Anyone w/Children Dx'd w/ADHD?

Hi all:


My daughter was recently diagnosed with ADHD, Inattentive Type. She’s 17. The psychiatrist recommended Concerta and she’s been taking it for about two weeks.


We see the doc on Monday for a med check. She has c/o anxiousness while on the medicine. Have your children had similar complaints?

My oldest son was diagnosed with the same type but put on Dexadrine. He lost a great amount of weight but didnt complain of anxiety. My husband and younger son have both been diagnosed with ADHD (the hyperactive type) and are taking Concerta. Again, no complaints of anxiety, however that doesn’t mean that your daughter is not feeling that. Did she start on an 18 mg dose or higher?

Hi there:


Thanks for your reply! She started with the 18mg. I discovered, however, she stopped taking the medication after a short while. Compliance with my formerly-little-lady-who’s-now-growing-up-on-me, is a problem. We will be visiting the psychiatrist a little later in the month to talk about other med options.


Her whole complaint centers around the need to see a psychiatrist and psychologist, and taking medication. She just doesn’t like it. She has finally “opened up” about her displeasure with the dx and the treatment. She has however, agreed to continue the search for the medication that will help her.


I’m concerned because school will be starting soon and she really struggled with her studies last year. I just don’t want her to become discouraged during the year as she did last year. I believe we’ll work it out - she’s just a little stubborn. I don’t know where she got that from…


Is the Dexadrine a stimulant as Ritalin and Concerta are?



Ritalin and Concerta are both preparations of methylphenidate which is a mild stimulant compared to Dexedrine (dextro isomer amphetamine).


Dexedrine used to be prescribed a lot (my mom took it for a while after she had my brother back in the '70s) for the appetite-suppressant effect, but the primary effect is sympathomimetic central nervous system stimulation. I have a friend who used to take it for ADHD (several years ago), so I imagine it used for the same general rationale as Ritalin. Dexedrine is listed in one of my EMS textbooks as a popular drug of abuse, but that may be an outdated reference. It seems like the popular stim now-a-days is home-brew crystal meth. =P


Tim

There are now several drugs out there which are not stimulants if the stimulant effects are bothering your daughter. You can of course talk to your psychopharm doc about these options.


I’d also commend to you and to her the Hallowell and Ratey book Delivered From Distraction which is a more recent update of their bestseller Driven to Distraction. I think it is helpful in that Hallowell writes from the point of view of someone with ADD (he prefers that term over ADHD) and talks about its positive as well as its negative aspects. (For instance, he talks about people who are excellent rules-followers, very organized, connect-the-dots-in-exactly-the-right-order as having Attention Surplus Disorder.) He also gives some attention to treatment options.


This is a diagnosis which is a bit vague, ever-expanding, and ultimately just our current social/medical frame to describe something real but hard to define. That makes it difficult for thoughtful people to accept that they have a disease or a diagnosis, since what the diagnosis (especially of inattentive type) represents is just one end of a continuum of fairly normal behavior. I think for many people it can be more helpful to think of the label as a way of realizing what is great about their brains as well as realizing what parts of their brains sometimes make life difficult. Hallowell is good on this, putting special focus on the attributes of ADD as well as the problems it can create.


Along these lines, some autistic people organizing on the internet have coined the phrase “neurodiversity”–(see http://www.neurodiversity.com and also see http://www.npr.org/templates/story/story.php?story… ) --that is, that we can either think of neurological/developmental diagnoses like autism and ADD as diseases, or simply as ways of describing different ways that brains are wired, each of which allow people to make different kinds of contributions and to see the world in different ways. I think this is a great way of thinking about neurology generally (it’s what I most love about how Oliver Sacks looks at the world and at his patients), and about ADD.


Best of luck to you and your daughter.


joe