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We need help

I have posted on here several times with some great responses and feedback.  My husband and I are at our wits end.  Our 13 year old son with ADHD/ODD cannot go more than 3 days in a row without getting into a fight or getting in trouble at school.  2 weeks ago he got into a fist fight at school and was happy because he thought he broke the kids nose.  Yesterday he got kicked out of 2 of his classes, 1 of which he had to be escorted out of class by a police officer.  He is on 60 MG Vyvanse, and sees a therapist.  We have tried the positive reinforcement, we have tried taking away his privileges.  He just doesn’t seem to care.  As summer comes closer we are distraught as to what to do with him.  We have been told not to leave him home alone because he cannot be trusted.  We have no family or friends that can watch him.  I was hoping to find an ADHD camp he could attend, but cannot find anything we can afford.  We cannot seem to reach our son and feel like we are out of options.  Any advice would be greatly appreciated.
Thank you!

Replies

Hi - the very first thing that popped into my mind while reading your post is “Is he on Vyvanse”? I see that he is on the max dose. 

Everyone handles Vyvanse differently but I can tell you from my own experience of taking it (I worked up to 40mg) as well as my teenage daughter’s experience (she was at 50mg) that it caused both of us to be extremely rage full at times. I would throw things at the wall, break things and yell like a drill sergeant at my family.  My daughter would also scream uncontrollably and try to punch holes in her wall.  Needless to say, the side-effects “irritable” and “moody” were quite an understatement!

Long story short, I stopped taking it altogether and we switched my daughter to Concerta.  However, that caused a skin allergy so we went back to a LOWER dose of Vyvanse (30mg) and the “irritation” and “moodiness” decreased significantly.  The quality of life gained back, despite a tad bit lower attention span, was worth it.

Is Vyvanse 60mg the only med that works for your son?

I wish you guys luck!

Posted by ADDsubmultdivide on May 02, 2014 at 5:57pm

Hi Cberry99,

So sorry you are struggling so much!

My first thought is to ask what his therapist says about all this. It sounds like there is more going on that just ADHD.

I would talk to his prescribing doctor about his behavior and possible trying a different medication. The amphetamines (Vyvanse and Adderall) made my son very aggressive and violent, when he hadn’t been before. There’s another entire class of stimulants for ADHD that can be tried (methylphenidates). Accepting current treatment when things are so bad is not okay. Your physicians need to keep digging and trying new things, until he is in a better place.

Also, I *strongly* recommend that you read Ross Greene’s books, “The Explosive Child” and “Lost at School”. There is something triggering your son’s behavior and these books will help you pinpoint that and work through it. (Check out his website as well at http://LivesInTheBalance.org, and a webinar archive with Dr. Greene here: http://www.additudemag.com/RCLP/sub/10272.html).

There’s also a great library of articles on defiant behavior on ADDitudeMag.com here: http://www.additudemag.com/resource-center/adhd-behavior-and-discipline.html.

Don’t accept troublesome behavior as status quo, just because he has ADHD. He shouldn’t have to live like this, and neither should your family.

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

Posted by adhdmomma on May 02, 2014 at 6:03pm

I am so sorry you are dealing with this. First of all, I have to ask about Vyvanse. I know this has been a popular new drug and many people do well on it. How long has your son been on it? Has he taken another stimulant before? Are his problems worse or better since he started Vyvanse. It may have nothing to do with it, but my son did not do well on Vyvanse. Maybe it was just a coincidence, but my son seemed to get worse when he switched to this drug. He seemed more agitated and more aggressive. I finally took him off of it when I noticed he had plucked out most of his eyebrows!

Have you looked into alternate schools? Is there a charter school in your area? School for troubled teens? Any type of partially or fully funded program for the summer?

What does his therapist say? Does he have any recommendations? (Maybe you need a new therapist/doctor.) I think you have to consider there may be something else going on, because this seems to be extreme behavior for a 13 year old even with ADHD/ODD. I have noticed that teenage boys with depression can exhibit a lot of anger and hostility rather than just withdrawal and sadness. How good is your insurance? Can you do some additional testing to determine what is going on? Will your insurance pay for a short term in-patient program?

Two years ago, my son had a suicide attempt and our insurance paid (well paid for part of it, still cost us about $2500) for him to go to a program for about a week for stabilization and they recommended he go to a treatment facility, but my husband wouldn’t agree. I wish we had done it then, when my son had no choice and insurance would have covered some of it.

My son is now 19 and we are still struggling with him - barely graduated from high school, flunked out of first semester of college, depression, anger, stealing from us, etc. My husband is finally willing to consider a treatment program (drugs are part of the problem), but since my son is no longer a minor, he has to agree.

Not to scare you, but I think you need to do something drastic now, before things escalate. Is there a scared straight or boot camp you could send him to this summer? I know cost is a problem, but if you don’t do something now, it may end up costing you more eventually. In the past 6 months we have probably wasted almost $20,000 on my son - wrecked car, tickets/fines, lawyer fees, stolen money/items, wasted college tuition, etc. I would call and talk to some of the camps/programs you are considering. Some of them may work with you on the cost or offer some type of financial aid.

