My son is almost 11 and has bipolar disorder, anxiety disorder and a bunch of learning disabilities. He was diagnosed with ADHD:I in January of 2011. We have not medicated for it at all because he is on meds for bipolar and anxiety already. It was a hard road to get him stable and for the most part he is doing great. Unfortunately what is left over are the ADHD symptoms and he is really struggling in school. He literally just cannot focus. His psychologist, psychiatrist, and teacher all think we should try meds for the ADHD but I am just sick at the thought at adding more meds. At the same time I want him to have the best possible chance at life. The psychiatrist gave me some literature to read but admitted he was 100% sure on which ones are safe with bipolar so I am trying to do some research on my own. Does anyone know which meds work for ADHD (inattention type) that are not in the stimulant category? I'm not decided on what to do yet, and the psychiatrist said it is my decision, so we'll have to see. Any help appreciated.
Non-stimulant ADHD meds?
My PDD-NOS son is on a few daily medications for allergies/asthma and so we went into ADHD medications for him with some concern about putting too many pharmaceuticals into him. However, we see the SIGNIFICANT difference it has made for my oldest son - truly night and day for his ability to focus, hold a conversation and participate appropriately in school. It really helped balance out his brain chemistry. So when school was starting to get to be a challenge beyond just behavior modifications and positive redirection, plus we had some safety issues, we decided to try medication. My oldest son is managed by a pediatrician, but we sought out a child psychiatrist for my PDD-NOS son, since we wanted to be sure to manage the drug interactions appropriately.
We have tried eight different medications over the past six months and are only getting about 50% improvement with the one we are currently using. Stimulants for him were a disaster. Some of the nonstimulants created too much somnolence/sedation, or aggression on the higher doses.
The nonstimulants like Intuniv, Strattera, and Kapvay work differently on ADHD than the stimulants do. Sometimes they are used in partnership with the stimulants. They may help with the activity/impulsivity but not help with focus issues. The extended release versions work differently and some kids dont' metabolize them the same way.
Be prepared to experiment and log observations like crazy. You may get lucky and land on something that works the first or second try (like with my first son) but it's been a long six months with my second son. We changed psychiatrists after 3 months, because the first one didn't talk to me about what he wanted to change, why, and what the risks were. He just prescribed meds like he was working off a to-do list (if X doesn't work, then prescribe Y, then Z) with no dialogue about what might be different about my kid. The new psychiatrist was also able to talk about why he won't try certain medications - where he feels the risk/reward is too great.
We really didn't want to medicate unnecessarily, and our goal is not to "drug him into compliance". But he's definitely a happier kid when he's able to participate and not constantly getting corrected. Not to mention, not doing stupid/scary stuff like bolting in the parking lot of the grocery store to chase a balloon, or running across the street to chase a squirrel. If my kid needed glasses, I wouldn't say he just had to try harder to see. I'd get him glasses.
The improvements the medication provide are adding enough value that we can now pursue additional social skills therapy. Before, it would have been a waste of time, he wouldn't have been able to absorb enough from the sessions.
There isn't a lot out there on the treatment of Bipolar and ADHD combined; as far as medication is concerned, all I can find is that it is that a person with bipolar should not take stimulants; I have not found any warnings against taking specific non-stimulant ADHD meds with bipolar.
I did find a recommendation to look for a psychiatrist who has experience working with children with bipolar disorder, and one who is a psychopharmacologist if possible (though any physician who treats patients with psychotropic medication is a psychopharmacologist in the general sense, in a more specific sense it is a physician with training in advanced psychopharmacology).
I also found a discussion on medicating ADHD with Bipolar; the link is at the end of the quote below.
A great site is www.drugdigest.com. It not only will give you invaluable information about meds, side effects, and what to watch for, it has a function that lets you list all of your meds (including over-the-counter products like aspirin or claritin and even herbals) and it will check to see how they interact. http://www.everydayhealth.com/forums/emotional-health/topic/bipolar-and-adhd-meds-do-they-mix
Edited by Emmeline II - 11/18/11 at 11:10am
It's used sometimes for bipolar depression:
It can be used for ADHD as well.