Reply to ADHD - what are the odds she won't need meds?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]TBH, medication is a huge help if you can find one that works.

Don’t be afraid to try. Discuss with psychoatrist - there are many options. The main class of meds used for ADHD are stimulants, and they can be tried for a day and discontinued immediately if they have any negative side effects.  The half life of stimulants is very short, which means that they don’t have effects that last days and once you stop them they are pretty much completely out of your system. If the stimulant is too high or an extended release your DD might be too stimulated to sleep. OTOH, by addressing her ADHD, she might be able to better stick to routines that help with sleep or be able to do homework more consistently and remember to turn it in and not worry about those things before sleep.

Also, there are other classes of medication that are NOT stimulants. Atomoxetine, for example, is not in the stimulant class.  It is an SNRI shown to be effective with ADHD.  It is thought to tamp down the DMN network of the brain which allows the brain network focused on task completion to operate more effectively.  Tamping down the DMN can help diminish rumination, which may be a reason why your DD can’t fall asleep.

Also, there are many other aspects of sleep which should be investigated - sleep apnea?  anxiety?  And there may be other things that can help with sleep - exercise, early morning light, melatonin, magnesium, etc.

Your kid should be fully evaluated by a psychiatrist who can help you discuss options and do med trials.

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the research shows that there may be short-term benefits of meds, but not long-term. I don’t say this to challenge/criticize anyone who found meds helpful for themselves or their child. but rather to reassure OP that she has a reasonable basis to choose not to medicate. [/quote]

That's not what DC's psychiatrist said. She made a very compelling case for medicating based on the research on long term outcomes for medicated vs non medicated. [/quote]

+1 I have not seen replicated, high quality research that backs what the first poster is saying. I agree with others op that if you are seeing self esteem impacts it is incredibly worthwhile to consider it. I have a child with ADHD and worked in this area professionally prior and in my personal experience, parents highly underestimate the "side effects" of struggling through this without the support of medication due to fear over potential medication side effects. I totally get it, I've been there myself, but the impacts on kids that can lead to other issues (anxiety, depression later) are really important to consider.

Talk to a psychiatrist. Don't count it out without at least talking to someone who is really an expert in this. Your concerns are so valid and we do use melatonin to help my son fall asleep due to the stimulant but it has been so, so worth it. There are also non-stimulant ADHD meds that can actually help with sleep, though I believe they usually aren't as helpful with the focus piece so may not be the right fit. But a good child psychiatrist will know waht the options are and insomnia is a common adhd symptom so you aren't alone! you are certainly not the only family navigating it and a good child psychiatrist will have seen many families through it. [/quote]

You don’t thing the NIH project is reputable and long-running? Ok.

Again no issue with people who chose medication. But the scare tactics and pronouncements about it are way too much. [/quote]

to the NIH study booster - you are misrepresenting the study.  it is only based on children who take medication for 14 months between the ages of 7-9.9 years.

Conclusions
Type or intensity of [b]14 months of treatment for ADHD[/b] in childhood ([b]at age 7.0–9.9 years old[/b]) does not predict functioning six-to-eight years later. Rather, early ADHD symptom trajectory regardless of treatment type is prognostic. This finding implies that children with behavioral and sociodemographic advantage, with the best response to any treatment, will have the best longterm prognosis. As a group, however, despite initial symptom improvement during treatment that is largely maintained post-treatment, children with Combined-Type ADHD exhibit significant impairment in adolescence. Innovative treatment approaches targeting specific areas of adolescent impairment are needed.[/quote]

NP.  This is the developmental period when we were told were most important to medicate - that DC would develop new, better, permanent pathways during this crucial stage of brain development because of stimulant medication.

It sounded dubious to me (and also undesirable) but I have also seen posters repeating the same thing. Taken for a time before puberty, stimulant meds have a permanent beneficial effect on the brain.  This study contradictd that.[/quote]

Yeah. I think parents like OP have to work hard to become scientifically/medically literate and tell the difference between a theory and something that is demonstrated with high-quality evidence.  The “developmental period” thing is a theory,  not evidence of the sort that needs to be weighed that heavily IMO.

At the same time parents (all people really) should do some introspection to understand their values wrt to medical care. If in your life you prefer to make decisions based on what most people do or prefer to just rely on what your doctor says, then that should inform how you handle ADHD too. The idea is you want to feel like you made a decision aligned with your values.

at the end of the day though, I really think a lot of sloganeering and fearmongering gets thrown around wrt ADHD. [/quote]

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