Psychiatrist recommendation for caffeine?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Well caffeine is a stimulant which are known to be helpful to people with ADHD. maybe the thought is to see whether you can get the result you want with a natural one since you are looking only to take the edge off. Your description makes it sound like she’s doing really well without medication and that you are reluctant.

I'm actually not at all reluctant. I just know that medication isn't going to fix everything and that it's probably a combination of medication, therapy, and accommodations. She can't remember to brush her hair or get dressed in the morning without numerous reminders (plus checklists) and my having to place the brush in her hand and stand there. Meltdowns take 30 minutes of full blown screaming and it's just her. My husband and I don't really even raise our voices, just ignore her until she calmer. Mostly I'm just looking for someone to take the issues seriously rather than a cursory glance esp. if we're paying $400/hour. I guess what I don't understand is if this is normal procedure.

Op, what you're describing wouldn't be changed at all by medication. It's not instantaneous.

Read the Kazdin method for behavioral approaches.

Actually, medication helps all of that. Behavioral approaches work too, but many kids need both. Recommending caffeine is ridiculous. You'd have to drink 20 cups of coffee to match what you get from a prescription stimulant.

One, stimulants are fast acting but not that fast. It’s not as though a kid will take a pill at 7 am and automatically get dressed a few minutes later because of the medication effect. Two, if the kid is inattentive, stimulants generally aren’t prescribed. Their purpose is to focus hyperactive kids. Third, the op’s built up behavioral patterns that can be quickly addressed.

You are wrong on the first two counts, and half wrong on the third. Of course it won't solve everything immediately. But the difference is dramatic and you can literally watch your kid change before your eyes. And doctors prescribe stimulants for inattentive all the time, many parents on this board have said so, and I've never seen a reference anywhere that said not to do it. "Focus hyperactivity" doesn't even make sense.

Yes long term behavior therapy is indicated. But it works much better with medication than without.

Yeah, that PP is totally wrong. The medication usually hits in about 30 minutes, so you can give a kid his medicine at 7, and by 7:30, he is getting dressed and on target to do what needs to be done. And, yes, stimulants are the first line of medication for inattentive ADHD, because they are proven so effective (unless the kid has some reason that stimulants are a bad idea for them).

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Well caffeine is a stimulant which are known to be helpful to people with ADHD. maybe the thought is to see whether you can get the result you want with a natural one since you are looking only to take the edge off. Your description makes it sound like she’s doing really well without medication and that you are reluctant.

I'm actually not at all reluctant. I just know that medication isn't going to fix everything and that it's probably a combination of medication, therapy, and accommodations. She can't remember to brush her hair or get dressed in the morning without numerous reminders (plus checklists) and my having to place the brush in her hand and stand there. Meltdowns take 30 minutes of full blown screaming and it's just her. My husband and I don't really even raise our voices, just ignore her until she calmer. Mostly I'm just looking for someone to take the issues seriously rather than a cursory glance esp. if we're paying $400/hour. I guess what I don't understand is if this is normal procedure.

Op, what you're describing wouldn't be changed at all by medication. It's not instantaneous.

Read the Kazdin method for behavioral approaches.

Actually, medication helps all of that. Behavioral approaches work too, but many kids need both. Recommending caffeine is ridiculous. You'd have to drink 20 cups of coffee to match what you get from a prescription stimulant.

One, stimulants are fast acting but not that fast. It’s not as though a kid will take a pill at 7 am and automatically get dressed a few minutes later because of the medication effect. Two, if the kid is inattentive, stimulants generally aren’t prescribed. Their purpose is to focus hyperactive kids. Third, the op’s built up behavioral patterns that can be quickly addressed.

You are wrong on the first two counts, and half wrong on the third. Of course it won't solve everything immediately. But the difference is dramatic and you can literally watch your kid change before your eyes. And doctors prescribe stimulants for inattentive all the time, many parents on this board have said so, and I've never seen a reference anywhere that said not to do it. "Focus hyperactivity" doesn't even make sense.

Yes long term behavior therapy is indicated. But it works much better with medication than without.

For pete’s Sake, here from the nih, “For many people, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus...”
https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

Stimulants are supposed to be for impulsivity and hyperactivity.

Okay, here's one from NIH database indicating that the study found no difference between ADHD Comboned Type and ADHD Primarily Inattentive in response to stimulant medication:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2830210/

[Anonymous]

One study of 25 kids doesn’t define best practices.

[Anonymous]

Anonymous wrote:One study of 25 kids doesn’t define best practices.

