What to do about ADHD meds for 15-year-old DD?

[Anonymous]

DD was on extended release Focalin for about a year to two years (10 mg). It seemed to help with emotional regulation. Then she recently stopped after starting/stopping, and feeling like it didn't help her to improve her attention and focus.

Then DD tried Concerta. She said it improved her focus but also made her tired. So we stopped.

Tried Adderall (today was the first day) at 10 mg. She said it caused a headache and took an advil in the afternoon. Should she keep going with the Adderall?

DD has anxiety, ADHD, ASD. She does very well at school but has difficulty completing chores at home and hyperfocuses.

(Has been taking 37.5 Zoloft throughout this period of time, and so that has been unchanged).

[Anonymous]

I am the OP. She has inattentative ADHD. Slow processing speed, but very high intellectual abilities.

[Anonymous]

Why is she taking it if she does well at school without?

[Anonymous]

Isn’t 10mg really really low? Different XR meds but my eight year old started at 18 mg.

[Anonymous]

My understanding is that it can take a few weeks to determine effectiveness after the proper dose is achieved.

We have gone through this before with two kids, several meds. We are just starting a new med (Concerta) for one child (14 yo, ADHD - executive function issues, some distraction, impulsivity) who has not been not on a stimulant for the last couple of years. Working with both psychiatrist and psychologist, we came up with a scale where we rank a handful of the child's behaviors - duration/frequency/intensity). This is going to help us understand whether the medicine is actually helping the child.

Good luck, it it a long haul.

[Anonymous]

OP, my daughter, sounds very similar to yours! Did you notice any interactions between the anxiety meds and ADHD meds?

[Anonymous]

Anonymous wrote:I am the OP. She has inattentative ADHD. Slow processing speed, but very high intellectual abilities.

Similar symptoms to my DC (but no anxiety or ASD). On the 25 mg generic dose (age 17), the difference is really obvious. Even daily conversations are markedly more "typical."

[Anonymous]

I am the OP. She's on ADHD meds because while she gets good grades in school, task completion is difficult. She told us in 6th/7th that she had long been struggling with the increasing demands of middle school homework, but thought she wasn't trying hard enough. High school homework / projects/ tests are much more demanding. She spends hours on her computer in the evenings on "homework", although I can tell a lot of the time is not efficiently used b/c she transitions between other fun stuff online (part of it is a strategy she uses to get homework done).

I don't know the interaction with her Zoloft. She's been on 37.5 of Zoloft this whole time b/c, when in 6th/7th she came forward, there was also very marked depressive symptoms. We've tried going down on the Zoloft, and her depressive symptoms get worse.

I'm somewhat regretting so much time on low dose Focalin, but it seemed at the time that it improved her emotional regulation. Although, when we would ask her, she would say she didn't know or wasn't sure what impact it had.

[Anonymous]

37 mg of Zoloft is really low -- my daughter is on 100mg and her doctor says that we have room to go up if needed. Could the emotional dysregulation and difficulty with task completion be under treated anxiety and depression?

[Anonymous]

These stimulant doses are so low - and going on and off the Concerta and Adderall so quickly is not really giving them a chance.

Folks with ADHD commonly describe the effect of stimulants as making them "tired" but in fact it could be calmness or focus instead.

[Anonymous]

You need to give it more than one day.....it sometimes takes a few doses - keep trying.

[Anonymous]

We increase to 50mg Zoloft after being on 25 for DS at ages 10-13. Now 14 we dropped Zoloft completely and find Lexapro more of a help. Sometimes and nobody knows why certain meds don't work as well after a few yrs like Zoloft.

We are on Focalin 10mg having tried just about everything else and it's been the best for us but we just started a few months ago.

Try Lexapro or other SSRI?

[Anonymous]

You should be asking your child psychiatrist these questions. Please tell me you have one and are not doing all of this with just a pediatrician? Mine would answer questions like this over text.

[Anonymous]

I am the OP. Yes we have a psychiatrist. She doesn't text with me. She's $225/30 minutes, but more than the cost, she doesn't have a definitive recommendation as to specific medications. Seems like trial-and-error. Start with the lowest dose, and we have discretion to double it, etc. Then come back if it doesn't work and get a new script if it doesn't work.

How do I know if things are working? Or not? And DD is in therapy as well.

[Anonymous]

Meds are trial and errror. I’d get another opinion but listen to your daughter.