Meds for Inattentive ADHD - Mothering Forums

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Old 08-05-2009, 12:47 AM - Thread Starter
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I usually post about my 5 year old son on this forum. However, I have 4 children. My oldest is 11 and has ADHD. He is very smart, social, fun-loving and has escaped many of the "pitfalls" of ADHD because he has compensated so well. I do not consider him "special needs".

HOWEVER... although much of his hyperactivity has resolved as he has gotten older, the other symptoms of his ADHD seem worse. It may just be that he is not progressing and the symptoms are more obvious as demands on him have increased...

Anyway, he is forgetful, inattentive, impulsive, unable to complete tasks, gets sidetracked very easily, etc, etc, etc, the usual stuff.

I am finding myself increasingly frustrated and angry with him and I just cannot help it! Nothing I ask him to do gets done, he loses everything, he forgets what I tell him, he doesn't follow SIMPLE household rules that my 5 year olds (even my special needs guy) can follow. And I have become a whiny nag! I hear myself and I hate it! I am constantly "on him" and nagging and none of it works! I hate to hear myself! I have tried routines, lists, etc and somehow still nothing gets done. He is supposed to practice math (he scored low on a placement test) and IF he finishes, half the answers are wrong. It is one thing after another. I never know what to let slide.

He is off meds for the summer but they weren't working so well for him anyway anymore. He was on Daytrana which helped a lot with the hyperactivity and impulsiveness but not so much with the inattentiveness and related problems.

Does anyone know if there is a particular med that works well for ADD as opposed to ADHD? At this point, he fits the description for inattentive type ADHD. I know this type is harder to treat. Is Adderall the one that is supposed to be best for ADD?

Thanks,
Kristin
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Old 08-05-2009, 05:43 PM
 
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Adderall is not a good choice. I oppose all medications for treating ADHD and I oppose Ritalin and Adderall especially.

Scientific American Mind has an article in the July 2009 issue on potential dangers of prescribing Ritalin and Adderall for pediatric ADHD. The SAM article focuses on a handful of recent animal studies which suggest that Ritalin and Adderall might alter the structure and function of the brain in ways that may be creating cognitive deficits.

The use of these drugs in pediatric populations is not viewed favorably by all researchers or treaters, even if they are common. Longitudinal research by NIMH shows that Ritalin and Adderall have no long term benefits. Medicated children do show more improvement in symptoms over the short term over children who receive behavioral treatment without medication, but medication does not improve the long term outcomes. Children who are not medicated do as well over the long term as children who are medicated. Children who are medicated for a short-term (2 years) do as well as children who are medicated for a long term. (8 years). The drugs seem to have no effect on long term outcomes.

These drugs have almost no improvement on academic performance. On average, children on these drugs get a very slight improvement in their reading skills and no improvement in math or spelling. The drugs help children conform their behavior to what the school expects, but they don't help children become better students.

The bottom-line is that these drugs give a short term gain in making kids shut up and sit down, with no associated improvement in short term academic performance, long term academic performance, or other long term outcomes. The trade-off for getting these kids to sit down and shut up is potentially steep.

The animal studies reported by SAM and other sources are now suggesting that use of these drugs may cause long-term changes to brain structure. A 2004 rat-study done at Harvard showed that exposure to Ritalin in adolescent rats lessened the rats ability to feel pleasure and increased their depressive symptoms as adults. A Yale study with rhesus monkeys found that monkeys exposed to Ritalin and Adderall develop deficits in their working memories. Another set of animal studies, along with some human studies, are suggesting that exposure to stimulants (ANY stimulants) increase the risk for Parkinson's as people age.

These are subtler changes than what has previously been observed. We have known for quite a while that if a child has a genetic susceptibility to bipolar disorder, Ritalin and Adderall can trigger bipolar symptoms. The drugs trigger these conditions at a younger age than is normally expected, and once triggered, the symptoms are worse than expected. Researchers have suggested that Ritalin and Adderrall can also trigger symptoms of childhood schizophrenia. Even in children who are not genetically vulnerable, these drugs can cause short term psychotic episodes.

