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Parents of ADHD Toddlers, Preschoolers

Three 1/2 year old boy

My grandson was diagnosed with ADHD & has temper issues. His dad is bi-polar and only has supervised visitation.

He is on risperidone 2 times per day & zoloft at night.

He is semi calmer than he had been & can be good at times. On weekends he seems to get more aggresive and you have to worry if he gets upset & he may scratch or bite. If he gets set on something he is hard to get to change his mind. My daughter worries about other kids safety.

Is anyone else dealing with this? If so what meds are they on? How do they handle this kind of behavior.

Replies

If your grandson was “diagnosed” as having ADHD at the age of 3 1/2 (when the youngest age of diagnosis is 4 years old as per the current DSM-5 criteria) I cannot help but wonder why it is that he was not “diagnosed” as having bipolar disorder instead, given that he has a first-degree relative diagnosed as such (father) and also considering the fact that he is being given zero medications to “treat” ADHD…but is being given
• one medication (an atypical antiphsychotic, Risperdal) that is frequently used to treat bipolar disorder & is sometimes used to treat ODD symptoms in those with ADHD
• plus an SSRI (Zoloft) which is totally contraindicated in anyone with bipolar disorder unless they are concurrently taking a mood stabilizer (which he is not) & which does not “treat” ADHD (if that is what he “has”).

Is there any chance that the doctor prescribing these medications has no idea what his “real” diagnosis is and is just throwing a bunch of medications at a THREE AND A HALF YEAR OLD CHILD as if this is a game of darts?

Posted by BC on Jul 14, 2014 at 5:25am

As BC said, these are not medications typically prescribe to such a young child. And it is even more odd to start with these types of medications for ADHD, instead of starting with mainstream treatment—stimulant medication (http://www.additudemag.com/adhd/article/2488.html).

I would seek a second opinion from a professional who specializes in ADHD.

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

Posted by adhdmomma on Jul 14, 2014 at 6:34pm

My son was started on tenex for angry outbursts first. It did help. I did get second opinion and both didn’t want to prescribe stimulants until age 6. The both together now are great. It was mentioned the options of inpatient or outpatient partial hospitalization but luckily we didn’t have to do that. I know the local mental health hospital has children as young as four.
Another decade earlier and another child and different doctor, stimulants were prescribed for my 3 year 10 month old daughter with good results. She had impulse and anger issues. I don’t think she would have made it through preschool without it! Much later she was diagnosed with mood disorder NOS. I think bipolar is very rarely diagnosed in children of any age.
I think also if there are other diagnosises they are treated first before adding Stimulants to the mix.
I know this is a heartbreaking situation. I have had mental healthcare myself to help deal with this. Thankfully your daughter and grandson have you as an advocate!

Posted by Counting Blessings on Jul 14, 2014 at 7:44pm

Just in case I was being too obtuse I think I should clarify a few things.  If the “suspected diagnosis” is ADHD but the practitioner prescribing the medications is simply reluctant to actually “treat” ADHD (due to nothing but a preference to abide by the DSM-5 criteria which somewhat arbitrarily determines there should be minimum chronological age reached before that diagnosis is given & treated “appropriately”) rather than go ahead and stick their neck out (which could conceivably get chopped off by government & insurance regulators) they end up doing things like this: throwing other medications at the problem that are most definitely less efficacious & are potentially even more dangerous than, for example, just giving a stimulant. 

In other words, this very young child/toddler is being potentially pharmaceutically mismanaged only in an effort to comply with certain “guidelines.”  It is simply a sad commentary on the state of medical care today—especially in the United States.  Because Big Brother is constantly watching over medical providers (in the guise of “managed care” via the Insurance Industry; in the guise of mandatory utilization of Electronic Health Records via the Federal Government) medical providers are playing a new version of CYA in an effort to stay under the radar OR color within the lines.  They are essentially coerced (or forced) into making medical decisions which may not have much, or anything, to do with what they believe is actually in the best interest of the patient (&/or the family). 

Medical providers these days are being so grossly micromanaged by outside interests (the Insurance Industry whose primary interest is not the health of the patient but the health of their own bottom line—money) + (government regulators whose primary interest seems to be in making sure there is no real Art or Science left in Medicine because cookie-cutter guidelines are so much easier for them to arbitrarily enforce; the alternative being to trust that the people who’ve devoted a lifetime to learning the Art & Science of Medicine just might know what they are doing—& do a better job of treating patients, AKA honoring that infamous Hippocratic Oath, if the government would just trust that they actually have the requisite training & skills to do so autonomously).

Long editorial—sorry.  But unless patients who’ve actually been “harmed” by this Brave New World of MicroMANAGED Medical Care fully understand why they are being “harmed” (& who is ultimately responsible for that “harm”)—regulators who seek to control the “equitable” distribution of resources and who do so under the very thin veil of promoting Social Justice & Social Welfare then the actual STATE of medical “care” in this country will only continue to do what it has done over the past couple decades—rapidly deteriorate.

Posted by BC on Jul 14, 2014 at 9:54pm

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