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Forum -> Parenting our children -> Our Challenging Children (gifted, ADHD, sensitive, defiant)
Has anyone medicated a child without using a psychiatrist?
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amother
Royalblue


 

Post Wed, Jan 23 2019, 8:47 pm
Ds has all the symptoms of adhd.
Lately his anger has gotten out of control.
He’s been going to different social workers over the years... none of them have ever been 100% convinced that he needs medication. It’s always left as a question mark...

our pediatrician who we trust immensely has recommended putting him on a low dose of concerta and see how he is.

On one hand, things are so bad at home that I can’t imagine it can be worse with medication.

On the other hand, I would want him to have a complete nuerological evaluation with a top psychiatrist before we begin the medication route.

DH does not feel ready to pay for this now. He’d rather have the pediatrician oversee the meds and take it from there.

BTW I completely trust the pediatrician and I know he will tell us if he feels we need to see a psychiatrist if he is not talking to the concerta.

So my question is, has anyone medicated their child without using a psychiatrist and only a pediatrician. Was it a success?

I need my son to function and can’t wait any longer.
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amother
Lawngreen


 

Post Wed, Jan 23 2019, 8:52 pm
Please don't. I'm the OP of the mentally ill thread. Please use a good psychiatrist.
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mha3484




 
 
    
 

Post Wed, Jan 23 2019, 8:58 pm
We use our ped to maintain our current meds but the practice also sees a lot of kids with adhd, they have a special clinic and they put a lot of emphasis on behavioral health. They are not typical. We started first with a developmental pediatrician who we loved but she moved out of town. If we were starting from the beginning, I would not use the regular ped.
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amother
Tangerine


 

Post Wed, Jan 23 2019, 9:03 pm
Lots and lots of people do it. Sometimes it turns out fine. Most of the time it's a really bad idea. Pediatric psych meds is an extremely precise science, and you want a specialist who does this all day long to be managing it. A pediatrician wouldn't typically diagnose and manage thyroid meds, heart meds, or seizure meds. I can't fathom why they think it's their place to manage psych meds.
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jflower




 
 
    
 

Post Wed, Jan 23 2019, 9:24 pm
What's the down side of starting with a low dose of concerta? You can always continue with a psychiatrist later to fine tune the meds.

It sounds as though you need immediate help. Why not try it?
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amother
Mustard


 

Post Wed, Jan 23 2019, 9:25 pm
Is it a normal ped or a developmental pediatrician?
I would totally trust a developmental pediatrician, because this is their expertise, not sure about a normal one.
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amother
Brunette


 

Post Wed, Jan 23 2019, 10:15 pm
Developmental pediatrician.
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amother
Royalblue


 

Post Wed, Jan 23 2019, 10:17 pm
jflower wrote:
What's the down side of starting with a low dose of concerta? You can always continue with a psychiatrist later to fine tune the meds.

It sounds as though you need immediate help. Why not try it?


Yes, that’s how I feel. I wanted to hear from others who have done it too.
He’ll continue with his therapist at the same time so we can ask his opinion as well.

I’m hesitant... I really am. DH would be willing to pay for a psychiatrist if the concerta doesn’t work out. Of course we are hoping that it will work out and we will have a pleasant child and save money too.
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amother
Powderblue


 

Post Wed, Jan 23 2019, 11:09 pm
It takes a while to figure out which medication works and at what dose. Once you start with a psychiatrist, you can go to your pediatrician for a refill.
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amother
Tangerine


 

Post Thu, Jan 24 2019, 12:06 am
amother wrote:
Yes, that’s how I feel. I wanted to hear from others who have done it too.
He’ll continue with his therapist at the same time so we can ask his opinion as well.

I’m hesitant... I really am. DH would be willing to pay for a psychiatrist if the concerta doesn’t work out. Of course we are hoping that it will work out and we will have a pleasant child and save money too.


Look, your pediatrician probably has a reason for choosing concerta over the other options. But I don't know that he has enough background and experience to be making that choice. It's very possible that a psychiatrist would ask you lots of pointed questions and choose a completely different category of medication (ie a non stimulant). Concerta may help. You may play around with the dosage and eventually find one that seems right. But you won't know what you're missing, because you're not dealing with a practitioner who knows what every detail in behavior indicates and what it will most likely respond to best.
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amother
Coral


 

Post Thu, Jan 24 2019, 1:24 am
Bad idea. You mentioned out of control anger, which could mask a mood disorder, anxiety, or depression. The ADHD may be just a piece of the puzzle, or not. He needs to be properly evaluated.
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FranticFrummie




 
 
    
 

Post Thu, Jan 24 2019, 6:14 am
amother wrote:
Bad idea. You mentioned out of control anger, which could mask a mood disorder, anxiety, or depression. The ADHD may be just a piece of the puzzle, or not. He needs to be properly evaluated.