We also know, BTW, that the use of Ritalin and Adderall has physical side effects. Ritalin and Adderall stunts growth in most kids. Kids who take these drugs lose about an inch off their adult height.
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Old 08-05-2009, 05:55 PM - Thread Starter
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I am not a big fan of medicating either. But the fact is my son went from barely hanging on in 3rd grade (we ended up taking him to Huntington Learning Center) to straight A's in 4th grade - and was asked to join the gifted program. It was like a fog was lifted from him. Not a miracle but definitely a help. That's all I want is to help my son.
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Old 08-05-2009, 06:27 PM
 
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KME - I understand where you're coming from. I myself have thought of this issue because DD clearly has ADD issues. Down the road we may have to consider some type of medication to help her. It's not something we want to do but sometimes if a low dose of a med will help our children focus and learn then it's not necessarily a bad thing.

You may want to get Dr. Kenneth Bock's book, Healing The New Childhood Epidemics. He covers ADD/ADHD meds he uses and what his experiences are with them.

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Old 08-06-2009, 12:49 PM
 
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I have inattentive ADD, and have had it since I was a kid, but it just got diagnosed a couple months ago. For various reasons I don't start my meds until next week, I've been Rx'd Adderall XR.

I have to say I'm really worried about my DD having ADD when she starts school. I don't think I could put her on meds. I saw the Frontline episode called the "Medicated Child" and it really scared me. The thing that scared me the most is that psych meds haven't been tested on children, the pharmaceutical companies have no idea how these drugs will affect the still developing brain of a child in the long term. Until more studies have been done, I think I would explore every other option, before I would even consider putting my DD on meds.

Have you looked into diet? I know a lot of people have had a lot of success with the Feingold diet. I'm actually looking at starting it myself. I don't like being on meds. The only reason I want to treat it at all is because I plan on going back to school in January, and I want to be able to get the most out of my education, especially since I'm going to school to be an elementary school teacher.

I also have an appointment with a doc who treats these things from a more holistic, natural, herbal approach. I can't get in to see him until Oct. though. So, I'm trying the Adderall more as an experiment, so I can tell this new doc I'm seeing whether or not it worked. Good luck I know it's not an easy decision to make, we all want what's best for our children.

Double majoring Philosophy/History single student mommy geek.gif to DD(4yo)dust.gif. I heartbeat.gif reading (mostly feminist philosophy, Simone de Beauvoir and Jane Addams are my intellectual heros. I'm a dork pinktongue.gif), and sewmachine.gif.
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Old 08-06-2009, 05:11 PM
 
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Dr. Bock's book also has natural supplements and dietary suggestions if you want to go that route.

Normal is just a setting on your dryer.
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Old 08-06-2009, 11:00 PM - Thread Starter
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Yes, we follow Feingold. I'll be honest - it hasn't helped much. I was planning to keep him off meds from now on but I am not sure he will be able to handle the demands of middle school. Today he and his friend were filling out invitations for their joint b'day party. His friend filled out about 15 while my son took the same amt of time to fill out 5!! He was so silly and distracted and messed up on several of them. If he can't even fill out some invitations how is he going to function in middle school next year?
I am so scared and worried for him!
I will check out that book that was mentioned.
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Old 08-06-2009, 11:31 PM
 
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I just switched to concerta, and have found it to be the best meds for my add I have ever tried. ( I have tried everything, including feingold)

And please try to remember it is just as frustrating for him as it is you

*~Kelly~*
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Old 08-07-2009, 12:12 AM - Thread Starter
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MommyKelly,

Thanks for the reminder that it is just as frustrating for him. Seriously, I DO need to be reminded of that. I am so NOT ADD, I forget he is probably trying his best.
Thanks again,
Kristin
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Old 08-07-2009, 05:06 PM
 
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Your welcome

I know how frustrating it is for me, and sometimes I have to remind Dh that I cant help stuff.

Good luck finding something that works for him!

