ADHD medication side effects/ downside to medicating? help..

amother

Seafoam

Mon, Aug 14 2017, 1:33 pm

Hi All!

My young teen DC just got diagnosed with ADHD. It isn't a typical case, it affects DC in school, but it wasn't so obvious for years. But, even more so, we think many of the struggles at home are related to it. We got the diagnosis and now we have an appt with the pediatrician to come and discuss medication options. I called my insurance and got a list of meds they cover. There a lot of medication options. DC also sees a counselor for this twice a week, in case you are going to suggest that.

Here are my questions:

1. I want something that will last most of the day, not just during school hours. We have difficulties at home and having DC regulated, calm and less impulsive at home will really benefit us all. In your experience, does the child take the med a second time so the effects help at home too after school hours? Does your child take it on weekends and vacation days too?

2. Does taking it so it will work in the afternoon/evening affect the child's ability to sleep?

3. What other side effects are there?

4. Someone told us not to medicate at all. Their thought was once you get the brain used to the drug, it will accommodate and not work as well. And if they ever stop - or miss a dose - or whatever, they are even worse than they originally were without the meds.
I don't know if this is true, the the idea really worries me.
Medication was our big hope, because DC really needs it and we don't have the resources to treat this without it (we give DC as much time as we can, but there are other kids too and other worries in the house...)

5. Which med do you use? Any suggestions for which have the fewest side effects?

6. Did DC or you stop using it or are still using it? at what age/stage?

PLEASE WHEN ANSWERING ANY QUESTION PLEASE TELL US WHICH MEDICATION YOUR DC (OR YOU) USES.

TUSM!!

amother

Ruby

Mon, Aug 14 2017, 4:22 pm

I have ADHD myself. I took Ritalin from age 11-15.

It was a miracle drug.

Back then (in the 90s), there were a lot less drug options. So Ritalin was 3 times a day, and I usually took it twice a day, which covered most of school and home. I didn't take the 3rd dose because it would interfere with my sleep if I did.

These days, they have a lot more medication options. Some work for some kids but not others. But in addition to the different medications themselves, many medications come in a short lasting form (e.g., take 2-3 times a day) or a long lasting form (only 1-2 a day). These do make a difference in terms of all sorts of things.

The only side effect I had from Ritalin was decreased appetite, which for me was not great because I was kind of small to begin with, I am average height now though, so it couldn't have affected things too much. This side affect is common in many ADHD meds.

I personally didn't usually take Ritalin on weekends and vacations, but that was my choice, ti doesn't have to be that way. If it helps your son at home, then he can take it all the time.

As far as what your friend said about them being worse off if they skip a dose than if they never started, I never found that to be true, nor do I know anyone who that is true for. That is common with other psychiatric medication though (e.g. for depression or anxiety, the withdrawal is horrendous, even from 1 missed day), but ADHD medication is generally shorter acting than those medications (even the long lasting forms) and generally doesn't have strong withdrawal. That being said, you should NEVER stop it alone. When the psychiatrist found out I was skipping doses, I got a very strong lecture, as there are side effects that need to be monitored for. But I always felt fine during the times when I skipped a dose or didn't take it on weekends/vacations, it was just like before I took medication.

I was also able to stop taking medication at 15. At first, the medication stopped working well around then (which is not uncommon during puberty, sometimes medication needs to be adjusted then), but I had learned enough skills and calmed down enough that I felt I wanted to try without medication for a while. I was so much more functional and never went back on it.

I personally highly recommend trying medication, it is a life changer. Importantly though, your son should in parallel learn coping strategies / compensatory skills for school and home settings to help him. Sometimes, those skills are enough and he can stop taking medication. Or, the medication could work great for him and he can take it forever and reach his highest potential that way and everyone wins.

amother

Floralwhite

Mon, Aug 14 2017, 5:41 pm

I am also a fan of meds, used appropriately. There are some real side effects to watch for, though.

A) IME, often, an extended release will get you through to the end of a school day but not much farther. A dose of short acting can be added. In a lot of kids, having meds in their system (the extended or the short) in the late afternoon/evening definitely makes sleep more difficult. If it's a real problem but the med is working really well for you, you can add in something to help with sleep.

B) Violence/irritability. It's rarer, but it happens with some people on some meds. I wouldn't not try a med because of it, but I'd keep my eyes open for it.

