to medicate or not?

[Anonymous]

My child is 8 years old and has an IEP for speech and, well, everything else except OT. She has friends, but struggles mightily in school--to focus, to write clearly--heck, holding the pencil to hard.
I've been talking to people, including teachers, about medication. Obviously, all evidence is anecdotal. Some say if you find the right med and dose (Focatin), everything improves: writing, reading, math, focus. Others say --stay away. Side effects. Personality changes and becomes "flat."
I am just at the beginning of this journey. I really am opposed to medication on a gut level, but if she had a fever, I'd give her Tylenol. She is suffering now--should we medicate? Can we try it and see what happens without adverse side effects?
Thanks for any guidance...
Wary Second-Grade Mom

[Anonymous]

I'm in the same boat and scared as shit at the thought of having my child try meds.

[Anonymous]

Yes. Your child is suffering and it would be cruel to withhold treatment. Many of us felt the same way and deeply regret that we didn't try medication sooner. My DC paid for my reluctance.

[Anonymous]

Depends. We are in year 2 of an ADHD diagnosis for 7 year old DS. The diagnosing doctor told us to medicate or we would be sorry. We have gone in hard with lots behavioral modification, rewards, and praise to address the issues. He is still lagging in subjects at school, but behavioral issues have improved tremendously. Maturity seems to help as well. I struggle with the question of medicating, but ultimately we have decided against it. And so far, we are not sorry.

Frankly, I recommend that anyone planning to medicate try the drug yourself. It is pretty strong stuff. It may not impact your decision, but it will at least give you some additional perspective.

[Anonymous]

Yes. Your child is suffering and it would be cruel to withhold treatment. Many of us felt the same way and deeply regret that we didn't try medication sooner. My DC paid for my reluctance.

+1

There are studies that show that children who don't receive appropriate care for this disability are at great risk for all kinds of bad outcomes (early sex, impulsive negative behavior, failing at school, drugs/alcohol). For a lot of kids, appropriate care is a combination of cognitive behavioral therapy (so they understand their own behavior and emotions) and medication.

We were also terrified of medications but now, at 14, we have been working on meds for 7 years. Sometimes DD has gone off of medication for a new baseline, sometimes we added a stimulant when needed, sometimes now. She outgrew different dosages and methods over the years, and we kept tweaking.

The best year DD ever had in school was 3rd grade, the first year she took ritalin. She gained several years academically, caught up with peers socially and behaviorally. Made all the difference.

Best of luck to you.

[Anonymous]

Anonymous wrote:My child is 8 years old and has an IEP for speech and, well, everything else except OT. She has friends, but struggles mightily in school--to focus, to write clearly--heck, holding the pencil to hard.
I've been talking to people, including teachers, about medication. Obviously, all evidence is anecdotal. Some say if you find the right med and dose (Focatin), everything improves: writing, reading, math, focus. Others say --stay away. Side effects. Personality changes and becomes "flat."
I am just at the beginning of this journey. I really am opposed to medication on a gut level, but if she had a fever, I'd give her Tylenol. She is suffering now--should we medicate? Can we try it and see what happens without adverse side effects?
Thanks for any guidance...
Wary Second-Grade Mom

Has she been diagnosed with ADHD?

[Anonymous]

For a speech delay, NO. For another issue, I would consider it.

[Anonymous]

It makes me sad that your child is suffering. Mine had a medical problem that resulted in meds being contraindicated until third grade. It was such a difficult time for my son. When he finally went on medication, he did great for two weeks then had a reaction and he had to go off of them for a day until we could get a new medication. He was devastated. For the first time in his life, he was successful and to lose it was more than he could bear. He couldn't get himself out of bed to go to school, he was so depressed. His reaction to losing the meds at the point where he could still so vividly remember the change they made for him was very eye opening about his struggles and how they effected him.

So many people talk about behavior when they dis medication. But ADHD is way more than behavior. My son was unable to write at all before medication and the day he started meds, he wrote eight grammatically correct sentences that contained semicolons and quotations in handwriting that was so beautiful it would have made a nun sing. I was shocked at how much my son knew but that was locked in his brain without medication.

Anyway, due to medical issues, I was understandably nervous about meds. What my sons doctor said was that the thing about these meds is that there are no lasting effects. They work for a few hours and whatever benefit or reaction you get ends at that point.

[Anonymous]

As an a person who wasn't diagnosed until adulthood with anxiety and ADD (because it simply wasn't on the radar when I was in younger), I realize how much meds have helped me. However, now seeing my son going through almost exactly the same issues I had when younger, I realize how much I want to try everything else TOO for him...diet, vigorous exercise, meditation/CBT/mindfulness...everything I discovered much later after learning negative/destructive coping patterns throughout childhood/young adulthood. I would never advise anyone against medication....ever. I have tried to go without meds, and I can't keep up. But I feel that there are other things that I do that also help me as well. I don't say medicate or don't. I would just not recommend medicating in isolation -- not that most parents do that -- but the other strategies are equally as important.