*~Kelly~*
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Old 08-09-2009, 05:36 PM
 
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Hi, I just found this thread through a search. My dd (8.5 going into 4th grade) has just been diagnosed ADHD-inattentive type. It was explained to me that ADD doesn't exist in the DSM-IV but that basically this is what one thinks of as ADD.

We're starting family therapy next week and also meeting with a child psychiatrist to discuss the possibility of medication. I don't like the idea of medication but I'm considering it for at least the short term until we can get some other supports in place.

FWIW my aunt is a special ed teacher and has lots of ADHD kids. She says in the short term the only med she's seen issues with is Adderall. She says it often seems to make the kids weepy and emotional. Of course that's just what she's seeing at school, she doesn't see the kids at home.

I'm going to look up the Scientific American Mind article the pp mentioned. Thanks!

Mom to (5) (9)
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Old 08-09-2009, 08:38 PM
 
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Don't give up on the Feingold diet unless you've been 100% for at least 2 months--it can take that long. Belonging to the Feingold Association is the way to be 100% because reading labels or looking at the package does not mean give you that 100% compliance. There is too much information not disclosesed on the label.

IF you were 100% compliance, communication with the organization or members there can help you find further addtives, etc. that might be necessary to eliminate.
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Old 08-16-2009, 12:53 AM
 
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I'm by no means an expert -- just thinking about how this might apply to my son. (I found this thread through a search of the forum.) But I wanted to recommend a book I just finished reading. Your description of your son's problems sound *exactly* like what the author describes. He gets all into the brain chemistry of how this occurs and why it's not simply a matter of inadequate will power. He is pretty much pro-meds (since he sees ADHD as a brain chemistry issue) but even for those of us who resist that route instinctively (as I do), it's important to hear that side of the argument. When considering the welfare of our kids, we have to look at all sides. The author is frank about the side effects of medication and the fact that meds don't work for all patients. He covers the various medication options, including at least one non-stimulant option. I can't say much more about that section -- I barely skimmed it, since we aren't at the stage where we would consider medication yet. I hasten to add that the meds section is only part of the book. Even if you skipped that chapter entirely, the rest of the book is an excellent and well written description of the symptoms and challenges of ADHD. Well worth a read, in conjunction with other books from other perspectives, I think. My initial criticism -- I may have more when I am more informed -- is that he does not make very clear the distinction between the different types of ADD/ADHD, though he refers to them frequently. I had to look elsewhere to get that cleared up. I'm sure that wouldn't be a problem for you, KME.

Stephanie mom to Brianna (6/00) , Alexander (6/02) , and Ethan (9/07) .
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Old 08-16-2009, 01:04 AM
 
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my ds has been on ritalin for 2 years and we are switching him to concerta because of the growth issue - his appetite has definitely increased (yay!) and he's doing terrific on it.

I was on finegold my whole childhood b/c my mom did not want me on meds and I can honestly say it did NOT help (me) and I really resent going through my whole childhood in a fog. when I see the tremendous difference meds have made in my children's lives I am saddened for what I missed out on...

I'm glad it works for other people, but it never worked for me....

I'm Andrea - I have three boys - 12 year old twins & an 11 year old

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Old 08-16-2009, 02:52 AM
 
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I take Concerta for ADD inattentive type, and I have had no side effects. I am feeling so much better since going on the meds - I took Ritalin before kids, no meds during pregnancy/nursing, and stayed off of them for a few years after. Then I was diagnosed with depression and an anxiety disorder, which I finally figured out was due to the untreated ADD.

My students who take Concerta are doing very well on it - no loss of appetite, no anger issues, like can happen with Ritalin. I think the slow release is key.

Best of luck with whatever you choose. I was not diagnosed/medicated as a child. It was just called being an underachiever back then.

It is a quality of life issue when considering meds. Do the possible side effects of taking the meds outweigh the potential increase in quality of life? If your child has never been on meds, you won't know until you do a trial. Are things rough enough to really consider it?