Also, maybe check with your local police department to see if they know of any programs. Talk with a counselor at your son’s school to see if they know of summer programs.Another possibility might be a Salvation Army Boys Club.

I googled “low cost troubled teens camp” and this website had some interesting ideas: http://www.troubledteenblog.com/forum/topic/inexpensive-programs-for-troubled-teens.

I really wish we had done more sooner for my son. We just kept thinking things would improve, but they didn’t. Good luck to you!

Posted by artistmom on May 02, 2014 at 6:28pm

Cody has been on Vyvanse for 2 years.  The last time his dosage was moved up to 60 MG was in August of last year.  He was just taken off his depression meds over a month ago because his doctor didn’t feel he needed it.  His therapist is no help at all she just keeps saying we need a plan and we will talk about it at his next session. I agree that we need to find a new one and have started making calls.  His grandmother thinks we need to admit him into the hospital and I’m starting to wonder if that is the way to go.  Today we are waiting for a call back from a police officer that we have reached out to.  Since Cody has been on Vyvanse for 2 years, could that still be the reason for his outbursts?  He is always saying he wants to be better, but just cannot seem to do it.

Posted by Cberry99 on May 02, 2014 at 6:38pm

Make some noise with the doc that prescribed the medicine….get a therapist referral from that doctor and dump the one you have now (forever).  Is there a mental health facility nearby? You might want to seek inpatient care for you son.  If he doesn’t meet their criteria for inpatient he might for outpatient care.  They, too, would know of therapists or other psychiatrists you could switch to.  And sometimes if you are being referred to a particular therapist or psychiatrist by a mental health facility you can get an appointment much faster than by just calling for one.  I assume, you both work….otherwise I would suggest homeschooling him for the rest of the school year while you seek treatment for him now.  Unfortunately artistmom is correct…..this is the time to spend the money and time working out the problems.  We, too, are now dealing with an “adult” and things are more difficult from the standpoint of him being “legal”.  I would also say that the medication (even if he’s been on 2 years) could be the problem…..all drug reactions or adverse effects do not happen immediately.  My son is on Metadate….seems to work for him with the attention issues.  Lastly, are you part of any time of support group for you and your husband?  You need help just as much as he does because it’s easy for us to forget about ourselves during times like this.

Posted by greyhairedmom on May 02, 2014 at 7:42pm

greyhairedmom, this website is all the support we have and I seem to only remember it in these desperate times.  I have missed so much work and been crying so much at work, I’m in fear of losing my job.  My husband has been having a rough time at work also because of this.  I know you are right, we need help too, but right now Cody is our priority.  We refuse to give up, but sometimes that is hard.  I love this site and the hope it gives me.

Posted by Cberry99 on May 02, 2014 at 7:58pm

I agree with the other posts re: the medication. Our son was tried on several different stimulant medications, which all seemed to affect him in a negative way. He would have outbursts and throw things,be mean to the pets.When he was able to tune in more to how he felt, he said it made his heart race and gave him chest pain at times.  Finally we were given the option of strattera. That may not help the focus as much as the others, but then it is hard to assess focus levels when the child is acting out like that.
We are having some major problems with getting homework completed and turned in, but the outbursts are much more rare now. I agree also that sadness and depression can be expressed in physical pounding, banging or breaking things. When our son gets to the point of crying, that is when the signs of anger start showing..
Best of luck to you! I hope that these posts will help you and your son!

Posted by momwifeme on May 05, 2014 at 5:44pm

Before anything I think you have to consider changing his medication..I have noticed what Vyvanse can cause mood swings and violent behavior just like the one your son is expliciting. I love focalin XR.

Posted by Griselda Solis on May 05, 2014 at 6:04pm

Sorry to hear this.  I remember when our son was younger starting in Kindergarten, now he is 15, always seemed to have two or three major episodes within the school year of ‘hurting someone’.  Our son, ‘G’, does not communicate real well with happenings during school.  We found out that there were many little things that happened, that most people would let go of, but G held on to all of these things until he exploded on someone.  Probably four years ago we had G participate in a program called STOP AND THINK.  This program has very specific steps to follow when something or someone was bothering him; in the hopes that some innocent bystander did not get hurt again.  I have to say it worked.  We had all these steps listed in four different places throughout our house so he was reminded if he didn’t follow thru with the steps that big trouble would happen.  This did work for us.  I realize your son is 19, but there could be something that just builds up in him quickly until the final ‘trigger’ , then the fight occurs.  High school is hard enough-maybe figure out if there is something going on at school.  I have learned to ask many little questions to get to the bigger issue.  This is frustrating but worth it.  The outbursts could also be a combination of many things. 

Just an extra bit about medication in general…my mother had been taking pain killers for years for her back.  Same dose, never questioned the doctor.  She started showing signs of memory loss and everything progressed fast; she is now in a nursing home and is only 66 years old.

My point to this is that medication affects the brain in ways we don’t know.  My mom’s experience has made me more aware since G has been taking medication for 9 years now.  How will all this medication affect our kids in years to come?  I’m still in search of a more natural way to help G.  Haven’t found it yet, but will continue to look.

