Stimulant rebound irritability - anyone else?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have a severely irritable ADHD kid. Does he take his meds, including afternoon boosters, on weekends? Have you noticed he is less irritable if he doesn't take his meds? Are you sure the irritability is from the meds and not from the ADHD?

My kid also slept poorly when taking an afternoon booster, so we discontinued that.

Yes mine takes it on weekends too - he is on meds mainly for impulsivity, hyperactivity, emotional regulation so he needs it every day. It has been a long time since I saw him off them consistently but when he is off then he is crankier overall. He needs a ton of activity and stimulation to be level

You may have a point about the booster but when we don’t give it he rebounds at school and then is just cranky there

It sounds like your kids might not be irritable from rebound, but instead just irritable when not under the effects of meds, since you said he is pretty bad when he doesn't take them. That's the way my.kid is, too. My kid is also highly irritable, and there are studies that show that severe irritability can be caused by severe Adhd. I do think intense activity helps. My kid needs it, too, but also resists it, and is very demand avoidant. Fun fun fun.

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2019.18101134

Op - so can we conclude from this that if your kid has adhd and early onset irritability it is, at very least, less likely to significantly worsen?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have a severely irritable ADHD kid. Does he take his meds, including afternoon boosters, on weekends? Have you noticed he is less irritable if he doesn't take his meds? Are you sure the irritability is from the meds and not from the ADHD?

My kid also slept poorly when taking an afternoon booster, so we discontinued that.

Yes mine takes it on weekends too - he is on meds mainly for impulsivity, hyperactivity, emotional regulation so he needs it every day. It has been a long time since I saw him off them consistently but when he is off then he is crankier overall. He needs a ton of activity and stimulation to be level

You may have a point about the booster but when we don’t give it he rebounds at school and then is just cranky there

It sounds like your kids might not be irritable from rebound, but instead just irritable when not under the effects of meds, since you said he is pretty bad when he doesn't take them. That's the way my.kid is, too. My kid is also highly irritable, and there are studies that show that severe irritability can be caused by severe Adhd. I do think intense activity helps. My kid needs it, too, but also resists it, and is very demand avoidant. Fun fun fun.

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2019.18101134

Op - yes - our psych (who I love and who is top adhd dude in ny area) insists the irritability is part of the adhd. It’s sad bc I can see dc get so irritated and frustrated that he cries - but he doesn’t seem ‘depressed’ - he is excited about everything and I think he feels generally good about himself and his life and home and family. He just feels like I feel at the airport whenever meds wear off.
Is he like that all the time off meds? He is more like tbh yes. The meds help him be less irritable. I think the irritability has strong roots in his dopamine issues - that come with the adhd.

Op, I am the first PP here above and I have the same kid that you do. Severe irritability that really damages our connection, but that doesn't seem at all rooted in depression. We have tried Lexapro (there is some anxiety, but Lexapro was a disaster) and tried Abilify. Also disaster. My kid is on guanfacine and I'm not sure it helps at all. Stimulant helps but only stays in the system for 5-6 hours, tops. I wish there was something that helped in mornings and evenings. our kid is also pretty defiant and demand avoidant, so it can be hard encourage more activity, which absolutely helps.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have a severely irritable ADHD kid. Does he take his meds, including afternoon boosters, on weekends? Have you noticed he is less irritable if he doesn't take his meds? Are you sure the irritability is from the meds and not from the ADHD?

My kid also slept poorly when taking an afternoon booster, so we discontinued that.