Neither does one person on the internet who cannot cite a single reference anywhere.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Well caffeine is a stimulant which are known to be helpful to people with ADHD. maybe the thought is to see whether you can get the result you want with a natural one since you are looking only to take the edge off. Your description makes it sound like she’s doing really well without medication and that you are reluctant.

I'm actually not at all reluctant. I just know that medication isn't going to fix everything and that it's probably a combination of medication, therapy, and accommodations. She can't remember to brush her hair or get dressed in the morning without numerous reminders (plus checklists) and my having to place the brush in her hand and stand there. Meltdowns take 30 minutes of full blown screaming and it's just her. My husband and I don't really even raise our voices, just ignore her until she calmer. Mostly I'm just looking for someone to take the issues seriously rather than a cursory glance esp. if we're paying $400/hour. I guess what I don't understand is if this is normal procedure.

Op, what you're describing wouldn't be changed at all by medication. It's not instantaneous.

Read the Kazdin method for behavioral approaches.

Actually, medication helps all of that. Behavioral approaches work too, but many kids need both. Recommending caffeine is ridiculous. You'd have to drink 20 cups of coffee to match what you get from a prescription stimulant.

One, stimulants are fast acting but not that fast. It’s not as though a kid will take a pill at 7 am and automatically get dressed a few minutes later because of the medication effect. Two, if the kid is inattentive, stimulants generally aren’t prescribed. Their purpose is to focus hyperactive kids. Third, the op’s built up behavioral patterns that can be quickly addressed.

You are wrong on the first two counts, and half wrong on the third. Of course it won't solve everything immediately. But the difference is dramatic and you can literally watch your kid change before your eyes. And doctors prescribe stimulants for inattentive all the time, many parents on this board have said so, and I've never seen a reference anywhere that said not to do it. "Focus hyperactivity" doesn't even make sense.

Yes long term behavior therapy is indicated. But it works much better with medication than without.

For pete’s Sake, here from the nih, “For many people, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus...”
https://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml

Stimulants are supposed to be for impulsivity and hyperactivity.

Umm, yeah it says it reduces hyperactivity and improves focus. Please find a reference somewhere that says stimilants

[Anonymous]

^^ stimulants don't work for inattentive type.

[Anonymous]

Anonymous wrote:^^ stimulants don't work for inattentive type.

OP here. If stimulants don't work for inattentive type, why would the psychiatrist suggest caffeine (a stimulant) for inattentive type?

Can someone with an ADHD inattentive type DC weigh on on recommended psychiatrists? I already spoke to our ped and while she said she'd could do the monitoring, she felt the case might be too complicated for her and it would be better to ask a psychiatrist for the first appointments.

[Anonymous]

Anonymous wrote:

Anonymous wrote:^^ stimulants don't work for inattentive type.

OP here. If stimulants don't work for inattentive type, why would the psychiatrist suggest caffeine (a stimulant) for inattentive type?

Can someone with an ADHD inattentive type DC weigh on on recommended psychiatrists? I already spoke to our ped and while she said she'd could do the monitoring, she felt the case might be too complicated for her and it would be better to ask a psychiatrist for the first appointments.

I am the PP you are responding, that was meant to finish the message above, which was cutoff. Stimulants do work on inattentive type. Only one poster here claims it doesn't. However, all treatment guidelines suggest stimulants as the first choice for all forms of ADHD.

Alan Zametkin at the Chesapeake ADHD Center specializes in ADHD so he would be a good choice for you. If you need someone who takes insurance, you can try Potomac Pediatrics. They work with a psychiatrist to develop a treatment plan, but a pediatrician does the monitoring.

[Anonymous]

Stimulants are the gold standard for everyone. I don't know why the PP is arguing otherwise. It is true, and a lot of people say this, Inattentive ADHD can be tricky to medicate. So can kids who have multiple things going in like ADHD and Anxiety, for example. What I have heard MUCH more often than anything else -- and I have been at this a long time and have a child psychiatrist, a development ped and a psychologist -- is that impulsivity is the hardest ADHD characteristic to get totally under control with medication.

In any case, if you are just looking for a story, my child
with ADHD Inattentive and Anxiety has been recommended stimulants since he was 6. We have been extremely cautious because of the anxiety component, tried and quickly abandoned them. Kid is 13 and we are doing a med trial again now that he is older.

[Anonymous]

We use Dr. Hefuna at Greater Washington Psychiatry. There are other doctors in the practice who are board certified in child and adolescent psychiatry. They take insurance.

