This can be so disheartening. I go through ups and downs with it. Here are some thoughts:

My DS sounds different than your DD (he can be emotional and impulsive, though not hyperactive), also high IQ and low memory (maybe also low processing speed?) Guanfacine and Stratera combined seem to be doing okay by him, but we have to be proactive about increasing them when he gains weight. I was shocked last year when he gained about 2 lbs and his Dr increased a dose by something like 15 mcg. Possible your kid had a growth spurt?

And how many doctors have you worked with? Not all prescribers are great for all families/kids. Might be worth calling up a few others in your abundant free time, presenting the difficulty, and saying, Do you think you would be helpful here? I think/hope these Drs do want to help kids and might be honest about saying, "I don't know if I could offer anything new to the mix" or "Yes, I think I might have some new ideas to try."

Good luck.

PP here. ALso forgot to say that Dan Shapiro does a session on figuring out the right meds you might want to attend.

We started with Ritalin and it worked. No need to try anything else. It's one of the oldest and safest stimulants. Started evening Clonidine at the same time for sleep.

Anonymous wrote:My kid has adhd, low processing speed and above average IQ (per stixrud report, most areas above 85%, except for processing speed, which is 24%).

We have tried:
Guafacine
Focalin
Concerta
Vyvanse

The guafacine doesn’t seem to do much besides make her tired.

The stimulants decrease her appetite and make it hard for her to fall asleep, but don’t seem to increase focus. Weirdly, they seem to decrease processing speed or make her seem more spacey/in her own world/less engaged.

Any improvement in focus seems pretty minor to us—we can’t really see a huge difference to anything besides appetite and sleep. What, if anything, should we try next?

I have heard Guafacine and Clonidine make you really tired for the first 2 weeks until they level out and start working. They are the only ones I hear take a bit of time.

Concerta is long acting and some kids struggle with falling asleep and eating. My DC takes methylphenidate with a hearty breakfast since it lasts about 8hrs vs Concerta's 12 hours. They drink a carnation high protein chocolate drink at lunch and whatever else they can eat (not much) but by dinner, they can eat again.

We do fish oil, a high zinc/iron multi vitamin, and extra vitamin D in AM. We do magnesium at dinner to help calm down for the evening and Clonidine at bedtime to sleep through the night.

It is a struggle OP. We really need parent groups so we can all talk and vent about this.

My ADHD/ASD/low processor has been on Adderall for a few years now. It's the only med that works, and it's banned in many countries because it is considered a dangerous drug because of its mixed amphetamine salt combo.

Adderall is the only medication that works for him, and only if he uses it sparingly. He can't take 20mg (his optimal focus dose) every day, otherwise after prolonged use for months, it doesn't work anymore. He takes 10mg extended release daily, and 20mg during exams or finals. When he needs a short span of focus, such as driving for errands, he takes 5mg immediate release.

Every ADHD stimulant has decreased his appetite, which is problematic for him because he is underweight and on a weight-gaining diet. That's another reason not to use meds at their optimal dosage.

And of course, no medication can correct the socio-emotional communication issues that autism causes.

This is not an easy journey. We have just taken our 24 year old daughter to her fifth college to try to get a handle on her needs. I rented a nearby apartment so that I can monitor her medications. We almost feel as if this is a last effort to get her launched. If this fails, we simply do not have the money to keep going and will keep her at home and set up a trust for her future care.

I’d work on executive functioning skills first. Helping them learn to focus. Daydreaming is a good thing, just they need to learn when to do it.

I probably would not medicate this kid. I have adhd as do two of my kids. IME, the medicine is best for helping with impulse control. It’s also great for weight control — when I take it I can work all day without eating and drink so much less coffee!
I think the best thing for executive function is to learn adaptations, and structure for your life (eg lists, routines, etc.). 8 years old is very young and I would not use medication unless there was a safety issue. One of my kids has been on adhd medication at high doses since age 5, but it is really necessary as a safety issue.

Op here. My DC is 8. She says she doesn't mind the meds, but doesn't feel a difference on them. She has combined presentation—very spacey, day dreams a ton, has trouble focusing, very wiggly. That said, like many adhd girls, she’s not disruptive, impulsive, hyper or highly emotional. It’s more that she just can’t focus on school/worksheets/participating because she daydreams.

Sounds like we should still keep experimenting.

How old is your DC?

Is it ADHD-Inattentive? We have a similar situation. Not sure what the answer is, but it seems common with this combination. We're still trying to find a med or mix of meds that work.

We tried a number of different medications until we found a Jornay PM/Guanfacine/Ritalin combo that worked for a couple of years until about a month ago. Now we are trying different medications again but this time with puberty in the mix! Good times.

Like the previous poster said, they don't work until they do, and it does take a lot of trial and error to find the right one(s).

Ritalin and adderall? Different dosea of those youve already tried? They dont work until they do, it can take forever to find a fit.

These numbers, most areas above 85%, except for processing speed, which is 24%, aren't very bad. If you've tried meds without success, try accomodations without meds and see how it goes.

My kid has adhd, low processing speed and above average IQ (per stixrud report, most areas above 85%, except for processing speed, which is 24%).

We have tried:
Guafacine
Focalin
Concerta
Vyvanse

The guafacine doesn’t seem to do much besides make her tired.

The stimulants decrease her appetite and make it hard for her to fall asleep, but don’t seem to increase focus. Weirdly, they seem to decrease processing speed or make her seem more spacey/in her own world/less engaged.

Any improvement in focus seems pretty minor to us—we can’t really see a huge difference to anything besides appetite and sleep. What, if anything, should we try next?