New guidelines for ADHD medications?

[Anonymous]

My son is a freshman in high school and has been on Concerta for years. He only takes it on school days. He was diagnosed with "severe ADHD" after a neuropsych evaluation at Kennedy Krieger. We have tried to stop the medication but his A-B grades go to C-F. Not to mention the constant movement and pacing. He appears to be uncomfortable in his own skin. Now the pediatrician is telling us that new guidelines suggest getting kids off stimulant medication before high school. I don't think he is going to renew my son's prescription. I am at a loss. I do not want to "drug" my child but I really feel he needs this medication. I have an older son in college with much less severe ADHD who self medicates with caffeine (large amounts) and nicotine (vaping) in order to concentrate when studying. Not sure this is any better than taking Concerta on school days. Has anyone else run into this? TIA

[Anonymous]

What is the doctor suggesting replacing the stimulants with?

I would love to see a link to this guidance.

[Anonymous]

No pediatrician should ever make psychiatric decisions. A generalist doctor should only renew an already established prescription. Our ped only agreed to take on my son’s ADHD care because he had been stabilized on a certain dose. If he were to have new symptoms and need something different, we would consult our psychiatrist.


So go to a psychiatrist. One specializing in ADHD would be even better. I recommend Dr Hemanth in Rockville.

[Anonymous]

We just renewed my DS (jr in HS) Concerta prescription. He has been on it since 5th grade. No discussing of taking him off.

[Anonymous]

I’ve read that it is good to try going without medication from time to time to determine if they are still needed as your child gets older.

But if you have done trial stoppages before and there were problems (sounds like that’s the case) and there are not significant side affects that outweighs the benefits I would be concerned too.

Perhaps consult a psychiatrist for a second opinion. What does your son say?

[Anonymous]

+1 on psychiatrist. No way are we stopping in high school. Our psychiatrist would never recommend that.

-signed mom of 8th grader that needs meds

[Anonymous]

The obvious solution is to find a psychiatrist. Alternatively, taper off the medication and go without for some time. Children grow and mature and they all outgrow the hyperactivity. A few also outgrow the impulsivity and attention issues.

[Anonymous]

The American Academy of Pediatrics puts out an ADHD treatment guideline. The current version is from 2011. There is nothing about taking adolescents off medication. The closest it comes to that is saying that dosage may need to be adjusted periodically for all kids to maximize benefits and minimize side effects.

A CDC summary.
https://www.cdc.gov/ncbddd/adhd/guidelines.html

The full guideline is here.
http://pediatrics.aappublications.org/content/128/5/1007

[Anonymous]

Thanks everyone. I don't know why the pediatrician said there were new guidelines. I took his word for it; he has treated my son for years. Clearly, if he refuses to prescribe, I will be looking for a psychiatrist. Thanks for the input.