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4 days on Adderall

My daughter was recently diagnosed with ADHD (mixed) with anxiety.  We had her tested because we knew something was different and we wanted to help her. This is hard, not knowing if what you do is the best thing for your little one (she is 8).  We tried Adderall last week and she was so wired, in actions, in her face…just high,  it seemed.  She seemed to think longer to get something out and when she would write something it had so much eraser marks from her trying to correct it.  Her laugh was missing.  I called the pediatrician told her what I was seeing and she said to stop it over the weekend if I wanted, I stopped all together.  We go back to her pediatrician on Monday.  I’m not sure what to do next, I’m debating any drugs.  She does fine in school, its not so good at home at times, not all of the time.  It has been a good week, I think it could be how I’m learning how to parent her with the ADHD.  She has a hard time keeping friends around, she has to be in charge with all their moves and they can NOT touch anything.  Would love to hear from you smile

Replies

My first thought is that if she was started on an appropriate dose (basically as low as it gets, then only titrate upwards after a couple weeks if seems to have no effect or little effect & no bad side-effects) then what you are seeing is more of a neurotypical reaction than an ADHD reaction (therefore the diagnosis of ADHD is a bit suspect).  If it was a dosage that is not the lowest possible then it may be too high for her (and ADHD diagnosis may be accurate).

Need to know the dose given before any tentative conclusion could possibly be made.

Posted by BC on Feb 06, 2014 at 6:42am

My daughter is 9, almost 10. She did not do well on adderall - very high strung. She lost weight (and, she’s a skinny mini) and couldn’t stop picking at her cuticles. We weren’t able to keep her on stimulants alone. We had to do a mix of strattera (an anti-depressant) with a stimulant. However, we have been changing meds and doses for over a year and still haven’t found a good combination. Our daughter’s social interactions are similar to what you describe, but she struggles elsewhere as well. I guess what I’m saying is that if you stick with meds, it might be trial and error for a bit until you get the results that best work for your daughter. Document what you see and what she experiences and don’t hesitate to call your doctor to make changes (we have, on occasion, emailed our prescribing physicians at the oddest of hours). Good luck.

Posted by MomofMack on Feb 06, 2014 at 6:50am

Also Adderall may not work for your child.  My son, now 12 was diagnosed at 7 has been prescribed everything except Ritalin, nothing has been totally successful and a couple of the meds were down right frightening. Every child reacts different, so we have been told.  We have ended up with Adderall because its the only med that comes close to helping, although Focalin was close second.  If you decide to continue medicating you may have try a couple before you hit the one that works for your daughter. And as someone said the dose will be a trial and error also. Hang in there!

Posted by Lamieh on Feb 06, 2014 at 7:20am

Pediatric psychiatrist ASAP.

Do not trust a pediatrician with your child’s mental health. They do general health and don’t have as firm a grasp on the ADHD medications as you need.

Love the pediatrician kind for rashes and flu shots but really you need an ADHD expert.

Posted by YellaRyan on Feb 06, 2014 at 9:23am

The “problem” (as I see it) is that way too many pediatricians (and others) are prescribing Adderall as a first-line drug.  Adderall is the racemic mixture of both the levo- and dextro-isomers of the compound (and the levo-isomer has zero effects on helping ADHD symptoms BUT does only give those horrible racy, shaky, speedy side-effects). Whereas Vyvanse and Dexedrine both are only the dextro-isomer.

So, there are lots of people who are taking what I consider to be the worst possible drug in it’s class, finding it makes them too keyed-up, more anxious, etc.  And all these prescriptions for Adderall create shortages of the drug…because that’s what gets prescribed too often, period. 

But Vyvanse is more expensive (but well worth it to skip those side-effects, get a drug that lasts longer, and doesn’t have the horrible rebound effect as it wears off), so that explains some of why Adderall gets tried first.

Posted by BC on Feb 06, 2014 at 10:25am

Lameih:

You do realize that Focalin is also a methylphenidate (the same class as Ritalin), right?