[Anonymous]

OP, have you talked to your child's doctor? Has medication been recommended? Start there and evaluate the specific recommendation.

[Anonymous]

My son is 8 and was received diagnosed with ADHD primarily inattentive. He had gotten in trouble at school nearly everyday since he started preschool. In 2nd grade, he broke down in tears (and he never cries) and said he just wants to be good but he can't. He was doing his best. He started on meds this school year and he is finally proud of himself. He isn't getting in trouble, he finishes his work, his handwriting is so neat that I don't recognize it, etc. The list goes on. If your child us suffering, I think you need to make a plan. If it includes meds, so be it. I could see my son going down the path my brother took since they are almost exactly alike. My brother started using drugs in high school and got kicked out. He did finish HS somewhere else but failed out of college and never went back.

[Anonymous]

I think you have to do a cost-benefit analysis. The good thing about stimulants is that they work immediately and leave the system quickly (unlike SSRIs on both counts) so you can do a trial without a huge risk. You have to take into account the risks of not medicating along with the risks of medicating. We did a trial with my child and and the negative side effects outweighed the benefits so we were advised to discontinue. But many people have had the opposite experience. These meds affect people very differently so you don't really know until you have tried them. As far as long term effects, which is always a big concern for me, a lot of the meds have been around for a long time so you can get some pretty good info.

[Anonymous]

Medication can be helpful but not on its own, as others have pointed out. Therapy and organizational help also often are needed. DS has been on medication for ADHD since he was 6. When it works well, it can be so beneficial. But it's true that kids outgrow dosages or medications stop working well. We're about to increase a medication that has worked well and hope it regains its effectiveness. Not medicating is a disservice to kids.

I would not worry about changes in personality, low effect etc These are basically myths (obviously, there are some kids who can't take these meds for a variety of reasons but the medication does not turn the vast majority of kids into zombies -- it just doesn't happen. Good luck!

[Anonymous]

Anonymous wrote:Medication can be helpful but not on its own, as others have pointed out. Therapy and organizational help also often are needed. DS has been on medication for ADHD since he was 6. When it works well, it can be so beneficial. But it's true that kids outgrow dosages or medications stop working well. We're about to increase a medication that has worked well and hope it regains its effectiveness. Not medicating is a disservice to kids.

I would not worry about changes in personality, low effect etc These are basically myths (obviously, there are some kids who can't take these meds for a variety of reasons but the medication does not turn the vast majority of kids into zombies -- it just doesn't happen. Good luck!

I totally agree. My oldest started meds in 1st grade (we have excellent routines/structure and had already tried diet, behavioral supports, etc.). He was taking Focalin and the side effects far outweighed the benefits. We stopped it because he lost too much weight, developed a significant tic and there were no noticeable improvements. He switched to Intuniv (a non-stimulant) and we saw improvements (negligible side effects) but nothing like what people talk about when they find the right med/dose. He was on Intuniv for 3 years when even those modest improvements disappeared. It was like he had no ability to self-regulate and the impact at school and home was significant. We were having a horrific week with him and in desperation gave him a low dose of Focalin again and it did wonders! The difference was amazing and he'd gained enough maturity to realize how much a difference medication makes. It's 1/4 the maximum dose we gave him 4 years ago. We see no evidence of a tic. He needs some help getting to sleep but not enough that we'd consider stopping the med. He's lost some weight but nothing like it was before and he's got far more appetite, especially on the weekends when he is medication free - unless there's a special activity and we do give him the medication those days. He participated in the Marine Corps Fun Run today and we did not medicate. It wasn't something that required much self-regulation

My youngest also takes Focalin and it's a wonderful medication for him. No discernible impact on his appetite (and he could stand to lose a few pounds) and he sleeps just fine. Teachers notice a huge difference in his ability to attend.

I also want to address your statement "all evidence is anecdotal". It's not. You should have the teachers complete a Vanderbilt Rating Scale before medication and then a month or so afterwards. In my experience, they're good reporters of behavior and aren't biased in their reporting when they know you've been giving medication. We've relied on them heavily to gauge when a medication/dose is effective. HTH.

[Anonymous]

Another thing you can do is have someone go into the class with a timer. Every five minutes they can note what your child is doing. On task? Off task? etc. You can do this for 1/2 hour or 60 minutes. In our DD's case, the practitioner did it twice, once off meds and once on meds. You could see the difference between on task/off task behavior. On meds, she was on-task something like 80% of the time. Off-meds she was about 40% on task. So you have evidence that it's working. In our case the practitioner did not know if she was on or off meds before this quick study, so it was basically a blind test of how the meds affected her classroom ability to focus. You could do something similar.