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Starting Med Trial! ADD inattentive ~ Adderall XR

Submitted by an LD OnLine user on

I just picked up my son’s prescription for Adderall XR 10mg. He is 10 years old and *may* be ADD inattentive (with dyslexia, slow processing and mild language difficulties).

My question: Are the hyperactivity and inattentive meds similar? My son is much more dreamy and kind of “out of it.” Would the same meds for hyperactivity be used for the non-hyper child?

I really don’t know if my son has ADD. We’ve done the Conner’s 3 times over the years with inconclusive results. But I feel that the time is right for a med trial to see if it makes any difference. I’d like to be able to rule out ADD and I feel this would be the best way to do so. (Then I could focus more on other potential answers like possible APD, HFA, absense seizures or temporal lobe epilepsy). Of course I’d love it if something helped with learning. I know this won’t correct his LD’s, but if it could help “wake him up” and allow him to work more efficiently towards remediating them, well, that would be good. Although, quite honestly, I’m not expecting anything.

Thanks for any information.
We’re starting the meds tomorrow morning!

Submitted by Anonymous on Thu, 09/23/2004 - 11:19 PM

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Not to discourage you, but the reading I have done suggests that it is much more difficult to get an effect from meds on the dreamy sort of ADD. Some in fact suggest that ADD-inattentive and ADHD with hyperactivity/impulsiveness are two different phenomena.

But keep us informed. I am interested.

Beth

Submitted by Anonymous on Fri, 09/24/2004 - 3:26 PM

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Go to http://millermom.proboards23.com there are lots of moms with experience on medication, remediation etc. who will share their knowlege and support.

And yes, it is the same meds for ADHyperD and ADD/Inattentive.
It takes time and trial to find the right dose and the right meds for each child. My son is ADD/Inattentive and APD. He is on Ritalin LA and doing well. He has tried Concerta, Adderall, AdderallXR, Strattera and finally Ritalin LA is the one that works really well with the least side effects.

If a child is comorbid with all LDs, the meds can only help up to a point, and remediation and accomodations should step in to help with the rest. My son’s APD has to be accomodated even though his attention has improved alot.

Good Luck with the Adderall and come visit us over at the site I mentioned. I don’t visit here as often anymore.

Mayleng

Submitted by Laura in CA on Fri, 09/24/2004 - 5:12 PM

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I gave him the pill at about 7:10. We had our first parent/teacher/student conference at 7:20. I didn’t mention anything to the teacher (should I have?). I want to see if she notices any difference.

I will say he was “completely out of it” at the conference. No eye contact, no reponses, it was like an autistic child (of course he has a non-documented diagnosis of HF autism by a neuropsych, so this isn’t that unusual). Today he has a 1/2 day at school so I’ll be curious to see how he’s doing when I pick him up for lunch. At some point I’d like to try the medication one day just to see what it’s like.

Does anyone here happen to know if this type of medication can affect the results of an EEG? Is this a medication that gets eliminated from the body pretty quickly?

MMM, thanks for the information about the other board! I’ll take a look at it.

Beth, it wouldn’t suprise me if the two were different phenomena. Well, I’ll let you know how it goes.

Submitted by Anonymous on Fri, 09/24/2004 - 5:34 PM

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It sounds like your son is on too high a dose. Many doctors like to start with the regular adderall to pinpoint dose effectiveness before moving on to the long-acting medications. Don’t worry though, even the long acting meds are out of the system within 24 hours max. If epilepsy is a possibility, you may want to go slow with any stimulants. They can lower the seizure threshhold, although it usually takes a pretty high dose to do so and there are many kids who take antiseizure meds and stimulants. I don’t really know if stimulants affect EEG results, but I have a feeling I may have read somewhere that they do.

Submitted by Laura in CA on Sat, 09/25/2004 - 6:28 AM

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Thanks for all the information! I agree that this is probably too high a dose and I think 5mg may be more appropriate.

After today, I have to seriously wonder, maybe my son does have ADD inattentiveness?

