Did sertraline help with your ADHD (possibly Asperger’s)teen son?

[Anonymous]

My 14 year old has been treated with 10mg methylphenidate for several years and had 1 mg of guanfacine added at the beginning of this school year. The guanfacince made a huge difference on his, for lack of a better description, intensity.

He was focused at school and doing fine academically, but he was intense. For instance, he would never let a topic drop if he wanted to prove a point, he would badger, he reminded me of a dog with a bone who was just intense. I hope that this explains it. The guanfacine mellowed him out a great deal.

During this past year, he still never hangs out with friends, and while he reports having friends, he is never invited anywhere. Also, he comes home after school and lays down and plays video games. He does have a sport and an activity, but doesn’t want to join anything else.

I see some of the old intensity creeping in as well. I am also seeing social anxiety and just him being withdrawn.

We are meeting with his psychologist, but I am wondering if people have experience with a similar scenario?

I think he may benefit from adding sertraline or I think maybe his dosing for the medication is too low and not therapeutic. Any advice would be really appreciated!

[Anonymous]

I have a kid on the spectrum with ADHD. They take a SSRI and stimulant. I also take those medications. Your description isn’t raising any red flags for me that he needs a SSRI. He sounds like a regular ADHD teen to me. Teen boys, especially ones that are neurodiverse, don’t do a lot of out of the house socializing. I assume he is playing video games online with friends. My teen’s emotional energy is depleted by the end of the week. So while they only have a couple of friends (who are also neurodivergent) they also just want to be alone to focus on their special interests most weekends. Obviously, if the anxiety or depression were interfering with day to life that would be different. But that doesn’t seem to be the case. They should be talking to a psychologist weekly if you think social anxiety is starting to impact them and/or to help with some of the difficulties of dealing with ADHD. Sounds like you have a great kid!

[Anonymous]

Our doctor says that Zoloft can be activating for kids with adhd - meaning it can cause hyperactivity. She says there are better for SSRIs for adhd kids

[Anonymous]

I have a kid who was diagnosed with ADHD but during the diagnosis process there was also a question about whether autism would be a better fit. I think there are social pragmatic overlaps in both diagnoses.

DC took a stimulant and sertraline. The sertraline really helped with a mildly oppositional mood and a tendancy to isolate and be irritated by people. It helped him make friends in that he wasn't so anxious about talking and didn't think as easily that people were jerks.

But, I think support building friendships by social skill training or therapy would be even more helpful. For example, DC often misses that people are making bids for attention - and thus doesn't respond. I have ADHD and do this too - someone just invited me to book club and in my head I could realize that it was an offer to be included and make friends but in practice it sounded so boring I couldn't bring myself to an enthusiastic yes. Medication helped me not say no immediately though.

PEERS training was recommended to us in the neuropsych intervention for people with either ADHD or Autism.

[Anonymous]

Not my kid. Tried it for a bit. Also tried Prozac. Now on the William's protocol. Trileptal and amantadine.

[Anonymous]

that’s a ton of medication just to make your kid “less intense.”

[Anonymous]

Anonymous wrote:that’s a ton of medication just to make your kid “less intense.”

OP here- this comment makes me feel terrible and oversimplifies my concerns. But, I know DCUM can be mean.

It’s challenging to explain a decade worth of behavior in one post. I am not asking for medical advice- I am seeking anecdotes about other peoples’ experiences.

Thanks for everybody who has shared their experiences. Obviously, we all want the best for our children.

[Anonymous]

My kiddo with a very similar profile us doing great on a combo of Vyvanse, guanfacine, and sertraline.

[Anonymous]

I would consider increasing the guanfacine a bit before adding a third medication. It sounds like the guanfacine has been helpful. People don't understand if they haven’t lived with a kid who gets angry and worked up about something for hours. Miserable for everyone.

[Anonymous]

Anonymous wrote:

Anonymous wrote:that’s a ton of medication just to make your kid “less intense.”

OP here- this comment makes me feel terrible and oversimplifies my concerns. But, I know DCUM can be mean.

It’s challenging to explain a decade worth of behavior in one post. I am not asking for medical advice- I am seeking anecdotes about other peoples’ experiences.

Thanks for everybody who has shared their experiences. Obviously, we all want the best for our children.

OP, I feel you. I am an adult with ADHD. ADHD is also known for "intense emotions". I thought the way I felt was normal, but in my 50s I went on Atomoxetine. I am now "less intense". I can see very clearly how my "intensity" has ruined professional relationships, made me vulnerable to abuse in personal relationships, made it harder for me to keep a large social and professional network, and just, in general, made me less happy. I'm grateful that I can take medicine to be less intense. I can wish some of my family members who also have ADHD would take some kind of SSRI or SNRI -- it would help them so much. They are all extremely smart and capable people, but their difficulty regulating emotions (because their emotions are much more intense than for most people), has made their personal and professional lives much harder.

So, long way of saying, you are right to explore meds and ignore the rude PP.

[Anonymous]

Anonymous wrote:Our doctor says that Zoloft can be activating for kids with adhd - meaning it can cause hyperactivity. She says there are better for SSRIs for adhd kids

NP. So what did your doctor suggest as an alternative to Zoloft?

[Anonymous]

Have an AuDHD teen on sertraline for almost two years now and it’s been very, very helpful. And it works well alongside his Concerta. He did have more classic anxiety symptoms than you’re describing… but I will say, a lot of issues are heightened by underlying anxiety, so it really may be worth a try. It is an exceptionally well researched, safe drug. It does take some time to kick in though so you will want to give it at least two months I’d say before you judge whether it has helped. Your doctor will advise you but i would say it’s worth a try if you think anxiety might be exacerbating things. And yeah i hear you on the intensity thing. People don’t know it if they don’t live with it! It’s like living with a kid who’s always at an 11 out of 10! It’s exhausting most especially for the kid experiencing it!