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ADHD in Boys

Son with ADHD, very defiant, failing school

We are really struggling with our 11 year old son.  He was diagnosed with ADHD at 5, we used the Daytrana patches for several years and they were great until they quit working and started causing real anger issues.  We have not found a medicine since that works very well, we have tried Concerta with a small dose of Intuniv and now Vyvanse.  We have tried multiple doses and so far nothing lasts all day, he is failing school, gets in trouble regularly and is so defiant, mouthy and disrespectful that I am going to lose my mind.  He is going for behavior counseling and we go to a child psychiatrist next week to try to see about different medications.  I am a total loss on what to do for him.  We did discover taking 2 doses 6 hours apart was keeping him from getting a good nights sleep but 1 dose in the morning does not work for all of school much less for evenings homework and forget about sports no way will he be able to play baseball right now.  Any suggestions on medications, questions for the doctor.  I am not new to ADHD my teen has it also but a total different situation, Vyvanse works great for her.

Replies

It’s taken a few years to get my son’s medicine type and dosage correct, but feels like things are working very well for him now.  He’s 10 years old and takes a combination of Straterra (twice a day) and Vyvanse.  He takes 18 mg of Straterra and 20 miligrams of Vyvanse in the morning w/breakfast and then 18 mg of Straterra at dinner time.  This combination works well for him and doesn’t necessarily interrupt his sleep, but I suspect it’s what causes him not to fall asleep closer to 10pm instead of 8:30 or 9pm (which is our goal).  That said, we let him read in bed and rub his back and help him relax so that he falls asleep more easily.  This combination of medicine does allow him to focus 100% during the school day and yes, it wears off by the time school is out…and so doing homework can be difficult…it takes longer than it should and some times he doens’t finish all of it…this is good enough for him and us.  Good luck!

Posted by Nica on Jan 21, 2014 at 11:09pm

Thank you we haven’t tried Straterra with him, we had such a bad experience with it on his sister that I have not wanted to use it.  We do use melatonin at night to help him shut down to sleep.  I wish he would bring home his homework to work on, it goes in cycles on whether he brings it home or not.  His teachers are hit and miss on making sure this happens.

Posted by dcisper on Jan 22, 2014 at 12:36am

At one point my oldest son was having problems with every stimulant he would take. so the doctor added “Guanfocine.”  Guanfocine is usually a blood pressure med., but is sometimes used for ADHD.  Another thing that my son takes in addition to Vyvanse and guanfocine is Gabbapentin (a seizure med. that is sometimes prescribed to help with the side effects of stimulants.)  This trio of meds is was the magic combo we were looking for—might be worth looking into.  Another idea——biofeedback therapy.

Posted by cre8vtype on Jan 22, 2014 at 6:34pm

Has your son been tested for ODD?  Our 12y/o son had ODD traits that developed into full ODD as he is getting closer to puberty.  We have put him on Abilify and it has helped.  He is also on Vyvanse, which barely lasts the school day.  Also highly recommend the Feingold diet, but having trouble enforcing it as he gets older and has more access to food without our supervision.

Posted by mmbanis on Jan 22, 2014 at 6:51pm

I have two thoughts to share:

1) My son had the same medication struggles. He is super-sensitive so he couldn’t tolerate many meds. When we found one that worked well (Concerta), it would lose effectiveness every two months like clockwork. When the dosage was increased, he’d get another two months, then we’d be back in the same place. He can’t tolerate high doses of stimulants. It took three years of medication trials with countless meds and doses but we did finally stumble on a combination that remains effective—stimulant (Concerta and Quillivant have both worked well for him but he is more himself on Quillivant) and Amantadine, a little-know medication that is approved for Parkinson’s tremors but is sometimes used off-label for ADHD. Our doctor was tenacious and didn’t give up on finding effective treatment for my son (well, our first doc gave up in 6 months and told me to accept it, so we went to a new doc).

2) If he is struggling in school, request a 504 Plan or an evaluation for IEP. If he rarely brings home homework, he should have an accommodation that a teacher checks his bag for all homework materials and assignments written down at the end of every day. If he’s failing, there are many more accommodations he could likely benefit from as well. The school is obligated to level the playing field for a child with disabilities. There’s a great section of articles on School Accommodations on AdditudeMag.com here: http://www.additudemag.com/topic/adhd-learning-disabilities/school-accommodations.html.

Keep working at it and you will find the right balance for your child.

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

Posted by adhdmomma on Jan 22, 2014 at 7:05pm

My son has been on numerous medications since 1st grade.He is 14 and Adhd.(hereditary)
He also had some learning disabilities like dyslexia and language processing issues.(Hereditary) The medicine was helpful in getting him to focus and learn up to his potential and control his impulses.. He has a high IQ.
Ritalin La 20 mg once in the morning worked for him and if he had sports in the after noon an additional dose of 5-10 mg of regular ritalin at 3-4 oclock worked.

Melatonin in the eves helps him sleep.

We started seeing a new Dr closer to home and she reccommended we try Vyvanse and it was a nightmare. It caused a lot of strange things including a lot of anger. Scarey!!I stopped seeing the new dr and went back to the old dr.Should have never switched.

They recommended trying Focalin because it is similar to ritalin with less side effects.
It works great. He takes focalin 25xr(Extended release in the day and if he has activities in the eve, an additional 10 mg of regular focalin at 4.He plays soccer and does boxing. If he has a big test to study for I also give it to him.
It helps him think clear and focus. Its awesome. His behavior also does a 360 because he can actually think about what he is doing before he does it. its a miracle…......seriously.In additon, I can have serious conversations when he is on it without all the interference of what is going on in his head(WHatever that is).
Also , it has less side effects than any of the others we tried.He also tried dayrana..in the past. The Focalin is great.

Also If he doesnt have any activities on the weekends or school breaks, I dont give him his medication unless he is going to be around a lot of kids ,or has a big project to complete,  . Maybe this helps with its being effective over time….....It also helps me to see how he is progressing on his own in the hopes of eventually not needing it anymore….
Its crazy how the drugs effect each kid different…...
Hope this helps.

Posted by MSMM on Jan 22, 2014 at 8:27pm

Ive heard if you only give the medication on school days it can be more effective, as the brain gets use to the stimulant it loses it affectiveness

Posted by ahyabooboo on Jan 29, 2014 at 6:19pm

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