So far, I think this medication has made a visible difference. My silent son talked A LOT today. This is unusual. He typically doesn’t speak very much and answers questions with with one or two word sentences. But today he gave me wordy descriptions of some of the stories he has heard or read in the past, spoke about different cloud layers and various other scientific phenomena. In addition, he spoke QUICKLY (at a “normal” rate!). Generally he speaks very slowly, loses his thoughts and can’t retrieve words. I can’t say his language difficulties were completely erased, but they did seem quite a bit diminished.

And it wasn’t like he was a non-stop “talker.” It was a two way conversation. He asked lots of questions today, shared his thoughts and wondered about things. He listened. He was “reciprocally social” and actually interested and aware of other people and things around him.

At one point, in the later part of the day, he did start to cry because he didn’t like how he couldn’t stop talking and was speaking “quickly” (asking questions, making remarks, comments, HAVING AN OPINION!).

It was really strange. I’m so used to “forcing him” to speak or try to remember things. His memory seemed improved.

One more thing. He spent about two hours on the piano today. He was concerned that he hadn’t spent enough time practicing over the week. He’s quite good at it, but today he sat and figured out (without the music) how to play the theme song for Harry Potter! Usually, he’ll start something like this, but get frustrated pretty quickly and give up. Today he worked on it until he had it and then proudly played it to his piano teacher!

So, does this mean my child may have ADD? Might something like this be a possible response for someone with attentional difficulties? I know he’s still dyslexic and has LD’s, but his language and frustration level seem improved.

By the way, he had a better appetite than normal. Very surprising! On the negative side, it’s after 11 p.m. and he can’t sleep.

Submitted by victoria on Sat, 09/25/2004 - 7:10 AM

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Well, it sounds like you have found something that really helps.

If the one pill is still a bit too high, you can try 1/2 or 3/4

We had to do this with my thyroid med — for a while I was on 3/4 of a pill, so I dissolved three pills in exactly four ounces of water, kept in a very clean bottle in the fridge, and I take exactly one ounce per day in a shot glass.

You have to check if the pills are coated in some way to control the rate they dissolve — if they are you can’t take a part of a pill. But otherwise it works well.

Submitted by JenM on Sat, 09/25/2004 - 12:25 PM

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The first day that my younger adhd child started meds the first thing I noticed was she came home from school and actually talked to me about her day in a cheerful manner. I almost cried! Previous to that she would come home and tell me she didn’t want to talk about it!

Not that it’s relevant to your case, but in her case her adhd greatly affects her visual processing. She was diagnosed by one doctor severely perceptually impaired and had all the symptoms of dyslexia. This led us to a specialist in neurodevelopment who diagnosed adhd. Since starting meds she was again retested by the original doctor who saw the perceptual impairment and clearly she tested within normal range. The first doctor told us that the testing results indicated that we had found the source of the problem which was the adhd because treating that basically resolved the LD issues. She still needs extra help because she does much better in smaller settings and anxiety is a big issue but academics alone are less of a struggle for her.

Submitted by KarenN on Sat, 09/25/2004 - 6:00 PM

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Wow Laura, I’m on the edge of my seat for you….

As you know we’ve been down this “is he add-inattentive ” path as well and a third profesional has determined that stimulant meds aren’t appropriate b/c of my son’s anxiety and mild tics.

Our psychiatrist said stimulant meds would make anyone more focused, even someone without ADD. But what you’ve described goes beyond that, and sounds like more efficient processing. And I think whether he meets the criteria for ADD or not, if you can improve the underlying processing it will make many things easier! I really hope this works for you!!

Submitted by Anonymous on Sun, 09/26/2004 - 1:08 AM

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Laura,

It sounds like you may have figured out a piece of the puzzle of your son. I am amazed at the differences you have seen. You must be so thrilled! The effects seem to go beyond attention…to more efficient processing, which I find pretty incredible. I would not expect medication to impact processing…but really it does sound like it has.

Keep us informed.