The only suggestion I have,  is to talk with your son everyday about every little thing that happened at school/home. It could be the most weird and stupidest thing that he could be holding on to that makes him most angry.

Posted by pricemama on May 05, 2014 at 6:52pm

Both classes of stimulants (amphetamines: Vyvanse, Adderall, etc) and (methylphenidates: Ritalin, Focalin, Concerta, Daytrana, Quillivant, etc) can cause the bad reactions you & others describe (mood swings, aggression, etc).  For some, these bad reactions will happen for both classes at any/all doses, for some they will happen only with drugs of one class but not the other, for some they will happen but only if/when the drug is given at higher than optimum doses, etc.

As far as I know there aren’t any good studies that compare the different classes (or the drugs within each class) head to head to find out if any one class has a higher incidence of causing them (or any within that class) at any/all doses in a greater proportion of people.

How people respond to each class (and to different drugs within a class) is very unique to each individual; one person’s bad experience with all stimulants, or all amphetamines, or all methylphenidates, or only to one particular drug in a certain class is only a reflection of that person’s unique chemistry and not something that can be extrapolated out to apply to someone else or to the population at large. 

Your first post was in November.  I don’t know when your step-son came to live with you—whether that was before or after the most recent increase up to 60mg Vyvanse (from an unknown but lower dose of Vyvanse). 

What needs to be examined is: did these ODD problems exist back before he started taking Vyvanse 2 years ago?  Have they progressively gotten worse (which could implicate the increasing dosages of Vyvanse but not necessarily)?  Have there been periods of increased frequency and/or intensity followed by periods of decreased frequency and/or intensity throughout those two years irrespective of what the dosage of Vyvanse was/is? 

You mention he had been taking an antidepressant until about a month ago.  What, if any, changes have you noticed in that one month period compared to all the months he was taking the antidepressant?  You don’t mention what antidepressant this was, but if it was any of the ones that is an inhibitor of one of the cytochrome P450 enzymes, 2D6, which includes Prozac & Paxil most notably, but also Wellbutrin (& possibly Cymbalta), there is a known drug interaction with all of the amphetamine class which can cause bad reactions such as these.  In addition some antihistamines/cold medicines (taken on a daily basis) will also interact with amphetamines in this manner.  The interaction causes a build up of amphetamine blood levels, and often it is a delayed build up over time (months).

Posted by BC on May 05, 2014 at 7:40pm

I agree with having your son’s physician re-evaluate his medication.  Also, please talk to the doctor about neurofeeback, or brain training, as an addition or eventually alternative to medication.  Studies are showing good success for treatment of ADHD and anger.

Good luck

Posted by KFW on May 05, 2014 at 8:44pm

You haven’t mentioned working with the school yet.  Is he in the Sp. Ed program?  He needs to be!  His ADHD is a disability that needs more than just classroom accommodations.  A 504 plan will not cut it.  He needs to be in a Behavior Intervention Class with a teacher who is specially trained to use positive behavior strategies.  If your school district doesn’t have such a class, then they need to send him to an appropriate school at their expense.  He may need this long term or he may just need it until proper meds are figured out.  It doesn’t matter if it is short-term or long-term.  It doesn’t matter if he’s getting good grades or bad grades.  His behavior is affecting his and the other students’ education.  Everyone’s well-being is at risk.

An IEP will give him some discipline rights.  If he keeps missing school due to his behavior (10 days of suspension starts the process), he needs to have an FBA, (Functional Behavior Assessment) and a resulting BIP, (Behavior Intervention Plan).  This is covered by IDEA law, 34 CFR Section 300.530(d)(ii). 

Please read From Emotions to Advocacy by Pam Wright.  You can get it in two days from Amazon.com- http://www.amazon.com/Wrightslaw-Emotions-Advocacy-Education-Survival/dp/1892320096/ref=sr_1_1?s=books&ie=UTF8&qid=1399335082&sr=1-1&keywords=from+emotions+to+advocacy.  Or get it directly from wrightslaw.com.

If he already has an IEP, call for a meeting immediately.  And read Pam’s book from cover to cover before you go.  If not, write a letter right away asking that he be evaluated.  Her book tells you exactly what to write.  Model letters are also on the website. 

Enroll him in summer school.  Make it a part of his IEP.  Then it is mandatory and can be backed up by a truancy officer.  Take the warning not to leave him alone this summer seriously.  Your community behavioral health department (mental health services) should be able to help you with this.  If you do, you will end up owing someone a vast amount of money because of his shenanigans.  Good luck.

Posted by ADHDteacher on May 06, 2014 at 5:00am

So Sorry to hear this.I just wanted to say that my son was on vyvance and it totally changed his whole demeanor very quickly.He became sneaky,nasty and really different from who he really is.I immediately stopped it and went back to adderall but added an afternoon dose and he got back to himself quickly so I knew it was the medication.Our Dr.said although this response is not typical it has happened with 3 other patients,all of them boys.

Posted by keeks on May 14, 2014 at 9:39pm

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