ADHD medication provider? Pediatrician or Psychiatrist

[Anonymous]

Child in 3rd grade, diagnosed with ADHD along with dysgraphia and dyscalculia. Prescribed 10MG vyvance (generic) from pediatrician. School sees positive results for focus and endurance for tasks. Unaided benchmark tests though are very bad for grade level. I would like her medication to be bumped up more. Is it better to deal with psychiatrist vs pediatrician on adhd medication tweaks?

[Anonymous]

Psychiatrist. Without a doubt.

[Anonymous]

Psychiatrist. They know so much more about the differences among medications.

[Anonymous]

Psychiatrist if in network. Might as well get on a waitlist.

[Anonymous]

Psychiatrist. Absolutely. As a pp mentioned, in the DMV this likely involves getting on a waitlist.

[Anonymous]

We seem to be the outliers, but we stuck with the pediatrician to manage our 8yo DD's ADHD meds. Our ped is very responsive, has known our kids since birth, and we are comfortable with her. DD takes only one mediation and doesn't have any additional diagnoses. So far, it's gone smoothly working with the ped, although we recognize we may have to change gears if we get to a point where it makes more sense to have a psychiatrist handle.

[Anonymous]

A psychiatrist would be better but might not be possible given the shortage. Our pediatrician is handling DD's Vyvanse prescription right now and we're also paying cash because our insurance only covers the never-available mythical generic version.

OP, how long has your DC been on the 10 mg dose? My DD is the same - ADHD, dyscalculia, dysgraphia. She was 2 grade levels behind in the 2nd grade when diagnosed. She's now in 7th and just about on grade level. This takes a lot of time, and upping the Vyvanse may or may not be a good next step. Another possibility to consider is a booster dose in the afternoon.

Best of luck!

[Anonymous]

Anonymous wrote:A psychiatrist would be better but might not be possible given the shortage. Our pediatrician is handling DD's Vyvanse prescription right now and we're also paying cash because our insurance only covers the never-available mythical generic version.

OP, how long has your DC been on the 10 mg dose? My DD is the same - ADHD, dyscalculia, dysgraphia. She was 2 grade levels behind in the 2nd grade when diagnosed. She's now in 7th and just about on grade level. This takes a lot of time, and upping the Vyvanse may or may not be a good next step. Another possibility to consider is a booster dose in the afternoon.

Best of luck!

She’s been on medication for about 3 months. Any other advice on how you have her at grade level for 7th?! I’m not sure I can Will her through school! We have a weekly math tutor but I’m not sure it does much, she seems to forget things quickly. Thanks!

[Anonymous]

We started with our pediatrician because she was the ADHD specialist in their practice. Figuring if we had trouble finding something that worked we'd switch to a psychiatrist. This approach worked fine for our first. Our 2nd eventually went to a psychiatrist.

[Anonymous]

We started with the pediatrician but once the dosage reached a certain threshold she outsourced us to a psychiatrist and we haven't looked back. They just have so many options and ideas at their disposal.

FWIW, 10 mg of Vyvanse is, very very low in dosage. It's great that you are seeing an improvement, but I wouldn't hesitate to ask about trying a higher dose.

[Anonymous]

Anonymous wrote:

Anonymous wrote:A psychiatrist would be better but might not be possible given the shortage. Our pediatrician is handling DD's Vyvanse prescription right now and we're also paying cash because our insurance only covers the never-available mythical generic version.

OP, how long has your DC been on the 10 mg dose? My DD is the same - ADHD, dyscalculia, dysgraphia. She was 2 grade levels behind in the 2nd grade when diagnosed. She's now in 7th and just about on grade level. This takes a lot of time, and upping the Vyvanse may or may not be a good next step. Another possibility to consider is a booster dose in the afternoon.

Best of luck!

She’s been on medication for about 3 months. Any other advice on how you have her at grade level for 7th?! I’m not sure I can Will her through school! We have a weekly math tutor but I’m not sure it does much, she seems to forget things quickly. Thanks!

What do you mean by benchmark testing? Standardized testing? If so, I wouldn’t be spending money on tutors or be basing medication decisions on that. I’d be most interested in school performance and grades. Standardized testing isn’t indicative of the performance ability of some kids.

[Anonymous]

Can I hijack and ask whether a pediatric neurologist would be an appropriate medication provider in similar circumstances (suspected ADHD, dysgraphia, dyslexia, diagnosed motor and speech disability)? We have a pediatric neuro appointment coming up at the end of the summer. Would there be reason to also schedule a psychiatrist appointment?

[Anonymous]

Anonymous wrote:Can I hijack and ask whether a pediatric neurologist would be an appropriate medication provider in similar circumstances (suspected ADHD, dysgraphia, dyslexia, diagnosed motor and speech disability)? We have a pediatric neuro appointment coming up at the end of the summer. Would there be reason to also schedule a psychiatrist appointment?

I would ask the neurologist if they have experience with ADHD, but I think most do not and you'll need a psychiatrist.

[Anonymous]

Anonymous wrote:Can I hijack and ask whether a pediatric neurologist would be an appropriate medication provider in similar circumstances (suspected ADHD, dysgraphia, dyslexia, diagnosed motor and speech disability)? We have a pediatric neuro appointment coming up at the end of the summer. Would there be reason to also schedule a psychiatrist appointment?

Agree - most people don’t go to a neurologist for this so they wouldn’t have the level of experience as a psychiatrist who does this stuff all day.

[Anonymous]

I have a very similar kid and recently asked this question to our evaluator and was told to start with a psychiatrist because they can figure out dosages and which med more easily than a ped. They're more familiar with it and can often get you to the right dose and med with less trial and error, but then if it's going well, you could switch to ped for ongoing consultation.