Beth

Submitted by marycas on Sun, 09/26/2004 - 1:25 AM

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My son is on AdderallXR for inattentive ADD(and we also have the nondocumented spectrum dx)

I am sold on the stuff. We tried Strattera becasue Adderall so adversely affects his appetite but Strat did the same poor eating thing. And it didnt help with the impulsivity

My son has no behavior issues but the meds diminish behaviors like cirling A everytime without reading through the choices, etc. He also has done some odd things off meds like cut his hair because it was bothering him(cute at 3, horrid at 12)

WIll the teachers notice?

Doubtful-although youre in a small school ,arent you?

Normally the dreamy ones arent noticed “dreaming’-theyre not being disruptive, after all

Did his handwriting change? Im serious-my sons writing is far neater on meds-its almost ‘stephen king’ like

A friend who helped in his pullout told me that the medication took away that line in his forehead when you explained things to him. I knew exactly what she meant. Instead of that wrinkle and “what” or “huh”, he comprehends better.

Its like he just processes better. My psych likened it to going up a hill in the right gear as opposed to the wrong gear. Yeah, you get there in the wrong gear but its so much tougher…..

Ritalin mellowed out my son too much-that is why we went with Adderall.

IF you try his meds, be sure you dont need to drive. I tried a 5 mg single dose and was a productive, focused person, but when he went on XR 20mg, I tried that and was an anxious mess. Stupidly, I had to drive somewhere and was freaked at traffic coming towards me and where and when to turn-not a good experience

And, yes, I know it was stupid-learned my lesson and havent touched the stuff since!!!!!!

And XR 15mg is the best dose for him-20 was too high-he had trouble sleeping, but when it first came out they didnt have 15’s.

Submitted by Anonymous on Sun, 09/26/2004 - 3:50 AM

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I have seen how proper meds work on kids that are slow processors. It was something I suspected and mentioned a long time ago when you first started posting…

One of the kids that I had treated as an SLP was just like Laura’s son.
I figured out he was ADD-Inattentive… he was an extremely slow processor, had problems reading and writing, he was very methodical, couldn’t stick to things that were tedious, he would start things and not finish them and he was really in his own little world and dreamy….and with meds he was talkative and doing so much better, but when the dosage was too high he was like a zombie and when the dosage was lower he was talking…His mom couldn’t believe it either…it was like his brain was turned ON :idea:

Meds can be a really good thing and to see a kid finally put it together is the best medicine of all…

:lol:

Congrats!!

Submitted by marycas on Sun, 09/26/2004 - 4:50 AM

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Hi Again Laura

When I posted the first time, Id entirely missed that 2nd page of posts-duh!

My understanding when we switched from regular Adderall to the XR was that 10mg of XR would be equivalent to taking the 5mg pill every 6 hrs. His 15 XR is like taking the 7.5mg individuals

So your ds is on a pretty low dose. Some of the side effects go away on their own(stomach pain, for ex) and some dont. I’m glad your son is eating better, not worse ;)

Give him some time to get used to the dose and dont try to half it-you just cant do that with the XR version. The delivery is weird-my adult ADD friend explained it but I dont remember the details. Suffice it to say it isnt a nice even delivery-it kind of ‘hits’ in highs and lows. She insists there is a hard ‘hit’ in the first 30 min where she is a little hyper and does best doing some physical activity. Its possible this is what made your son a little zoned immediately afterwards he took the pill

I havent noticed it with my son.

Interesting that he noticed how talkative he was and was concerned. This could all be part of the adjustment too-they can be a little emotional. Again, most of these side effects go away after a week or two

When do you see the dr again?

Submitted by Laura in CA on Mon, 09/27/2004 - 7:12 PM

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We didn’t use the medication over the weekend so I can’t add any more to my observations. My husband is not thrilled with my decision to try this and insists that we only use it for school.

So…I’ll be very curious to see how things go this week. The weird thing is my son has had a lot of testing and has not been diagnosed with ADD. So I have to wonder, maybe the medication helps overall processing? Isn’t it basically an “upper.” (At least that’s what my husband says! He thinks the meds would have this effect on anyone). I just don’t know. I don’t “like” the idea of medicating my child, but I’m really at a point where I’ve already grasped at so many different straws that there are very few left. I don’t have too many choises.