C) Rebound effect. This is actually pretty common. When the meds wear off, for a period of time, the behavior swings in the opposite direction, and for the next half hour, hour, whatever, they may be extra irritable or distracted (more than the usual without the meds). Again, something to watch for, but many people find it manageable at home and that it's worth it.

I'd ask the dr about the side effects of each particular drug he recommends, particularly rebound. I'd also ask, when he recommends something, why he recommends that one. Lastly, please expect that it may take more than one try to find the right drug and the right dose.

Lastly, there are some people who can't tolerate stimulants (Ritalin, Adderol, etc)- either they don't work well or the side effects are too strong. This can be the case if there is more of an atypical adhd presentation. There are other options. Straterra is a non-stimulant med targeted at attention. If the main issues are impulsivity, volatility, and/or irritability, I would look at Intuniv. Intuniv can also be combined with a stimulant.

amother

Seafoam

Mon, Aug 14 2017, 9:28 pm

The rebound affect worries me. I am having hard time at home and if the teachers get an angel and I get a monster, I might loose it. The teachers don't even think it is so bad. Just we do. DC is impulsive, always needs to be stimulated/seeking pleasure and love to break rules just because. Yes, the counselor is working with DC, but the principal and the drs and we all think meds could be a game changer.

We have a pediatrician appt this week. We will get started on whichever we decide on. We have a psychiatry appt in a month. They will see how it is going and give their opinion on what to do going forward.

I am just worried that the meds won't help at home, or DC won't want to take it at home/weekends bc it isn't school, or that DC won't sleep. That won't be good for any of us. We have a lot of areas of stress right now, this is just one on the list.

amother

Goldenrod

Mon, Aug 14 2017, 9:30 pm

amother wrote:

My son is on Vyvanse. I was warned that the side effects are loss of appetite and sleep. Bh he has not exhibited any of those. It's definitely worth a try.

amother

Floralwhite

Mon, Aug 14 2017, 10:00 pm

Is dc very inattentive? Or are the primary symptoms those you describe (impulsive, seeking stimulation)? Because if so, Intuniv was amazing for us. And it stays in your bloodstream, unlike stimulants, without any of the side effects I described. Only issue is dc has to be able to swallow a pill. It's small, but can't be broken up.

The cool thing about stimulants is that when a pill runs out, it's gone from your kid completely. So, say you try Adderal ot Vyvanse and after a short trial period, you don't like what you see. So you stop it, and try something else. And most likely won't need a new appt. Call in, make a new plan for a new med, go pick up the scrip, and try again.

amother

Dodgerblue

Mon, Aug 14 2017, 11:12 pm

amother wrote:

My son started with Concerta for school but we added intunive because his behavior was still unmanageable at home.

amother

Vermilion

Mon, Aug 14 2017, 11:31 pm

We have seen the rebound effect with Ritalin, just the regular short-acting one. Rebound lasts not too long, maybe a few hours, and consists of more irritability and being emotionally hypersensitive.
Regarding the person who told you meds will end up worsening the original condition (I think that's what they were implying from what you wrote), I don't think that's borne out by research and clinical experience. In fact, the medications seems to help the brain "catch up" and make up for the developmental lag of the ADHD brain. That's why some people are able to entirely stop using ADHD meds as they grow older. Like the earlier poster said was her experience.
I was really anti-medication until I realized how much my kid's self-esteem was being affected by the ADHD symptoms. And also I read about how unmedicated children with ADHD are at higher risk of things like substance abuse when they get older.

amother

Pink

Tue, Aug 15 2017, 3:23 am

1. There are several ADHD meds that are long-acting. Concerta, Ritalin LA, and Adderall XR are three of the big ones.

2. There will probably be a "crash" at some point before bedtime. The medication leaving your system can have side effects for some people (including bad moods, anger, headaches, hunger) or it could just cause tiredness and nothing else. And if the medication doesn't leave your system before bedtime, insomnia will probably be a problem.

3. There are all kinds of potential side effects. Or it could work beautifully with no side effects. It really, really depends on the individual person and the specific drug. This is why you need an expert doctor involved. Your kid might need to try a few different meds/doses before finding one that works well.

4. This is not true. The medication keeps working over time. It's true that there can be a withdrawal period after use of a medication for some time. And during the withdrawal period, the person might be even less focused than they were before taking medication. But that passes fairly quickly (usually within a few days), like with going off caffeine. It's not a permanent state.

