Anonymous wrote:

Anonymous wrote:Have you tried other meds besides Guanfacine? There are way more effective meds out there for this profile and Guanfacine is usually one of the first things tried bc it’s low stakes.

guanfacine can cause irritability and mood swings. I’ve seen a child become periodically distraught and sobbing on guanfacine in response to really small things.

OP needs to work with a really, really good psychiatrist who understands that the #1 goal is reducing behavioral outbursts not ADHD per se. We are in a confusing moment with a lot of misinformation about ADHD causing everything under the sun and the notion that treating ADHD is the #1 priority. In OP’s shoes I would find a doctor who is very conservative and doesn’t do polypharmacy - so wean them off guanfacine and start a very very low dose SSRI, probably.

Anonymous wrote:Have you tried other meds besides Guanfacine? There are way more effective meds out there for this profile and Guanfacine is usually one of the first things tried bc it’s low stakes.

Anonymous wrote:

Anonymous wrote:Can’t SSRIs make children suicidal and have lasting effects on their sex drives and heights? And then be really hard to wean off of? This is OP. I am not trying to be obnoxious- this is my genuine fear and I would love to be reassured. I have never taken anti depressants and don’t know anyone in my family who has done so. I am just anxious about giving them to my elementary aged kids. Sincere thanks again to everyone who has responded. I’m very very thankful to be able to ask you all.

Op, I have two kids, both with multiple diagnoses, including ADHD and anxiety. Both medicated for ADHd and things were better (like so much better) but still pretty bad.

I stuck with therapy and would not try SSRIs for my (young - 8 and 10) kids because I was worried about potentially adverse side effects. We had some bad experiences when trialing stimulants, and I dreaded doing it again. I also had a sibling who had a side effect from an SSRI that required hospitalization, so I worried about that happening to my kids.

Things got really bad at home (kids mostly held it together at school) - one child couldn’t move through most rooms of our home, daily meltdowns, paralyzing intrusive thoughts. Other child would talk about how they didn’t want to live when dealing with with grades or daily homework. I realized that this really wasn’t normal and things were going to get worse unless I tried something else. There were no other therapies to try (we have done OT, family therapy, social skills, and they do individual therapy) and kids are in a small nurturing private school. We are lucky in that we have the financial resources to try any therapy we thought would help, and yet it felt like my kids were struggling no matter what we did, and I didn’t know what else to do, but the situation was not sustainable.

I think I hear that in your OP - something needs to change because your kids aren’t happy, and you probably aren’t either. Unless you really have a desire to homeschool your kids, I would try meds to treat anxiety before you move.

SSRIs for my kids have changed their lives. They are both so much less unhappy. My daughter can go into all the rooms in our house. My other one stops talking about dying. They also seem happier, but it’s amazing to see that they were truly suffering and now it’s much less.

Things at home are better, too. I used to scream (I know I am not supposed to scream but nothing would break through with my kids) daily. Now I maybe yell once a month? Enough that I finally understand how other parents might be able to parent without screaming. I am able to be a better parent and partner.

Sorry for the long post - just wanted to show that there are parents on here who have also struggled with the decision to medicate.

Anonymous wrote:Can’t SSRIs make children suicidal and have lasting effects on their sex drives and heights? And then be really hard to wean off of? This is OP. I am not trying to be obnoxious- this is my genuine fear and I would love to be reassured. I have never taken anti depressants and don’t know anyone in my family who has done so. I am just anxious about giving them to my elementary aged kids. Sincere thanks again to everyone who has responded. I’m very very thankful to be able to ask you all.

Anonymous wrote:

Anonymous wrote:OP again—the two SN kiddos both have IEPs. They are in general education. The school has been understanding, considering how challenging they are—we are in a DCPS in NW DC.

Have you pursued a non-public placement? If you could get even one of the kids settled at a school that's actually capable of handling them, life might be a lot easier.

You also might consider trying to set some boundaries with the school. If your kids have chronic behavior issues, then you don't need to be notified every time someone has a behavior. You already know they have behavior and they only need to call you if it's an actual emergency. See if you can get a written daily or weekly summary instead. That may reduce your stress level, as well as create a paper trail that can be helpful if you need it later.

Anonymous wrote:

Anonymous wrote:OP again—the two SN kiddos both have IEPs. They are in general education. The school has been understanding, considering how challenging they are—we are in a DCPS in NW DC.

Oh man. DCPS has very, very few resouces for normal/high IQ kids with behavioral issues. And it is SO isolating at the wealthier DCPSs because you get the side-eye from the parents of the perfect “advanced learner” kids.

Sorry if I missed it, but did you get an FBA and a BIP? Did you ask for a professional actually *trained* in autism to help design the BIP? You may need to really insist on this and consider calling the Ombusdsman if the school team won’t do it. Did you have a consult help with the IEP?

As for the calls, you can actually refuse to take them. Eventually in elementary school I snapped and told the person calling to relay the latest bad thing my kid did “Do not call me any more unless it is to describe the antecedent to the behavior, the behavior, and how exactly you implemented the BIP in response to this behavior, which as you know is well documented as expected behavior that arises from his disability.”

Anonymous wrote:OP again—the two SN kiddos both have IEPs. They are in general education. The school has been understanding, considering how challenging they are—we are in a DCPS in NW DC.

Anonymous wrote:

Anonymous wrote:OP here. Thank you for the responses. I am not from the U.S. originally so I do worry about how I would fit in somewhere in, say, the Midwest. My in laws are local (DC suburbs) and my own family are all still overseas.

Re meds we have tried Ritalin and Adderall, both of which made oldest DC very jittery and agitated. Then guanfacine which they’ve both been on for ages, which helped at first but now doesn’t seem to be helping as much (and makes them fall asleep and wake up very early… couldn’t give it at night as it gave nightmares). I am a bit scared of SSRIs and things like Abilify because of the lasting side effects. Like, I don’t want to add more issues with medication if a lifestyle change could help.
Part of the issue is that I have not been able to find anyone who can handle DC. We tried nannies in the pandemic and 3 of them quit. So we are doing almost all afterschool care ourselves, plus some grandparent help. I don’t think most nannies could handle my kids behavior, even if we could financially swing it. Private schools would almost certainly kick them out due to behavioral issues. Just feel a bit trapped.

You've only tried treating the ADHD -- you haven't even tried treating the anxiety. If you want to move somewhere slower/cheaper, by all means, do it. But it's not fair to make the kids live with anxiety -- it's a terrible feeling.

Fwiw, my child was on abilify for two years before we saw any concerning side effects -- and the peace we got in those two years allowed so much growth in social skills and relationship building. When weight and a1c crept up, we switched to latuda and weight immediately came down.

Anonymous wrote:Huge thanks to 19:28 poster for the kindness and reassurance that shines from your post, as well as for generously sharing your experience. I am glad that things are better for your children. You absolutely got to the heart of many of my fears.

I spoke to Maddux when my oldest was in first grade and they were extremely nice but said they would not be able to support him. Both of my SN DCs have had violent outbursts at school which means that a private is not really an option (we also could not afford it).

Thank you again everyone. You have convinced me that medication would be a better step than a move. I was worried that I would be being selfish by medicating them to tamp down their feelings, rather than trying to address the anxiety school produces in them with a more fundamental lifestyle change, but I think that our problems would just follow us.