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My 14 year old has multiple mental issues. He's been on more medications then I've ever seen a kid on. When he arrived, the meds were stopped as no one knew what he needed. His RAD was so severe at that point it was tough to tell what was what. Last summer, his rages became violent and he was placed on Risperdal which helped a great deal. Psych doc suspects bi-polar. We know he is ADHD(after dealing with what was RAD, FAE, ODD, PTSD and SID). Due to apparent insurance rules, their is an order in which they try these meds. He's been unmedicated, but doc had school do lists and added Adderal. Bad mix. My son seemed clearer for a few days, but his frustration tolerance dropped dramatically and he put his fist through his bedroom window last week in a fit of rage(lucky for him their were thick curtains that took most the glass). So now we have to try Ritalin before Straterra. My question-should I just push to drop the ADHD drug again or is there a chance Stratterra will not cause the raging or lesson the effect of Risperdal?
Anyone's kids react to the stimulant drugs but not the Stratterra?(which I'm sure is spelled wrong)
Bi-polar symptoms are very similar to ADHD ... doctors have difficulty using the term bi-polar for many children because they are so close! ... medications for ADHD (such as Adderall or Straterra) seem to activate the manic/cycling episodes in many bi-polar persons. The rages our child exhibited while on both were unreal! Risperdal or Trileptal (which has had some success in bi-polar patients) are often coupled with Wellbutrin or an anti-psychotic drug which often work well together. Risperdal has been known to activate anxiety though - whatever you do - do not let them couple that with Paxil or anything similar - it can be deadly ... produces great hallucinations and suicidal idiocies! When you raise questions, the doctor may suggest stopping the Risperdal and trying just the ADHD medications - as our child is now on ... which are having absolutely no success!
Not sure if this answers your question but hope it helps.
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Thank you. That's what I think, too-that the med mix is a bad idea and he was better off without the ADHD drug. He has been on ADHD meds without risperdal before and they were useless so I don't think he'll try that. The school is being less then cooperative about filling out the evals the doc wants and he certainly doesn't need the extra meds at home. Think I'll push to just drop the med as he was doing so much better before doc asked for the schools input(and his daily charts don't indicate any problems at school, either until the meds were added)
Three things: First off, from everyone although adhd and bi-polar tend to go hand in hand the adhd meds have really undesirable effects on children that are bi-polar. Secondly, we tried Straterra for our adhd son last year and it was a nightmare. He was an emotional mess, his handwriting was illegible, and even though he is anadvanced student (was 7 then) he couldn't remember how to do his simple math problems. His doctor has stopped prescribing it due to negative results. Finally, and most importantly public schools are required to do everything they can to accomadate children with learning disabilities. If the teachers are being less than cooperative go to the school counselor and/or principle. If you are still not getting the support you need go to the district level.
Straterra isn't the best. DO NOT go to Straterra after your son's been on Adderall. We made that mistake with our son, he was on Adderall but wasn't always taking his second dose (thanks to the school system!) and Straterra was only a one pill a day med. It caused all kinds of problems. My son was punished in school for falling asleep in class, not paying attention and outbursts. The side effect of sleepiness isn't well known by doctors that prescribe Strattera. We went back to the Adderall. We're so happy that Adderall came out with XR. My son was on Ritalin when he was small (been on meds since age 6 for ADHD) and ended with shakes and was worse than without the meds.
As what AMARYLANDFAMILY suggested, have your son's other medications changed. His body may have gotten used to what he's currently on now or he just needs a change to something better.
As for your son putting his fist through the window. My son still deals with anger problems and sees a psychiatrist for it. She no longer feels he needs to see her (after 3 years of seeing him); most of his anger outbursts are normal teenage ranting. But at times, we send him back to her when we feel that he needs an outside retrospective. Since he has been on Adderall, he had no problem with anger till he turned 14 and the teen hormones kicked in full force. Have you checked into having your son see a child psychiatrist? I know the one we used helped my son a lot with his emotions and added Mood Disorder to his ADHD. My son is 15 years old now. I swear on Adderall. It's been the best thing for our son. But, as a parent, you have to keep up on things, even doctors screw up and dont check up and some of the books they use aren't up to date for drug reactions.
I do check with DrKoop.com for drug interactions. The site is slow but it very good. My son was put on antidepressant meds (for suicide thoughts because of a bully. Once again thanks to the school system and their lack of help) and when he started to have severe headaches, I checked and there was a severe drug reaction warning. I had him taken off the antidepressant meds (heck, meds for ADHD are mostly antidep anyways!).
We had problems as well with the school system and called the superintendent to help get the ball rolling. You have to stay on top of your child's teachers and principal. Get their email addys. Also, be careful, some school counselors aren't worth a hoot. My son's wasn't.
The school counselor told me he's handle the school's part so we'll see. I do use emails with the teacher.
My son does see a child psychiatrist and the Risperdal is not the problem drug. Never will I put this child on Adderal again. My son's not much of a sleeper, so that side effect wouldn't bother him. Also, I'm not concerned with him getting in trouble at school. If he's behavior is extreme, they let me know. He did start the Ritalin yesterday and seems very out of it or foggy today. Not sure if it's related to the meds or if he's catching a cold. Straterra is the non stimulant med, right? I just heard it interacts better with the Risperidal, but who knows.
I very much appreciate everyones advice and will proceed very cautiosly with any med switches.
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I can certainly relate to the meds menu issues with ADHD and BiPolar! Our 15 yr old had been on dexedrine originally for hyperactivity symptoms, which seemed to work pretty well ... needing increasing as he got older and bigger. With events, a hospitalization and additional diagnosis of bi-polar, we went through several months of medication additions, adjustments and changes until fixing on a combination of lithium, strattera and abilify which seemed to work prety well for him. (With Adderall he was extremely sleepy and gained over twenty pounds!).
I am always leary of generalizing about meds based upon one person's case ... there are so many factors involved as to how an individual will respond to or tolerate a medication. We have always tried to be proactive working with physicians to find the right combinations at the time to help our son ... knowing that a particular combination is not likely to be the cure-all or end-all.
And, as far as school helping: get EVERYTHING written into an IEP (even if you need to call for an IEP Review meeting regularly), and know that you may need to escalate beyond the school to the District, or even to the State Board of Education, Special Education Compliance Section in order to get the cooperation you need for your son.