Thanks for all the information and support. I’ll let you know what I observe the rest of this week.

Submitted by marycas on Mon, 09/27/2004 - 7:31 PM

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I do think they have some sort of effect on everyone, but I suspect it is pretty mild-like too many cups of coffe. Yes, they are uppers.

IMO IF they end up REALLY working, there is something in the brain chemistry that causes these kids to react so strongly.

Remind DH that most ADHD kids are not like ours but are hyper, cant sit still versions who take a stimulant and calm down. I mean…..obviously the brain chemistry isnt normal or those kids would be climbing the walls on the medication, not calming down!!!!

Yes, I have heard anecdotal evidence(Pattim is certainly one)that it helps processing and increases working memory

There is a memory component of ADHD that I dont think we know enough about. Its like an afterthought in what I read “oh, yeah, ADHD seems to affect memory”

Geez, in school, especially for inattentive kids, memory is SOOOOO major!!!!!

What I noticed in ds’s schoolwork first off was the consistency. Typical for him was to start a test or assignment doing quite well-page one would often be perfect;page two would have multiple errors and page 3 would be all wrong. It wasnt related to the difficulty of the material.

Handwriting Ive already mentionned

More organized desk and binder. I saw his locker at middle school open house-spotless with texts stacked in order of his classes. I saw other kids lockers-papers fell as they opened the door. I was impressed

Less frustration for me when explaining new concepts. He catches on faster

Less of ‘that look’ in his eyes. “Hello, earth calling Blake”

Hope things continue to go well. It took DH a good year to get on board but he is with us now

Submitted by JenM on Mon, 09/27/2004 - 8:54 PM

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my younger child has her working memory greatly affected by adhd. The meds have helped her immensely as already posted! We also had taken many other steps and there was not a whole lot left. She would have needed special education had we not taken that step. That would have been fine if that was what she needed. When the school speech language person tested her memory it was at 6%. Working memory was one of the major areas the neurodevelopmental specialist picked up on and she basically had no visual memory at all. This was one of the major reasons she was experiencing so much difficulty reading.

Submitted by Laura in CA on Mon, 09/27/2004 - 9:43 PM

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Interestingly, my son seems to test quite well in areas like memory, and even areas of speech and language (really, his only language testing weakness is RAN). But in day-to-day functioning it’s like someone who’s half asleep or “not there.” I think there are times during the day when he seems to function a little better then at other times (and somehow this has gotten him through school up to this point with his difficulties being overlooked. Of course, this year he has his first “hard” teacher). Also, he has excellent attentional skills (sort of like a hyperfocus without the hyper), even to tedious and difficult tasks. I’d have to say most of all I’m interested to see what the effect on his language skills will be. It would be interesting to test his RAN with the meds.

The other day a boy had commented to him that he “wasn’t good at anything.” We had a very difficult time last year with teasing. Some kids were calling him names like “stupid,” “weird,” “geek,” etc… Verbally, my son hasn’t had the language skills to deal with this. I’m hoping the meds may help. I know on Friday he seemed to be much more verbally adept. In fact, he made some complex statements I wish I would have written down. I don’t remember them, but I was thinking how clever they were. In addition, they weren’t made haltingly like someone having to really think about what they were saying. The speed was quick or “normal.”

Submitted by Anonymous on Tue, 09/28/2004 - 1:47 PM

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I find this discussion interesting. Is ADD the cause of short term memory issues (like in Jen’s child’s case) or slow processing (Laura’s child) such that medication addressing the ADD also improves other things? Or is it that for some reason stimulants improve other types of processing besides attention, even though they are not approved for them? Laura, for example, notes that her child has not been diagnosed with attentional difficulties.

My own child was diagnosed several years ago with ADD-inattentive by a neurologist. We were considering a trial of medication. That summer we did Interactive Metronome and more Neuronet. In fall, none of his teachers (two of whom had him the previous year) thought it was necessary.