THIS. I would never give a med without a psych eval, and especially with anger issues. There are some uncommon side effects that can make anger worse (not everyone reacts the same).

He needs to see a psych doc for a baseline evaluation, so that if the meds need adjusting, the doc will have something for comparison.

When it comes to your child's brain, it really doesn't pay to put the cart before the horse. Things need to be done in a seder. Otherwise you're just throwing darts in the dark and hoping for the best.

BTDT.
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amother
Royalblue


 

Post Thu, Jan 24 2019, 7:22 am
amother wrote:
Bad idea. You mentioned out of control anger, which could mask a mood disorder, anxiety, or depression. The ADHD may be just a piece of the puzzle, or not. He needs to be properly evaluated.


Okay,,, that makes sense.. and what FF said too
It would make things so much worse for us if he didn’t react to the concerta...

Why would I take him to a developmental pediatrician if he wouldn’t prescribe medication?

Doesn’t it make sense to just go to a psychiatrist who evaluated and deals with the medication too.
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amother
Apricot


 

Post Thu, Jan 24 2019, 8:22 am
I’ve been working with kids with ADHD for over 20 years. I agree as stated above- may not be ADHD or maybe ADHD and some type of mood disorder combined. Go to a highly recomended psychiatrist- they may not take your insurance. Where do you live, maybe we can suggest someone.
However, if DH won’t budge until you try the concerta, try the low dose, you and DS’s teachers should see a difference in 48 hours or so. At least you will start the process and can tell the psychiatrist about how he did on the low dose. Doctors begin with low doses to rule out side effects, with the intention of building up to the correct dose for the child’s body size etc. In most cases, the medications don’t really “work” or work optimally until the full dose is given. Try to impress upon DH that a psychiatrist is trained in this and that you should not be playing around, even if the low dose does make a change, perhaps the psychiatrist would recommend something that would work even better...
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animeme




 
 
    
 

Post Thu, Jan 24 2019, 9:04 am
You also need someone well-trained with side effects, which often show up on the low doses before the desires effects do. And irritability and sometimes anger/rage can happen, particularly as the meds wear off.
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Chayalle




 
 
    
 

Post Thu, Jan 24 2019, 9:07 am
I have a relative who went that route with a child, and then went to a psychiatrist who was worth what they paid him (not much.) The child is now a VERY out of control teen. He is finally seeing a good psychiatrist, but the damage done over the years can't be undone by now.
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amother
Goldenrod


 

Post Thu, Jan 24 2019, 9:12 am
FranticFrummie wrote:
THIS. I would never give a med without a psych eval, and especially with anger issues. There are some uncommon side effects that can make anger worse (not everyone reacts the same).

He needs to see a psych doc for a baseline evaluation, so that if the meds need adjusting, the doc will have something for comparison.

When it comes to your child's brain, it really doesn't pay to put the cart before the horse. Things need to be done in a seder. Otherwise you're just throwing darts in the dark and hoping for the best.

BTDT.


Cldnt agree more. As a mother of 2 cildren on meds, weve had some nast side effects. Im all for medication but not if its not properly managed. Especially if your child has anger issues. Its well known that stimulants can make it much worse. Weve jumped from medication 2 medication ( in the end were hrs not even on a stimulant. He cant tolerate it) till we found the one he is thriving on
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amother
Royalblue


 

Post Thu, Jan 24 2019, 9:25 am
Chayalle wrote:
I have a relative who went that route with a child, and then went to a psychiatrist who was worth what they paid him (not much.) The child is now a VERY out of control teen. He is finally seeing a good psychiatrist, but the damage done over the years can't be undone by now.


Chayalle, can you please tell me the name of the good psychiatrist? My son is an out of control pre teen...
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Chayalle




 
 
    
 

Post Thu, Jan 24 2019, 9:33 am
amother wrote:
Chayalle, can you please tell me the name of the good psychiatrist? My son is an out of control pre teen...


You can pm me.
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amother
Goldenrod


 

Post Thu, Jan 24 2019, 10:23 am
amother wrote:
Chayalle, can you please tell me the name of the good psychiatrist? My son is an out of control pre teen...


Dr sabina hack is phenomenal. Charges $$$$ but worth every penny
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