Do we keep trying stimulants for teen?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:It could very well be anxiety. Not sure why you assume it isn’t. ADHD and stimulants are way oversold as the answer to everything.

I was thinking the same thing. Maybe the diagnosis is wrong and they are trying to treat something that doesn’t exist. One thing I’ve seen is that where the treatment doesn’t work, you reconsider the diagnosis.

+1. Although there definitely are plenty of people with ADHD who dislike stimulants or don’t find they help.

THIS!

Op, my daughter sounds very similar to yours and all the docs ever wanted to do was say anxiety. It was so frustrating because she never got nervous, was very social, played intense sports, etc… but her brain was constantly running, her mouth was running, and she was impulsive, reactive, and highly stimulated. That is ADHD and not anxiety. You know your kid. Be proactive.

We had to try 5 different stimulants and also tried Wellbutrin and even Straterra. Most didn’t work or made her more agitated. I asked for a different type of stimulant as methylphenidates did not work at all. She is now on Vyvanse in AM and Clonidine in PM and she is finally feeling more calm and less reactive. Don’t give up. What works for some does not work for others

[Anonymous]

Anonymous wrote:OP here - she had a neuropsych eval that confirmed her ADHD after her therapist pushed for it after her old psychiatrist said just anxiety. She used to be on SSRI (Zoloft and then Lexapro) prior to eval and they were terrible. Just flattened her and tons of side effects.

Her new doctor said ADHD can present like anxiety when she is overstimulated. Her doctor says yes it can be co-morbid but many undiagnosed teen girls get diagnosed with anxiety, BPD, and even bipolar sometimes instead because most old school docs don’t know the true symptoms of ADHD in teen girls. They don’t think anxiety is an issue.

So I’m just asking if anyone had success going through a lot of stimulants to find one vs going to non stimulants.

We’ve tried many different stimulants and a couple different SSRIs. We’ve finally found the right combination for DD17 and she’s been very stable the last couple years: doing well in school, anxiety managed, better emotional regulation. She’s on Dextroamphetamine and Fluoxetine (Prozac).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My 13yo DD takes 30mg of Ritalin on school days. If you ask her she will say she feels no different BUT if you ask her teachers they say she’s more focused.
She took a 4 hour CPR/first aid course this summer and I had her take one beforehand. The instructor asked which kid was mine and then complimented me on how focused and attentive she was. I could have hugged him.
Ask the people around her if they see a difference.

She can mask well with good classes/teachers but struggles in poor classes regardless.

Do stimulants actually relax the mind and impulses or just heightened focus for inattentive?

Kids with adhd do well when it’s a subject they’re interested in. They can focus. They struggle with things that are boring tk them. That may be his your kid does well in some classes and not others. It’s not true masking.
My kid is amazing on the basketball court. So focused the entire time. It’s amazing to watch. But as soon as she had to do anything academic she’s all over the place.
I’m the PP with the 13yo

OP describes a lot of symptoms that do not sound like ADHD. We really do a disservice when everything is claimed to be ADHD and therefore solved by a stimulant. OP needs to work further and see if he issue is anxiety (in which case an SSRI might help) or if a therapy like DBT might be appropriate.

What symptoms sound like anxiety and not adhd?

[Anonymous]

It sounds like you've only tried the methylphenidate class of stimulants (Metadate, Concerta, Focalin all fit here), so trying something from the amphetamine class (Adderall, Vyvanse, etc.) would be a logical next step. Many people respond well only to one class and very poorly to the other - Vyvanse was awful for my son but he has thrived on Concerta/Focalin, and I know it's the opposite for a lot of people.

[Anonymous]

My almost 16yo son has had a hard time finding a med that helps with his severe ADHD inattentive type. I actually made the psychiatrist really break it down for me at the last visit and go down the list of every drug we've tried since he was in 3rd gr. He's done a bunch of stimulants and one non-stimulant.

What I found was that the previous doctor we were seeing just kept trying new stimulants in the same class (is that the right word?? there's the adderall/amphetamine side and then there's the ritalin/methylphenidate side). She kept giving him different methylphenidates and none of them worked. So I suggested we try one from the amphetamine side. We're only four weeks in, but for the first time ever, he's reporting that it's working and we're seeing homework completion like we've never seen before.

Point is, maybe keep trying and really look at what you've tried and haven't tried and see if there is any pattern.

