Stimulant medication even if its not officially ADD

From working in a dev. eval clinic, I know there are many “views” of AD/HD….that said, use standardized instruments(not just clinical interviews one on one) to evaluate it(search on Russell Barkley’s work); it is usually present before age 7, seen in all settings, and usually if there is a dx of PDD, MR, autism, etc. you don’t meet the criteria for AD/HD. Usually anxiety is a reason not to use the stimulant drugs, and from what I know from other parents, inattentive ADD is not that responsive to stimulants. Schwablearning has a good section of Russell Barkley’s explanation of the different types of AD/HD.

Basically all the indicators are that ADHD is not the issue, and there may be issues that stimulants would make worse, not better. Still you could probably find a doc to write the script anyway if you are curious if you went in and described the right symptoms — just read the web pages or books. Personally I would need a better reason than “well, it will be out of the body quickly” even though yea, it’s all pretty subjective too.

This why I come to this board. Such sensible advise!
We have a psychiatrist on our “team” and will be talking strategy and meds with him anyway. I’ll be curious to see what he says.

I don’t mean to be flippant about the use of medication at all. It just seems like it keeps coming up, and there’s a part of me that would like to know if it would make a difference. But I had forgotten that stimulants can exacerbate anxiety behaviors.

Hi Karen,

My son was diagnosed with “probable” inattentive ADHD, and we put him on a trial of stimulant meds. They were great for his focus, but his anxiety became a little more severe (not enough that I figured it out before the end of school last year). At the beginning of this school year, we put my son on Wellbutrin (1/2 dose) for the anxiety, and a very low dose of stimulant meds (Ritalin). This combination has worked for him beautifully. I never thought I’d see the day when I was double medicating a 9 year old - but it DOES work (for him).

I’ve been where you are with the worry and anxiety myself about whether I was doing the right thing - but seeing a bright, shiny face when he gets off the school bus, vs. last year’s scowl, has convinced me. I’m just not sure if we have to do this forever or if we can work him off it - that’s for a future conversation with the doctor.

Lil

his psychologist felt it was anxiety at first and I disagreed. Then she seemed to put a lot of stock in the TOVA taken after that first session and agreed with the ADD inattentive dx-but cautionned me to watch for anxiety.

I feel the adderall has helped tremendously. He is so well behaved its hard for a teacher to call him implusive. But blurting out ‘house’ when you see an ‘h’ isnt just weak reading skills-theres a level of impulsiveness there another child who either goes silent pondering or tries to sound out doesnt show. It doesnt just have to be physical impulsiveness-jumping off a high wall, bopping someone in the head

Ditto for attention-20 questions and the first 6 are perfect, the remaining 14 incorrect with a few skipped to boot. Thats lack of attention. It doesnt have to be turned around in his seat or getting up for the 18th drink of water.

JMO but thats what you were wanting

I would see if there was a drug you could ‘try’ that would not be likely to exacerbate the anxiety if indeed that is there. there are other options than ritalin and adderall out there, but you would probably need to do some of your own research and them speak to dr.

For information on ADHD meds go to:

http://www.medscape.com/viewarticle/437026_1?WebLogicSession=PZTb4vha6icy5YP2PMMqYbA383qlNoSzVE1H1GSrqTW9nosos1Rs|-8161781252434006331/184161393/6/7001/7001/7002/7002/7001/-1

You have to register at medscape, but once you have done it, it doesn’t have to be done again.

nt

Hi Karen,

My younger, NLD-ish son has been dx’d with generalized anxiety disorder and ADHD/Inattentive and LD. We decided that the anxiety was the biggest problem and the psychiatrist put him on Wellbutrin. It has helped a lot. He still is inattentive, but at least he’s not overloading on frustration and anxiety, so he’s doing better in school. I’d be very nervous about trying anyhting that could exacerbate his anxiety.

My older son who is NLD can also be inattentive, but his attention problems are very clearly realated to anxiety in an inappropriate school setting. Put him in a classroom where he feels safe and adequately supported academically, and his inattention completely evaporates. He’s not on any meds.

Karen

marycas,
you just described the difference between my add/inattentive son and my adhd son LOL!!!

Amyf-

How would you describe your 2 children? I find listening to parents describe what they see if so much more helpful than looking at some diagnostic checklist!

I have to agree with Lil. Her sons experiences mirror my eight year old daughters. She was also moody, and often seemed depressed. She takes the stimulant, Adderal for her inattentiveness, as do I recently, which is very, very helpful, and she is not hyperative, but mostly inattentive. She began taking Paxil, an antideppresant in January of this year. For the first time, she will actually initiate conversations with others. She will make eye contact with people now and smiles often, both things that she rarely did before the antidepressant, which is also good for anxiety. I too was fearful about medicating my child, but after seeing the positive results, I have to agree with Lil. It is also important to note that her academic abilities have improved dramatically over the last year on stimulants, and then the Paxil too. She still has issues with inattentiveness, and we are working on improving her ability to catch herself when she begins drifting out. Some of her problems have to do with her LD’s in reading and math. When the teacher is explaining new material and there is something that my daughter doesn’t get right away, she gets caught on it and before she knows it they are down on problem five and she is still on two. I have discussed this with the teacher and the special ed. teacher though in hopes of working out a solution. I also have my daughter undergoing a private comprehensive evaluation with our local Universities Neuro-psych. specialty clinic. I want to get their opinion about whether the special ed. services my daughter receives are comprehensive enough to meet her needs. I will keep you posted. Hope this rambling might help you.
Deb