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ADHD combined type - medication recommendation


Our daughter was officially diagnosed with ADHD (combine type) in August of this year.  Has anyone had success using a medication to control ADHD combined type symptoms that did not suppress appetite?  We recently took our daughter off Adderall XR (a stimulant) due to decreased appetite and subsequent weight loss.  She also was having a very difficult time sleeping at night.  When it was wearing off, she would get very irritable and combative.  Now that she is off the medication her symptoms are much more noticeable than they were when she was on the medication.

Our pediatrician mentioned giving Strattera a try.  It is a non-stimulant.  Does anyone have any experience using this medication?  Did it affect appetite, increase mood swings, or affect sleep?

Are there any other medications we could consider trying that do not affect appetite, cause mood swings, or make it hard to sleep at night?

Thanks so much for any input you can offer.

Replies

my 13 year old son uses Adderall and we constantly have to have him eat when he is not hungery.  we found the same rebound issues you are discussing so we added intuniv and no longer have that issue.

Posted by dubajm on Dec 26, 2013 at 5:36pm

Your best bet is to consult an ADHD specialist. They have a lot of experience with ADHD medications and know the alternatives for your situation. A psychiatrist or neurologist are options, as long as they specialize in ADHD.

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

Posted by adhdmomma on Dec 26, 2013 at 10:00pm

adhdmomma posted with comment about ADHD specialist.
Where can you find an ADHD specialist? Seems there is not one in my area. Psychiatrist writes prescriptions but never really talks about problems—rarely returns a telephone call.

Posted by Great on Dec 27, 2013 at 12:05am

Hi Great!

You are right, it can be tough to find an ADHD specialist. Here’s what I would try:

1. Check the directory on ADDitudeMag.com at http://directory.additudemag.com/. You can search by location.

2. Google and see if you can find talk of an ADHD specialist in your area.

3. Ask around. Is there a local support group? If so, attend and ask others there who they see and if they are happy with them. Word of mouth is a great way to find a specialist.

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

Posted by adhdmomma on Dec 27, 2013 at 1:08pm

Thank you to those that replied.  I was just wanting to get feedback from parents that had practical experience using medication successfully with their children.  We will probably give Strattera a try when we go back in few weeks.  Take care.

Posted by mjsmom73 on Dec 28, 2013 at 10:03pm

My daughter is 10yo now.  She was diagnosed with ADHD after kindergarten.  We tried several stimulants but the ups/downs and the lack of appetite during the day was more than we could take. Our dr suggested intuniv first because it seems you can reduce the stimulant with that.  And then we tried Strattera, however we were warned that it only works with about 40% of patients.  Luckily, it totally works for my daughter and we took her off the stimulants completely.  Since strattera and intuniv are long term meds, we don’t have the daily ups/downs and the appetite issues.  So, grateful!
As far as moodiness, I have tried several things.  I thought that my daughter might have a sensitivity to wheat or Seasonal Affective Disorder as I do, but I find that the one thing that affects her moods the most is time with me.  If I lay by her at night and we chat and I come wake her up and snuggle for a few minutes and “love her up”, that is connected to her moods WAY MORE than anything else I can find.  Her tendency to lose control (anger-wise) is GREATLY reduced when I spend quality one on one time with her.
To sleep at night, my daughter takes clonidine and melatonin.  ALSO, I knew she could sleep but she had bad sleep habits, so I offered her a $1 for every night she went to sleep on her own…quickly.  After about 2 months and $30, she could go sleep on her own quickly.  I don’t pay her but if she wants something and she has been going to sleep at night, “reward” her.  Well worth the money.  Now she knows how to go to sleep because she had to do it often.

Posted by mamallamaG on Dec 30, 2013 at 5:57am

Oh and I have been taking my daughter to her regular pediatrician… I thought we might be missing something and took her to a recommended ADHD neurologist and no…  He said the same things, recommended the same things…  BUT our pediatrician has been practicing for 30 years and has two nurses that are ADHD advocates because of their own children. ...Not all pediatricians are equal.  wink

Posted by mamallamaG on Dec 30, 2013 at 5:59am

mamallamaG, thank you for your thorough reply. 

I forgot to mention that our daughter is 8 1/2 but we have been seeing symptoms for several years.  We really noticed an increase in her symptoms during and after moving when her dad got a new job.  We are far away from family and friends, so the transition has been tough. 

We give her Clonidine and melatonin at night, as well.  We give it to her 1 hour before bedtime. She also developed bad sleep habits (especially during the move—we were living with my father-in-law for several months before we were able to join my husband after he found his new job).  It has gotten much better after stopping the stimulants, however.  While on the stimulants, she kept complaining that it “hurt to close her eyes.”  She is getting much better at staying in bed at bedtime now and not doing things to keep stimulating her mind.  We read to her for about a half hour at night and then put on “relaxation stories.”  We don’t usually hear anything from her until morning.

I am happy to hear that you have had good success with Strattera.  I am hoping that we will have a good experience, as well.  I especially hope that it will not affect her appetite negatively.  She started out using Focalin XR then changed to Adderall ER and lost 13 pounds in 4 months.  When her weight was not stablizing and continuing to decrease, we decided the stimulants were not worth what little improvement we saw.  She also was having terrible mood swings. Now that she is off the medicine (it has been one week), the hyperactivity is back but at least she is nicer to be around (for the most part, at least).

We are fortunate to have a wonderful pediatrician, as well.  The one we had before left a great deal to be desired (like not taking our concerns seriously and dismissing her symptoms as “just a phase”).  It is nice to have a pediatrician that really listens and is trying to actually help.  He is also seems to be very knowledgeable about ADHD, so we feel comfortable taking his advice.

We have also been doing a great deal of research into ADHD so that we can ask the right questions and get our daughter the help she needs to be successful.

Best wishes and thank you again for your helpful input!

Posted by mjsmom73 on Dec 30, 2013 at 7:09pm

My then eight-year-old son (now 10) was prescribed Straterra, and I was glad because it’s not a stimulant. But he became a zombie on that drug. He had no appetite, was tired all the time, cried a lot and got upset about the slightest thing. He then went on Concerta, which is better. His appetite is suppressed but not like before. I think he may have to have a higher dosage now though I’m concerned about how that’s going to go.

Unfortunately, there’s no way to know which drug will work best for our kids. It’s a hit-and-miss kind of thing. I know of a girl who takes Staterra and it works fine for her but it was absolutely the wrong medication for my boy.

All the best, and happy new year.

Posted by Camille1521 on Jan 01, 2014 at 10:02pm

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