His attention issues have become clearer to me as we have improved other processing. For a long while it was difficult to know if he wasn’t paying attention because things were hard or if attention was the primary culprit. I see now that his mind races to other things and that he requires physical exercise to concentrate. He knows the latter and will tell me that he needs to go ride his bike to wake his mind up.

He has had much therapy and his working memory and RAN are now in the normal range, although not strong. He is doing well but he still is more inconsistent than other kids.

So I ask the question I do partly because I wonder for my son. His attentional difficulties really are not severe enough at this point for me to consider medication. But if medication improves overall processing, it might be another issue.

Beth

Submitted by Anonymous on Tue, 09/28/2004 - 4:31 PM

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Hi Ladies -
I hardly every post but always read your valuable advise. I have to participate this time though as we are going through so much of the same issues.

My son now 9 is in 3rd. Been throught the usual behavioral, reading & writing problems. Testing showed Add and visual processing problems. After taking many of your opions seriosuly we started Adderall rx at 5 mg in spring 03 (up to 10 then 15 then back to 10)and started VT in fall of 03. The bevior issues of being overly silly and poor social problem solving have cleared up. This allows the slower processing and lack of focus and attention to be more apparent… I think. Though we’ve done extensive testing I keep wondering is there is a language/speech/auditory processing going on? OR are these thingsjust part of the ADD..obviosly the attention focus is… Sorry thinking out loud a bit.

I’ll be honest I took the adderaall as a test and it made me very focused an productive that day. Of course my sons wieght is a problem. This is week 4 of school and he has been unmedicated to date as we are thinking of switching to Welbutrin. ( My qusetuins aboiut that will come in another posts :-)) I have spent the last few month more fcused on sustained attention/focus and processing speed myself. His 504 meeting was this am and his fabulous male (a 1st) teacher said starting and staying on task appear to be his biggest challenge as of yet. So I do think the adderall was helping to some degree. In our case the benefits were biggest in the behavior (impulsivity) catagory.

Submitted by Laura in CA on Wed, 09/29/2004 - 4:59 PM

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For us, the true test will be…how may (or may not) the meds be helping at school and in the classroom? I think my son has true LD’s and it’s not merely a matter of ADD (attention and memory problems primarily due to LD’s and not LD’s due to attentional problems).

When I have a better idea of what the meds are doing then I have to decide if they are worth it. I wish I could observe my son in class to see the difference. Maybe I should let the teacher know he is on meds and ask her to observe. I know Monday after school I asked her how he did that day and she said, “Okay.” She didn’t mention anything about him being more focused or speaking out more in class or participating more..or there being any noticable change. I didn’t talk with her yesterday, but I might stop by today after school and ask. Or, maybe I can ask to help in the class sometime this week (and observe! ;-).

The one negative thing I have noticed is my son does seem slightly more temperamental after school. The other evening he was upset with one song he’s learning to play on the piano, and last night he was weepy about how he has so much homework that all he does is “work all day and all night!” (Actually, he really did have too much homework!!!).

The other night his reading seemed quite good (low errors and no counting pages to find out when he’d be finished or try to bargain for reduced reading), but then last night I had him do some speed drills before bed and he made a lot of errors. Of course, I do realize I’m probably observing him at a bad time when he’s “coming off” the meds.

By the way, thanks all for sharing your experience with these meds. It is fascinating and yet, it’s also frightening too. For example, if they do help does that mean we’re dependent on them? Will our kids need to be medicated the rest of their life? Will ADD-inattentive kids ever “out grow” or mature out of this? Can meds help in “retraining” the brain, or is it more like glasses where you just become more and more dependent on them?