5. Which med has the fewest/least bad side effects depends on the individual.

General note - Medication for ADHD is best used along with therapy/education. It's rare that you can just medicate a kid and that makes things better long-term.

Not that the short term isn't important. But do keep the long term in mind, too. Your child probably needs help learning life skills that people with ADHD tend to lack - organization, planning and preparing for tasks, study skills, impulse control, certain social skills.

There are occupational therapists who specialize in this. Or, if the problem is about conflict in specific relationships (and not just him engaging in specific problematic behaviors, eg speaking impulsively or getting violent), a family therapist might be better.

I get that it's hard with several kids at home but it's really really worthwhile to invest in this, too, not just the meds.

amother

Ruby

Tue, Aug 15 2017, 5:50 am

amother wrote:

I was the amother who took ritalin. I never had any rebound affect - it doesn't happen to everyone, so don't avoid medication because of that. And if it does happen, you can switch to a different medication or to a short lasting / extended release dose.

As far as whether it will help at home, that why I stressed the importance of learning coping skills / management strategies for both school and home. Medicaiton quiets the brain activity but won't magically teach your child how to be organized and get things done - but it will help him focus enough to learn those skills and function better at school and home.

Your best bet is to try and see how it goes. If it's worse with the medication than without it, try a different med or if nothing is better than you can just stop and no lasting effects. But for many people, it's better with medication, and you shouldn't not use it just because maybe it will be worse.

amother

Amethyst

Tue, Aug 15 2017, 9:38 am

I was forced on medication for many years as a child. I took over 8 different types of medication and I hated it.

I don't beleive in it, but I hear it does wonders for others. I just got too burnt out, and hurt from it so it's hard for me to give advice. My only advice to give you is to go see a GOOD phsyciatrist, and LISTEN TO YOUR KID. You may have to change the meds over 20 times, discovering what works best for her- it's tiring, and hard. You need to know that before you start. Meds are a person by person basis, it's not simple. One person may hallucinate from a medication that does wonders for the next person.

You will probably need to check in every 2 weeks to try and switch stuff around till ou get the right mix. In any case, LISTEN TO YOUR KID. Medication for me took away my personality and left my lethargic, weak, tired, and unconfident. But no one really cared since I wasn't hyper and I could focus.

I beg you to involve your kid as much as you can and listen to every concern they have.....

amother

Burgundy

Tue, Aug 15 2017, 10:53 am

there are lots of side effects. dh tutors many kids on these meds and some days he is saying how amazing meds can be and most days he is saying "it is so sad"--anxiety and tics are two common side effects. with that said, realize that meds are not the final answer. after your child starts meds, hopefully (after the dose is FINALLY fined tuned and correct) he will be calm enough to be able to learn new coping and functional skills.

I know of an adult who was on all kinds of meds that saved his marrage and really helped him function. He ended up with heart and anxiety issues (side effects from the meds)---now, he cannot take the meds. However, the skills he learned while taking the meds has helped tremendously!!! He thinks "how did I act when I was on the meds" and now he has a basis to go back to to know how to function normally. His wife says "he really needs meds---but it is manageable now; where before he ever took meds it just wasn't doable."

besides meds, if you can get him exercising, riding a bike, the more the better, it can really help!!! removing chemicals from the diet (and in some cases sugar and white flour) from the diet, it can also be helpful, but it's kind of hard to talk to teenagers about food and diet.

one other thing high doses of omega 3 have been shown to help A LOT at so that kids/adults can cut their doses down

Last edited by amother on Tue, Aug 15 2017, 10:54 am; edited 1 time in total

FranticFrummie

Tue, Aug 15 2017, 10:54 am

I have serious ADD, and for a while I took Adderall. I started with 5mg. My problem is that I also have General Anxiety Disorder, and after a while it sent me into full blown panic attacks. I'm also Bipolar, so it triggered manic episodes.

It worked wonders for my attention and efficiency, but the side effects got to be too much to handle so I had to stop.

When I started Ulpan I broke my leftover tablets in half, and took 2.5mg in the morning. It was just enough to get me through a 4 hour class, but occassionally I would feel my heart trying to race out of my chest.

Because of my underlying issues, my experience is NOT typical. Don't judge by me, just keep an eye on the side effects. I still think Adderall is a great medication, I just wish I tolerated it better.