, why should I try medication if I already finished school and don't need to concentrate? In what aspects will I become better? Why did you start taking Adderall until now?. Why do you think you need it?
 
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mblondebaby replied to dino12's response:
Try to keep in mind that diffrent milligrams come in different strengths. My son has been the same hieght and weight and been on 10 miligrams of one pill and 20 miligrams of a different one. I've learned from working at the hospital that diferent meds have different strenghths and therefore different doses. I do agree that you need to have a doctor you feel comfortable with, but that doesn't mean it has to be a psychiatrist. My son was treated by a neurologist, and now sees a ped and I am perfectly satisfied. Give the treatment a chance. You may find your fear of pills and the stereotype may rob your son.
 
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Boyzmomee replied to dino12's response:
I would have a specialist see him such as a child psychiatrist.

If you are scared of requesting a consult because of the physician's offense or anger, I'd go to another pediatrician quick.
 
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motherofrob responded:
What about if you give him a half dose and see how that works instead. We use Daytrana patch at 10 mg for our son he is about 40 lbs
 
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motherofrob responded:
It is a shame that you have to worry about offending your Dr. I sometimes feel that I am bothering my Primary care dr in reference to referrals. But the truth is that we are the only advocate that our children have and the Dr while important does not live with our children. Ultimately we are the ones who will have to live with the choices we make and I know that as a parent you will feel better if you know that you did your personal best for your son. It doesn't change the outcome but at least it gives us some peace.
 
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sammers2121 responded:
We had very similar problems with our son. My son was on Adderall XR 15 mg for a few years. He would be on it during the school year and off of it in the summer and it worked great! He was doing well at school and everything. Then he started to throw these awful tantrums. Which then turned into full out rage. That was sooo scary because that is such strange behavior for him. I started looking up info about it and I found out that there is this thing called adderall rage. That, along with the fact that he developed 2 heart murmers and had just about stopped growing ( he was down to the 3rd% for height and weight) made us decide it was best to give him a break from the meds for a while. Which was very hard because it did help him focus and do well in school but it was hurting his health so much that I didn'tknow what else to do. I started giving him an Omega supplement and small doses of caffeine throughout the day. That has helped alot. He has grown 2 inches and gained 10 pounds since december and the rage is gone. I started a blog about my expirience with my son. Maybe you will see some similarities between your son and mine? Maybe you have some pointers that could help us as well? I basically just feel helpless and heartbroken over this struggle. Hang in there and I would suggest getting a second opinion on the dosage.
 
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sammers2121 responded:
Oh, and the blog is,

http://amomsbattlewithadhd.blogspot.com/
 
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dino12 replied to sammers2121's response:
Thanks for your advice. I am really worried because my son is very, very irritable. He seems to get angry for nothing. In the morning, he did not want to shower and slammed the door and was screaming inside the bathroom very angry and punching things. Then, when he finished taking a shower, he got out very calm. He was not angery anymore. I had not yet given him his med.. Since it was sunday, I don't like to give it on the weekends. How did your son develop the heart murmers and how did you notice? What kind of Omega supplement do you give your son? My son does not know how to swallow. I give his med. with applesauce. I feel glad that I am not alone. It relieves me to know that there are more mothers feeling the way I do. I don't know if I will take the Adderall away since he just started about one month and a half. If my son keeps getting worse, I will talk seriously with my doc. Sometimes I feel impotent. I worry all day for him.
 
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Boyzmomee replied to dino12's response:
I still would talk to your doctor about your son's irritability. Different kids can require different medications.

Costco has an omega three supplement for kids that come in gummy bear form. I give them to my son along with his Adderall. They also have a gummy multi and a gummy calcium!

I'd caution against attributing all physical abnormalities to the medication. Many could be pre-exiting conditions as murmurs can be found during routine screening because the child has taken Adderall. It does not mean that it was not there before!
 
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Andrew Adesman, MD replied to dino12's response:
A few suggestions/comments: Sometmes adjusting the dose can resolve the side effect of irritability (30, then 20 then 25), but I suspect your son would do better either with a different amphetamine formulation (perhaps Vyvanse) or with a different medication (one of the methylphenidate formulations). Another trick that is sometimes helpful is to split the morning dose -- giving half the capsue initially and then the other half 30 minutes later. You should discuss this with your prescribing clinician. This doctor almost certainly knows and accepts that it often take some adjustment, and that sometimes one has to give up on one medication and try another.

As for specialists, child psychiatrists, child neurologists, and developmental pediatricians are all specialists in ADHD. Your pediatrician may actually appreciate you going to a specialist if his initial suggestions are not proving helpful.

Your son comes first; do not worry about offending your pediatrician. You can thank him for his care and concern and include him in the choice of finding a suitable consultant.
 
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sammers2121 replied to Boyzmomee's response:
I agree that you should talk to your son's doctor. There are many different meds and maybe another would work great for him. My son didn't have the heart mumer's before. Because of his size he had been getting regular screenings/ekg's for the last couple of years that he was on the adderall. He didn't have them before. THat doesn't mean that your son will develop them, that's just what happened to mine. With my son, the problems he was having was because of the med. I give him Omega 3,6 and 9. It's a supplement that I got at walmart that contains all 3. It doesn't help the ADHD itself, but the emtional outbursts and things like that are gone. After this summer we will be putting him back on meds, but not adderall.


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