[Anonymous]

Anonymous wrote:Help me figure this out. I need recommendations for a second opinion for a psychiatrist.
My 11 year old DC has fairly severe ADHD primarily inattentive, executive functioning, and processing speed issues. We have a full neuropsych and have been in various forms of therapy for the past four years. It's gotten to the point where I need someone to help us look at medication to take the edge off so she's more receptive to therapy. She's extraordinarily forgetful, disorganized, erupts easily and takes a long time to cool down, etc. I took her to a psychiatrist for an evaluation expecting a serious discussion about potential medication and the result was an hour interview (both together), psychiatrist flipped through the 60 pages of evaluations (without reading it ahead of time), and a one paragraph summary report suggesting we give her natural caffeine and melatonin. Only caffeine she'd normally imbibe would be in the form of chocolate or a Frappuccino.

Is this normal? Has anyone encountered this before? I kind of feel defrauded out of $400.

I need a second opinion on this matter, but the first one came recommended from this forum and from someone I know personally, and we paid out of pocket. Psychiatrists that accept insurance seem hard to find and while I was willing to spend the money first time around, we don't make a ton, and I'm unsure of paying out of pocket again to be given a "Starbucks" prescription. I'm not insistent on medication being a requirement, but if I'm paying $400- $500, I'd like to know that someone is taking our concerns seriously.

Any suggestions for a psychiatrist that does a thorough evaluation? TIA.

You daughter is exhibiting hallmark signs of ADHD and needs medications in addition to all the other interventions you are doing. I would take her to another psychiatrist. Medication will help all those symptoms you are describing. Please try to make an appointment with child psychiatry at Hopkins or Kennedy Kriejer because they take insurance. It may take awhile to get an appointment but once she is stabilized on medication, her pediatrician may accept to prescribe the medications so you don't need to go to the psychiatrist as much.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^^ stimulants don't work for inattentive type.

OP here. If stimulants don't work for inattentive type, why would the psychiatrist suggest caffeine (a stimulant) for inattentive type?

Can someone with an ADHD inattentive type DC weigh on on recommended psychiatrists? I already spoke to our ped and while she said she'd could do the monitoring, she felt the case might be too complicated for her and it would be better to ask a psychiatrist for the first appointments.

I am the PP you are responding, that was meant to finish the message above, which was cutoff. Stimulants do work on inattentive type. Only one poster here claims it doesn't. However, all treatment guidelines suggest stimulants as the first choice for all forms of ADHD.

Alan Zametkin at the Chesapeake ADHD Center specializes in ADHD so he would be a good choice for you. If you need someone who takes insurance, you can try Potomac Pediatrics. They work with a psychiatrist to develop a treatment plan, but a pediatrician does the monitoring.

Stimulants have an effect on everyone who takes them. One study of 25 kids doesn’t mean they’re the gold standard for inattentive adhd. Op, read the nih link. Your dad may need to be on an Ssri to help stabilize her mood—put her on more even footing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:^^ stimulants don't work for inattentive type.

OP here. If stimulants don't work for inattentive type, why would the psychiatrist suggest caffeine (a stimulant) for inattentive type?

Can someone with an ADHD inattentive type DC weigh on on recommended psychiatrists? I already spoke to our ped and while she said she'd could do the monitoring, she felt the case might be too complicated for her and it would be better to ask a psychiatrist for the first appointments.

I am the PP you are responding, that was meant to finish the message above, which was cutoff. Stimulants do work on inattentive type. Only one poster here claims it doesn't. However, all treatment guidelines suggest stimulants as the first choice for all forms of ADHD.

Alan Zametkin at the Chesapeake ADHD Center specializes in ADHD so he would be a good choice for you. If you need someone who takes insurance, you can try Potomac Pediatrics. They work with a psychiatrist to develop a treatment plan, but a pediatrician does the monitoring.

Stimulants have an effect on everyone who takes them. One study of 25 kids doesn’t mean they’re the gold standard for inattentive adhd. Op, read the nih link. Your dad may need to be on an Ssri to help stabilize her mood—put her on more even footing.

The NIH link you supplied does not support your claim.

[Anonymous]

AAP treatment guidelines for ADHD. Recommends stimulants for all school age ADHD children, no distinction as to type of ADHD.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500647/

[Anonymous]

..... if the kid is inattentive, stimulants generally aren’t prescribed.....

This is the second time I've seen you state this. What evidence do you have that supports this assertion? It contradicts everything I've read and experienced - and contradicts what the researchers at NIH have discussed with us as recently as last summer. We participate in the longitudinal ADHD there.

My boys are ADHD/Inattentive and stimulant medication has made a huge difference in their ability to attend. It's not a silver bullet but I sure would hate to think a less informed person making a decision based on your nonsense.