While I am talking about positive outcomes in my case, I am not "pro-med". In my career as a special ed teacher, I can never recommend/suggest/mention meds, and I have encouraged parents to take "med vacations" whenever they want to if they are feeling that their child is finding alternative relief or they just want to check and see what their child looks like off meds when they are in a new developmental stage.

I think a lot of people look at meds for kids as a life-long dependency on meds, but a fair number of kids I have worked with have taken meds for a short time, increased their academic skills, self-confidence and coping skills, matured, and then went off the meds. It can also give parents the opportunity to take a breath and learn about alternative ways to accomodate their child's style and needs.
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Old 04-14-2014, 04:20 PM
 
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The only med that worked w my son was Intuniv, a non-stimulant. I agree with some of the other moms that Adderral is not a great choice. I had a horrible experience w it. I also introduced a lot of behavior therapy (gently asking the child why what they said or did and what would have been a better reaction) and reminders on a daily basis. A lot of this mirrors social skills training. I was really pleased how much it worked and my son had less need for his meds. After he turned 11 we nixed the meds totally and continue the behavioral reinforcement daily, along w Omega-3 vitamins and CoQ10.
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Old 04-21-2014, 09:33 AM
 
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Quote:
Originally Posted by RiverTam View Post

Adderall is not a good choice. I oppose all medications for treating ADHD and I oppose Ritalin and Adderall especially.

Scientific American Mind has an article in the July 2009 issue on potential dangers of prescribing Ritalin and Adderall for pediatric ADHD. The SAM article focuses on a handful of recent animal studies which suggest that Ritalin and Adderall might alter the structure and function of the brain in ways that may be creating cognitive deficits.

The use of these drugs in pediatric populations is not viewed favorably by all researchers or treaters, even if they are common. Longitudinal research by NIMH shows that Ritalin and Adderall have no long term benefits. Medicated children do show more improvement in symptoms over the short term over children who receive behavioral treatment without medication, but medication does not improve the long term outcomes. Children who are not medicated do as well over the long term as children who are medicated. Children who are medicated for a short-term (2 years) do as well as children who are medicated for a long term. (8 years). The drugs seem to have no effect on long term outcomes.

These drugs have almost no improvement on academic performance. On average, children on these drugs get a very slight improvement in their reading skills and no improvement in math or spelling. The drugs help children conform their behavior to what the school expects, but they don't help children become better students.

The bottom-line is that these drugs give a short term gain in making kids shut up and sit down, with no associated improvement in short term academic performance, long term academic performance, or other long term outcomes. The trade-off for getting these kids to sit down and shut up is potentially steep.

The animal studies reported by SAM and other sources are now suggesting that use of these drugs may cause long-term changes to brain structure. A 2004 rat-study done at Harvard showed that exposure to Ritalin in adolescent rats lessened the rats ability to feel pleasure and increased their depressive symptoms as adults. A Yale study with rhesus monkeys found that monkeys exposed to Ritalin and Adderall develop deficits in their working memories. Another set of animal studies, along with some human studies, are suggesting that exposure to stimulants (ANY stimulants) increase the risk for Parkinson's as people age.

These are subtler changes than what has previously been observed. We have known for quite a while that if a child has a genetic susceptibility to bipolar disorder, Ritalin and Adderall can trigger bipolar symptoms. The drugs trigger these conditions at a younger age than is normally expected, and once triggered, the symptoms are worse than expected. Researchers have suggested that Ritalin and Adderrall can also trigger symptoms of childhood schizophrenia. Even in children who are not genetically vulnerable, these drugs can cause short term psychotic episodes.

We also know, BTW, that the use of Ritalin and Adderall has physical side effects. Ritalin and Adderall stunts growth in most kids. Kids who take these drugs lose about an inch off their adult height.

I dont want to hijack the thread.  I just read this post and wanted to ask, were doses and time length taken into consideration in the studies that showed altered brain structure? (presumably from interfering with the dopamin feedback mechanism)  For eg,  are outcomes different  with a very low dose and short time interval use (lets say 5mg for 6mths ) versus say a child escalating from a low dose to an average of 20mg for years. It seems to me a big difference....

Ill go back to reading the rest of the thread....

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