Yes mine takes it on weekends too - he is on meds mainly for impulsivity, hyperactivity, emotional regulation so he needs it every day. It has been a long time since I saw him off them consistently but when he is off then he is crankier overall. He needs a ton of activity and stimulation to be level

You may have a point about the booster but when we don’t give it he rebounds at school and then is just cranky there

It sounds like your kids might not be irritable from rebound, but instead just irritable when not under the effects of meds, since you said he is pretty bad when he doesn't take them. That's the way my.kid is, too. My kid is also highly irritable, and there are studies that show that severe irritability can be caused by severe Adhd. I do think intense activity helps. My kid needs it, too, but also resists it, and is very demand avoidant. Fun fun fun.

https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2019.18101134

Op - yes - our psych (who I love and who is top adhd dude in ny area) insists the irritability is part of the adhd. It’s sad bc I can see dc get so irritated and frustrated that he cries - but he doesn’t seem ‘depressed’ - he is excited about everything and I think he feels generally good about himself and his life and home and family. He just feels like I feel at the airport whenever meds wear off.
Is he like that all the time off meds? He is more like tbh yes. The meds help him be less irritable. I think the irritability has strong roots in his dopamine issues - that come with the adhd.

Op, I am the first PP here above and I have the same kid that you do. Severe irritability that really damages our connection, but that doesn't seem at all rooted in depression. We have tried Lexapro (there is some anxiety, but Lexapro was a disaster) and tried Abilify. Also disaster. My kid is on guanfacine and I'm not sure it helps at all. Stimulant helps but only stays in the system for 5-6 hours, tops. I wish there was something that helped in mornings and evenings. our kid is also pretty defiant and demand avoidant, so it can be hard encourage more activity, which absolutely helps.

Have you tried sertraline as opposed to the lexapro?

[Anonymous]

Anonymous wrote:

Anonymous wrote:How old is DC?

I highly suggest adding the another ADHD med - SLEEP. We were in a similar situation and the one thing we knew we needed to concentrate on was getting a solid 9 hours of sleep a night, the recommended amount for our kid's age. DC's sleep was all over the place. We have started to use melatonin and it has really gotten us to our sleep goal. DC takes 3mg on school nights.

I totally agree with you that sleep is so important but 3mg is A LOT of melatonin especially for a kid. Was your doctor ok with that? When I give it to my child we do no more than 0.5 mg. My own doctor told me no more than 1 mg for an adult.

My 10 year old takes 5 mg, otherwise he is awake all night (and this has even happened on the 5 mg unless he is run ragged during the day). If he is on any less than 70 mg of Vyvanse he is uncontrollable at school and home, but it affects him falling asleep. He is very severely ADHD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:How old is DC?

I highly suggest adding the another ADHD med - SLEEP. We were in a similar situation and the one thing we knew we needed to concentrate on was getting a solid 9 hours of sleep a night, the recommended amount for our kid's age. DC's sleep was all over the place. We have started to use melatonin and it has really gotten us to our sleep goal. DC takes 3mg on school nights.

I totally agree with you that sleep is so important but 3mg is A LOT of melatonin especially for a kid. Was your doctor ok with that? When I give it to my child we do no more than 0.5 mg. My own doctor told me no more than 1 mg for an adult.

My 10 year old takes 5 mg, otherwise he is awake all night (and this has even happened on the 5 mg unless he is run ragged during the day). If he is on any less than 70 mg of Vyvanse he is uncontrollable at school and home, but it affects him falling asleep. He is very severely ADHD.

I'm the PP above who said their DS is on a stim non-stim combo for severe adhd. If I forgot to give DS his meds, there is a 100% chance -- even now in 5th grade - that he would get sent home from school for off the charts physical and bad behavior. So I am totally with you. But we found the "side effects" of the stim untenable. His pediatrician said they were expected effects, and not "bad side effects". That we should just assume rebound, no sleep, no eating, anxiety and flat personality. We couldn't stand the effects. So I insisted on trying other things (with psychiatrist's permission). That's when we tried the non-stim, which allowed us to dramatically reduce the stimulant, essentially lose all the side effects, and have the bonus of the drowsiness on the non-stim. He went from staying up until 12-1am every night in Kindergarten, to falling asleep as soon as I put him in bed. Even if it's 8pm.