Submitted by Anonymous on Wed, 09/29/2004 - 6:57 PM

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Laura,
My son was rather emotional in the evenings (5 to 7ish) for about a month after starting Adderal Rx. It did level off though. Generally though he still complains of a vague minor stomach ache at the end of the day.
Keep us posted.
Chris

Submitted by marycas on Thu, 09/30/2004 - 2:36 AM

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I think the meds are probably mostly out of his system by evening so if you want to first hand observe effects, you need to get to him sooner

Our ped says she gives out 5mg tabs for evening use to get through homework because the XR will usually be gone by then

So far we havent needed to go there but his workload has been light. I DO see the forehead crinkle though :wink:

The ideal would be for my son to do homework after school but 1)I dont have the heart to enforce that 2)it interferes with my work schedule

Does he need to be on meds forever?

I have no doubts he will do fine in life. It’s school that gives him the problems because material is taught in a way he doesnt learn. I too see the inattention as a secondary problem to his learning style(or LD)

If he chooses to go to college, he will need them longer. But, irregardless, when its time for REAL life, I think he will be fine

He’s competent

It was teh most valuable thing I learned last year homeschooling. When you homeschool, you see what they CAN do. School only seems to tell me what he CANT do :(

.I dont worry about ‘meds forever’ anymore but I took almost 3 yrs to get here!!!!

Submitted by KarenN on Thu, 09/30/2004 - 11:50 AM

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For what its worth, our neurologist said he sees alot of improvement in attention and organization in kids like ours at the time of puberty. Says the hormones are good for the brain in this way. So maybe, just maybe, some natural develoment will kick in and alleviate the need for medication.

Submitted by Laura in CA on Thu, 09/30/2004 - 7:14 PM

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Wow, that’s positive!!! I’m glad to hear that puberty may start some good things. Biologically that makes sense.

This morning my son was VERY chatty and hyper…annoying his sister. Even she made a comment about the medication and his bothersome behavior. I don’t think he was necessarily too hyper, but maybe closer to “normal.” He had a huge amount of homework last night, was able to finish most of it and then woke up early, finished it, then practiced piano and created a lovely song.

One thing we’ve been doing is the Home Vision Therapy program (I was able to get a disc from a local eye doctor). It’s about 20 or 30 minutes every night. I think the meds may be helping him with this program, in particular visual motor. I don’t have any proof, but it would be fascinating to do a study on this to get an idea how much it may or may not make a difference.

Submitted by Alison2280 on Thu, 10/14/2004 - 6:18 AM

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Hi there - I’m new to this group but just reading your posts resonated so strongly with what we are going through with our son who’s 8. We started adderall SR at 7.5 mg about 6 mos ago - after many years of alternative therapies - and I have to say it transformed him in the classroom and at home. No more impulsive behaviours (I heard Strattera does not cater for the inpulsivity whereas Adderall does), 100pc improvement in focusing, more chatty, calmer by nature. But, appetite has gone down (with his weight) and he has trouble dropping off to sleep. I too have noticed more weepiness and “stroppiness” but is this just normal 8 yr old behaviour coming through? He also has a CAPD and of couse this is still causing processing problems, reading comprehension etc. The calmer demeanor in class does at least help him to learn, participate and benefit from the support therapy he receives in school. I worry about how long he’ll need to have the meds and if there is a proven diet alternative. Has anyone used hte meds for an extended period or had success with diet in helping ADHD (we did have a full neuro-psych exam done) ??? Thanks!

Submitted by kristin on Tue, 10/19/2004 - 9:49 PM

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Adderall is a VERY serious medication. There are reasons it is a controlled (schedule II) medication. There are all kinds of things the doctors don’t tell you about his drug. I was prescribed Adderall as an adult and was on it for 4 1/2 years. I had horrible side effects that I was told were not caused by the meds. You child is only ten, he can’t tell you if something bad is going on inside him from this medication. It is truly scary. Go to this site and look.

I am not some nut that is anti medication. I have researched adderall because of the problems I have had and the things I have found, parents killing there kids, moms becoming psychotic and their kids dying from injuries in accidents…

http://www.nlm.nih.gov/medlineplus/druginfo/medmaster/a601234.html

There are always times it is appropriate to prescribe medications. IMO, you and your families safety is so important, you should read all you can on any medication prescribed.

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