Stimulant withdrawal?
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Anonymous
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We’re trying to tease out if son’s irritability is linked to his stimulant (adderall). Figured summer break is a good time to try. He’s 6, and based on his behavior 1.5 years ago just before we started the med, I assume there’s no way he’s able to do camps or school without a stimulant yet. But we’re going to do the experiment anyhow, because it can give us data about whether it might be worth experimenting with non stimulants.
He has been on 15m of adderall. Today we dropped him to 10mg and may drop to 5mg later this week, depending on what we see. He’s also on 2mg intuniv. He was pretty wired so far this morning (lessened after two or three hours) and also struggling with a tic/stereotypy that he had mostly repressed in recent months. I’m surprised how wired he was for the first couple hours, because 10mg was his daily dose as recently as 8 months ago. And he wasn’t on intuniv then. The 10mg of adderall without intuniv was a good fit. Obviously this is just the first day, but I’m curious what we can expect this week. Just wondering what folks’ experience has been dropping off stimulants (whether tapering, or cold turkey) for hyper compulsive type kids. The “withdrawal” symptoms on dr google say people should be fatigued and crash in the first few days, but I’m wondering if that is non adhd college kid addict types who were abusing it. Did anyone see increased hyperactivity after stopping? How long did it last? (As an aside, increased hyperactivity makes sense to me because his body probably needs to adjust to not having the calming effect of the stimulant). |
Anonymous
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Be careful, OP. I'm not trying to scare you. But a few kids have horrible side effects. My 14 year old son tried to take his life after coming off of Vyvanse. We were working with our doctor to determine if his drastic mood shifts were caused by fluctuating medication levels. He has severe ADHD but we will never give him or any of our kids another stimulant. Had I known this was a possibility, we never would have used medication.
He has been off medication for two years. He struggles is school. But he is happy and healthy. Never, ever again. |
Anonymous
Yes, you are trying to scare her. OP, talk to your doctor and don’t seek medical advice on an anonymous board. There are many folks on here with their own agenda. Personally, I think stimulants help my child function in society. Without them, he would really suffer. |
Anonymous
To the PP who posted this, was your DS taking it daily and if so for how long? I'm sorry to hear your son had so much trouble coming off it. Did you taper him off? I would appreciate any details you're willing to share. Our DS has been taking just M-F when in school, if off weekends and takes as needed in summer so not daily. He does seem grumpier the day after he stops. |
Anonymous
He was on Adderall for two years. We switched to Vyvanse to try to avoid the afternoon drop. He kept saying he felt "flat" and we couldn't get him to do any of the things he normally loved. He was also always angry. The psychiatrist thought Vyvanse might be a better choice. He was on it for six months before we decided to wean him off of it. He tried to kill himself about a week later. He said he just felt like nothing mattered anymore. His therapist thinks the medication kept his emotions up so high that when he came down, he just couldn't cope. He is a different kid off medication. He still has ADHD. It's difficult to manage. But not as difficult as the mood swings, anger, and depression. And PP - I'm not trying to scare anyone. I wish someone had told me depression and suicide we're real risks. I might have been able to intervene sooner. I hope you never have to deal with a suicide attempt. My son tried to slice his wrists. It is a something no parent should ever see. |
Anonymous
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OP here with an update. Saturday was his first day where we bumped down to 10mg adderall (compared with previous 15mg). He's still on 2 mg intuniv, which he takes in the mornings. Saturday he was a bit hyper but nothing too bad. He was pretty wildly hyper yesterday (day 2). Like, my DH and i are struggling to remember him ever being that hyper before he started adhd meds (2 years ago). The hyperactivity was just his body being in full motion -- running around the house, jumping on furniture etc. He was having trouble focusing on things for more than a few minutes. Just by way of background, focus was never his problem. He was just too hyper and, in particular, touchy and physical in school. If not for school, we used to say we could have lived with his behavior at home. But sheesh, yesterday's behavior is hard to imagine living with!!
All that said, he's quite compliant (when i tell him to clean something, he does it, for example) and extremely happy. DH and i both agree that his personality is really shining through. No irritability at all (though a little crying about a few things yesterday). So the weird thing is that he is this hyper -- but he's still on 10mg adderall and 2mg intuniv. It's not like we dropped him off everything. In fact, last fall he was on 10mg adderall and NO intuniv, and he was getting by in school. Now he's on 10mg adderall and intuniv, and i just dropped him off at camp and wondering how long it'll be before i get a call to come pick him up. So a couple questions: 1. Does it sound normal to have extreme hyperactivity in the days tapering off adderall? Will he readjust? Time frame? 2. You'd think he'd have some benefit to having 10mg adderall in his system. But it's like he might as well have no adderall in him. If 15mg is his *perfect* adderall dose to keep him well behaved, is it possible that the dose below (10mg) will have zero effect? or would you expect it to have *some* impact on his behavior, even if it leaves room for improvement? |
Anonymous
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Aren't all 6 year old kids hyper? Having taken adderall since I was about 8, I think it should be illegal to medicate kids that young. It completely stripped me of my personality, it didn't help me do well in school and I don't remember a lot from after I started taking it. I only started doing well in school (university) when I stopped taking it.
