Psychiatrist recommendation for caffeine?

[Anonymous]

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.

[Anonymous]

Does your kid have an IEP?

[Anonymous]

For which therapy do you need medication to "take the edge off?"

[Anonymous]

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.

[Anonymous]

I am very surprised that the psychiatrist didn't give you ideas about medication. I would call him back and tell him you want a prescription.

[Anonymous]

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.

[Anonymous]

Anonymous wrote:I am very surprised that the psychiatrist didn't give you ideas about medication. I would call him back and tell him you want a prescription.

So, the longer story is that I called back three times over the course of the month and finally got someone to call back and address our concerns about the lack of thoroughness. When I initially made the appointment, they said a portion would be parent only and a portion w/o the parent. The head psychiatrist agreed to talk to us about our concerns, but we'd have to bring her back there for another evaluation.

[Anonymous]

Some doctors are better than others.

But the psychiatrist doesn’t necessarily need to read your whole report — especially if it is from a well-regarded provider. They can jump to the bottom line.

If you feel you got short shrift, find another. You have to trust this person and $400 is a cheap price to pay to save time with someone who isn’t going to work well with your family.

[Anonymous]

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.

[Anonymous]

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.

[Anonymous]

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.

[Anonymous]

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.

That was just my impression from your post and you did wait a long time to try medication. Anyway, Here are my thoughts. ADHD medications can be prescribed and managed by your pediatrician. (DCUM frowns upon this but in the real world that’s what most people do. Psychiatrists are necessary if there are multiple issues or it is t working at the pediatrician). Medication management takes a number of appointments - it’s not a one time thing. It gets expensive fast, so you probably want to use someone that takes your insurance. if you don’t want to use your ped, you should find an in plan psychiatrist.

Good luck, OP.

[Anonymous]

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.

[Anonymous]

I never would have believed the caffeine thing, but it had an instantaneous effect on my kid the first time we tried it.

I gave my kid a couple of ounces of coffee with milk, and he went from bouncing off the walls to practically falling asleep. He was calm, well behaved and focused the entire day. To say I was shocked by his reaction was an understatement.

We decr3ased the amount, and about 2 ounces mixed with cream seems to do the trick. More than that makes him look like he is going to fall right asleep.

I was working with him on math and he was struggling, crying, day dreaming, doodling, etc. I gave him a little coffee with milk, brought his empty mug to the sink to rinse, and by the time I got back to the table he had finished the entire worksheet that we had been struggling with for 30 minutes. Not only did he finish it but he looked at me and said wow that was easy. F2f?

A couple of ounces of dark chocolate work too.

We do not do it every day, just days when he is having a little trouble or when he has something big like a test.

We always said no to caffeinated soda because we assumed it would make him wild. He tried some the other day, started yawning big jaw cracking eye watering yawns, and asked why does soda make him so sleepy.

OP the coffee suggestion of the doctor might be a very good one to try and way better than medication. At the least I would give it a shot. It is worming for my kid.

[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.

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.