[Anonymous]

Anonymous wrote:Anxiety is frequently co-morbid with ADHD. Has your dd been screened for anxiety? Does her therapist suspect anxiety? The stimulants that help kids focus in school also help them focus on things that make them anxious. A non stimulant medication for ADHD might benefit your dd, but she might also need treatment for anxiety.

+1 My nephew tried several stimulants to treat ADHD and nothing helped. They switched to an anti-anxiety medication and it made a huge difference.

[Anonymous]

I have an AuADHD kid and have had to rule out stimulants. He either hated the way they made him feel OR we hated the personality and mood differences they created.

Wellbutrin seemed to be tolerated until we realized that ongoing gastro issues pretty perfectly aligned with starting the meds and were negating any benefit.

It's been a really frustrating slog for us. Prozac has helped with anxiety, so we are sticking with that for now.

[Anonymous]

Do we ask to try something else? It seems like a lot of her friends that are diagnosed are on Vyvanse.

My son is on Vyvanse (a fairly high dose). It has been far more helpful than prior stimulants - you can still tell he has ADHD but it is far better controlled. It did increase his anxiety, but we were so pleased with the result that we decided to try him on a low dose of antianxiety meds to counteract.

[Anonymous]

Anonymous wrote:Drugs don’t teach new skills. You need to work on the things that are causing problems every single day.

It's chicken and egg. The medication is often the on-ramp to slowing the mind down enough to focus and learn those executive functioning and coping skills. We don't tell people suffering from bipolar disorder to just go to therapy. There are multiple tools to use.

[Anonymous]

Did you never try Prozac?

[Anonymous]

Anonymous wrote:

Anonymous wrote:Anxiety is frequently co-morbid with ADHD. Has your dd been screened for anxiety? Does her therapist suspect anxiety? The stimulants that help kids focus in school also help them focus on things that make them anxious. A non stimulant medication for ADHD might benefit your dd, but she might also need treatment for anxiety.

+1 My nephew tried several stimulants to treat ADHD and nothing helped. They switched to an anti-anxiety medication and it made a huge difference.

Same but what I found is it didn’t help with the ADHD at all. Just the anxiety that creeped in because of not feeling “normal” with peers because of ADHD symptoms. So after failed stimulants, we started Lexapro and then starting Concerta a month later. So much better.

[Anonymous]

Anonymous wrote:It sounds like you've only tried the methylphenidate class of stimulants (Metadate, Concerta, Focalin all fit here), so trying something from the amphetamine class (Adderall, Vyvanse, etc.) would be a logical next step. Many people respond well only to one class and very poorly to the other - Vyvanse was awful for my son but he has thrived on Concerta/Focalin, and I know it's the opposite for a lot of people.

OP here. Thank you. That is what I’m thinking. It’s all the same class and just slight differences and release times. It seemed like a waste. I am going to ask to try a different class and I hope that works.

[Anonymous]

By all means yes keep trying - those are all methylphenidate drugs - need to try also the other branch - adderall and vyvanse etc. It took us well over a year plus to find the right dose and med.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Drugs don’t teach new skills. You need to work on the things that are causing problems every single day.

It's chicken and egg. The medication is often the on-ramp to slowing the mind down enough to focus and learn those executive functioning and coping skills. We don't tell people suffering from bipolar disorder to just go to therapy. There are multiple tools to use.

Meds are a last resort for most people.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My 13yo DD takes 30mg of Ritalin on school days. If you ask her she will say she feels no different BUT if you ask her teachers they say she’s more focused.
She took a 4 hour CPR/first aid course this summer and I had her take one beforehand. The instructor asked which kid was mine and then complimented me on how focused and attentive she was. I could have hugged him.
Ask the people around her if they see a difference.

She can mask well with good classes/teachers but struggles in poor classes regardless.

Do stimulants actually relax the mind and impulses or just heightened focus for inattentive?

Kids with adhd do well when it’s a subject they’re interested in. They can focus. They struggle with things that are boring tk them. That may be his your kid does well in some classes and not others. It’s not true masking.
My kid is amazing on the basketball court. So focused the entire time. It’s amazing to watch. But as soon as she had to do anything academic she’s all over the place.
I’m the PP with the 13yo

OP describes a lot of symptoms that do not sound like ADHD. We really do a disservice when everything is claimed to be ADHD and therefore solved by a stimulant. OP needs to work further and see if he issue is anxiety (in which case an SSRI might help) or if a therapy like DBT might be appropriate.

What symptoms sound like anxiety and not adhd?

OP describes it as anxiety. Emotional instability also sounds like a personality issue requiring therapy not ADHD.