Some kids are just really hyper. It's their child personality. If you work with it instead of medicating it away, you might find yourself raising a great person. |
Anonymous
OP here. I'm guessing you aren't the parent of a SN kid? No, some kids really *are* that much more hyper than others. Our DS was a danger to himself and others when he was unmedicated. We didn't go a day that some well meaning stranger would comment "whoa - he is really a handful" with a pitying look. Further, it was literally impossible to "parent" our son before he was medicated. He was too hyper and couldn't sit still or process instructions because his brain was going a mile a minute. Once we started medicating, it was amazing because he could finally "hear" us for the first time. This was also the advice of all the behavior therapists we talked to, who said a 4-7 year old boy can't access the behavior tools you give him if his brain can't calm down. |
Anonymous
As he grows, his dosing needs may change. It's possible he really needs the 15 mg now. If you don't see him settling down in 3 or 4 days, he probably needs the higher dose. In my experience, too low a dose has no effect at all, so yes, if dropping 10 mg may make him may seem completely unmedicated. |
Anonymous
Thanks for posting your story. I'm the PP who asked. I'm so sorry your son and family went through that. My brother tried the same thing in his 20s. He had untreated ADHD, anxiety and depression that was untreated except by his self medication with alcohol, then he went on Prozac (it was new then) and on it he became suicidal and tried to kill himself the same as your son. These medications are so powerful but do work for so many. However, doctors do not sufficiently warn parents of the suicide dangers. To give you some hope, my brother did eventually get better through AA (sober for several decades despite a relapse 6 years in), therapy and finding the right meds, starting exercise, quitting smoking, finding a career he was interested in, and so on. He is now a college English professor, un-medicated, sober for several decades and has raised 2 great teenagers. The turnaround happened in his mid 20s. It was touch and go until then but AA was very helpful during that time as well as finding meds that worked to get him stable. Once he had other supports in place, he went off and on meds for a while as needed (eg our sister died suddenly and that was a huge trama). After the suicide attempt, it was hard for him and us to trust medicine again but he somehow did and found some that worked for him. |
Anonymous
Personality changes are usually a sign of overmedicating or the wrong medication. It's really awful that happened to you, but it isn't the norm. My kid's personality hasn't changed, she is just better behaved, more focused and not bouncing off the walls. |
Anonymous
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OP reporting back. So we cut back the adderall from 15 to 10mg on a Saturday. He remained on 2mg intuniv. Saturday he was a bit hyper but manageable. Sunday he was dangerously hyper. Monday he was pretty nuts but not so dangerous (babysitter and speech therapist both commented on his energy and wild body- I hadn’t told them about the meds). Tuesday he was quite hyper but manageable. By Wednesday he seemed to settle into being hyper but not out of control. Like, we could deal at home and he focused at his camp (LEGO camp which he loves) but there’s no way we could send him to school.
But interestingly, we really did love the kid who showed up out from under the stimulant. Happy, joyful, mostly compliant (but requires a lot of corralling to get things done), making jokes, taking jokes, up for anything. The reason we wanted to try the reduction is because Ds seemed quite joyless and over sensitive in the last year. It seems at first blush that it really might have been the adderall. Of course, to get the happy kid we also had to take an unacceptable level of hyperactivity. Our school starts In two weeks so we had the option of either going back on full adderall, adding in some more intuniv over time, and trying to wean him off the adderall again in a few months (hoping that the intuniv countered the withdrawal hyperactivity, because there’s no way he could have gong to school on those days), or leaving him on the reduced adderall and adding in some intuniv now and hope it settles into him before school. We tried the latter. We have done threee days extra intuniv thus far and the hyperactivity is greatly reduced but he is, no surprise, very tired and more moody and less joyful. Really hoping the moody/joyful thing is just a temporary side effect that goes away once he is less tired. We will definitely give it the whole month. If we’re still seeing moodiness in a month, I think we’ll also have to contemplate if it’s still the adderall, and if the extra intuniv will give us a cushion to go down even more. Anyhow, just providing an update in case anyone else experiences the same thing taking their kid off stimulants! You definitely need to hang in there a week before assuming your kid is too hyper to be without. |
Anonymous
| Do you have a doctor supervising this medication tape? Rebound effects are a standard response to reduce stimulant dosages, and it can take a good week (sometimes longer) for someone to adjust to a lower dose. |
Anonymous
Yes, of course. We’re doing all this under the care of son’s pediatric psychiatrist, who is very well regarded. |
Anonymous
I'm the mother of four boys. You might call them special needs if I don't take them out to the park or swimming or to one of their sports first thing in the morning to run off all their energy. |