Posted by BC on Feb 06, 2014 at 10:33am

BC,
Nope, but it sure made him cranky! My point was that we have gone thru most of “ADD” meds.
As far as Vyvanse, my son had an awful reaction to it.  Rammed his head into walls screaming crying, and yes on the lowest dose.  As I said each child is different and the Adderall, for now is the lesser of evils. (please note, just because my son reacted that way to Vyvanse doesnt mean anyone else’s will)

Posted by Lamieh on Feb 06, 2014 at 1:00pm

There are different types of stimulants that basically fall into two categories: methylphenidate and amphetamine (here’s a chart of all medications for ADHD: http://www.myadhd.com/treatment_tools/medicationchart.html). Adderall is amphetamine (as well as Vyvanse). Some individuals with ADHD can’t tolerate one of the types. My son cannot take anything in the amphetamine class with side effects much like you describe as well as severe anger and violence from a normally very sweet kid.

If you feel your child can benefit from medications, I would try something in the methylphenidate category before giving up. Each child reacts to each stimulant differently, so all you can do is keep trying until you discover the right dosage and med for your child. Work with your child’s prescribing doctor to determine the best treatment for them.

Penny
ADDconnect Moderator & Mom to Tween Boy with ADHD and LDs

Posted by adhdmomma on Feb 06, 2014 at 6:43pm

I understand the necessity of working with a pediatrician sometimes depending on the availability of child psychiatrists, but in the case of your dd having ADHD and anxiety, this can be tricky. 

My dd has ADHD and anxiety, but this was worsened due to sensitivity with the allergy medicine Singular.  Like your dd, she was ok with classwork, but had difficulty at home and with friendships and social issues.  For example, my dd (even now as a 13 yo) does not get a lot of social cues and does not understand changes in tone of voice or “get” teasing, for example unless she is on her meds.  She was diagnosed in 4th grade, in 7th now.  She did not have good friendships until she began the medication. 

She has been on vyvance, which was too strong for her, and Concerta, which has worked wonders.  We did use our wonderful pediatrician, but have switched to a child psychiatrist because her anxiety came back when she hit puberty.  It went away when she stopped using the Singular, but has returned worse than before.  We are aware that stimulants can cause anxiety, also, and with so many things that can go on, have decided that we need the experience of a psychiatrist and all their training and knowledge, since it is their specialty.

I do recommend the book “understanding girls and women with ADHD” by Kathleen Nadeau, Ellen Littman & Patricia Quinn.  This was a huge help and resource for us.

Posted by MollyMS on Feb 07, 2014 at 1:29am

Thanks everyone!  I appreciate all your comments.  My daughter was prescribed 10 mg. capsule, once daily.

Posted by stormymom on Feb 07, 2014 at 7:03am

The lowest dose for both Adderall & Adderall XR is 5 mg.  It is always best practice to start at the lowest possible dose and go up from there.  If there is a concurrent diagnosis of anxiety that general rule is even more important to follow because what might be a helpful drug, when given too much & too soon can be overwhelming.  So the jury is still out on whether or not it might be both tolerable & helpful for her if it was given at only 5mg starting out.  So that is a possible next step.

Trying Vyvanse at the lowest possible dose (20mg) is another possible next step. 

Trying any one of the others from the methylphenidate class (Ritalin etc) at the lowest possible dosage is another option.

Because Straterra is particularly effective in children (more so than in adults) that non-stimulant also started out at the lowest possible dose is yet another option.  Be advised it’s most common side effect is stomach upset/nausea. 

Sometimes anxiety is primarily a function of the ADHD, so once a good fit for a stimulant is found, the anxiety then becomes a thing of the past.  That seems counter-intuitive to many people (a stimulant getting rid of anxiety) but it is true.  Regardless of whether the anxiety is a separate co-existing independent diagnosis or only a function of untreated ADHD, IMO, this group of patients would be the ones who are the most sensitive to too much of anything being given right out of the starting gate and should always follow the Start Low & Go Slow rule in proper upward dosing of stimulants.

Posted by BC on Feb 07, 2014 at 7:44am

we started on 1/2 pf a 5 mg pill, i’m sure her little body had way too much adderall.

Posted by livingwith-adhd&add;-infamily on Feb 07, 2014 at 7:14pm

My son is 6 and was diagnosed with ADHD a few months ago.  We tried three different meds before we found the one that worked.  It is pretty common to use trial and error until you find the right one.  Keep on the search because it will make her life so much better (and yours, too) when it works!  By the way, Adderall made my son even more hyper.  His thoughts were going so fast he could hardly talk without stuttering. 

Tracy
http://adhdandkids.com

Posted by Tracy47 on Feb 12, 2014 at 11:28pm

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