Serious Ritalin issue...please help!

[Jen C.]

I want to begin my saying how greatful I am to anyone who can offer any wisdom, knowledge or anything of the like on this subject. I haven't posted in so long, but couldn't think of anywhere else to turn for a sympathetic ear, and some great advice. I know this is not medical advice, and I am consulting professionals, but I'm curious if any one has experienced this.

My 6 year old son was diagnosed ADHD in fall of 07. I have always known him to have "quirky" behaviors, and have been concerned for many years. The kindergarten teacher did not suspect a need to test for ADHD, but described Chad as very sensitive and shy. He has never had hyperactivity issues, just more impulsivity issues. This year in Sept, after only 3 weeks of school, his teacheer suggested he be evaluated for ADHD. This teacher had had my daughter (a perfectly well mannered, well behaved, academically gifted child) the year prior. Trusting her opinion, I took him to our pediatrician. The evaluation process took several months. I started out vehemently opposed to medication. I tried psychotherapy, dietary changes, etc. The teacher remained firm that she thought Chad could really benefit from medicinal therapy.
In January, our pediatrician recommended I try him on Ritalin SR 20 mg, taken once a day. Her reasoning for choosing that med was it has been around the longest, it is time released, and it is the lowest possible dose. Reluctantly I agreed. Initially, it worked like magic. However, after a month of treatment we began to see sever rebound effects when he awas coming off of the medication like around 4:30 or 5:00. His classroom work improved, and his teacheers offered nothing but praise.
The rebound effects had become so bad in April that I questioned both my psychologist and my pediatrician if we should adjust or change entirely the medication. My pediatrician said to wait one more week, and see if he might have "spring fever". When I called her back on Mon. she was on vacation for 2 weeks!!
Chad had had the worst 9 days of his life. He has become an obsessive nail biter (he NEVER bit his nails, in fact he loathed having them cut). he is becoming progressively more withdrawn, as well as verbally abusive at home, combative, and all around next to mimpossible. He is having violent outbursts (throwing things, destroying things) in his room when he is given a time out for his inappropriate language. I have an appointment tomorrow morning at 9:30 am with the Dr. on call in my pediatrician practice. I don't know what to do. Do I stop the Ritalin on my own? Should I give it tomorrow? Does this sound like something that just might happen out of nowhere when taking a med for 3 plus months? Any help is so greatly appreciated. I am at my wits end!!! THANK YOU!:(

[DestinationWDW]

:pixie: Hi Jen! First of all....prayers and pixie dust to you and Chad. Second of all...you are not alone. What you are describing sounds very familiar to my husband and I. Our 10 year old son has it too. We have been through several different medications that at first worked and like you, got praises from teachers...but after awhile:fit::plot: would start up again...right at (like you say) the most wonderful time of the day when you just want to bond with your family and eat dinner!!! I actually was getting resentful towards my son as my other 2 children could get no attention from us.....we are starting in one of these stages again. What we have found that he usually needs an increase in dosage or a new med altogther. Kids grow and :confused:maybe develop a tolerance to med they are on? My son seeing his doctor Thursday. I would go ahead and give him his prescribed med in am and go on to your appt. I have found that though my son may be a "jabber jaws" and need more supervision than others - he is extremely intelligent, knowing more about the upcoming election than a lot of adults I know, asks "deep" questions re: religion and other topics that at times I need to seek guidance from our Pastor or do research to answer!!!! This will wax and wane for you, but Chad will still grow and be fine - best advice is to NOT hold his med when you go to Disney, I was dumb enough to try that once! ;) Praying for you and Chad for a good office visit in am! :hug:

[princessjojo]

One of our boys is on Ritalin LA. He also has some of the same side effects you have described such as the aggressiveness, but he also gets a stomach ache some afternoons around 3pm that last about an hour then it's gone. He has had the loss of appetite and lost some weight, but eat very well on the weekends when he's not on his medication. I think our difference is that with Colbey, he himself can tell a difference, and during stressful times at school such as End of Grade testing, he makes sure he takes his medication. He will be the first to tell you he can focus much better and does better on his test. I on the other hand, will be the first to say that after a few days off his medication, I'm looking for it wanting him to take it because he reminds me of the critter in Over the Hedge that was so spastic.

We've just learned to take the good with the bad. I keep his behavior in line and when I see him starting to act out, I call him in to whereever I am as sort of a time-out without the punishment. I just try to distract him from whatever is making him angry.

It's tough, but in the long run, I can only hope I'm doing the right thing for him. One thing I do to extend his time during the afternoon is make sure I don't give him his medication until we pull up at the school. That way, he starts "coming down" around 5-6 and after that, he's starting to get ready for dinner and bed before his alter ego takes over.

Good luck. Changing his medication may be an answer, but just don't give up.

[PirateLover]

I can't speak to ritalin exactly but I do know that some meds can have adverse reactions when they've built up in your system. Medication is tricky. I am on a certain medication where I can only take a quarter of the smallest prescribed dosage, and I have to skip it two days a month otherwise I get a very upset stomach, headaches etc. So yea, just because he's been on it for 3 months and had no reaction doesn't really mean anything. I hope you are able to get this figured out quickly. :pixie: for you and your little boy.

[Hope0277]

This is actually my very first post on here. I am currently in pharmacy school and thought I would share what I do know about stimulants. With ritalin or any stimulant medication the patient may experience a rebound effect. Irritability is another issue that is found with these medications. The physician must first rule out any other disorders that may be evident (i.e. depression). If these are all effects of the medication, the physician may want to adjust the dosage of the ritalin, add an antidepressant or mood stabilizer, or switch agents all together. I would give Chad his morning dose tomorrow and see what the physician says. It is difficult, but you and your son will get through this. Best of luck to you. By the way...I moved from the West Bloomfield/Farmington Hills area two years ago to attend school. Where from the hand are you?

[Jen C.]

Thanks so much for all of the kind words, and advice.
We will be following up with the physician on call later this afternoon, but I have a feeling that it is time for a medication change.
I truly wish there was a more holistic way...
Hope...I am from Macomb County, so not to far from your Oakland County roots! Thanks for the pharmaceutical approach!:blush:

[Dakota Rose]

I'm not in the same boat as you, but I completely understand your desire to find something more holistic to treat the ADHD. Generally, doctors are reluctant to go down that path (don't get me started on that rant). In addition to seeing your ped and keeping him on the meds until they change dose/med, I would suggest seeing a Naturopath or an herbalist. There are treatments such as biofeedback and acupuncture that many have found success with using. Even a health coach could point you in a good direction. Maybe stop by your local natural health/vitamin store and see if they have some folks to recommend. :) Good luck!

[tinklover]

I have gone thru the same thing with my son. I to tried everything from diet changes to natural herbal remedies and nothing worked. I finally gave in and told his doc to give him meds. they started him on the ritalin and with in a 3 week period he actually became worse. the ritalin was not working for him. turns out he also had OCD so his doc put him on adderall, and he also had ODD so he then was also taking risperdol(sp?) and he refused to sleep so they started him on an antidepressant to help make him drowsy which was remeron. they eventually took him off of remeron and had me give him benadryl every other night. You just have to keep trying different meds and med combinations till you find teh one that works. I feel bad because I hate to see my child on medication but it helped him so much he went form a toddler who was kicked out of 9 dayscares in 3 yrs to being an honor roll student aho gets nothing but praise form his teachers. I am now in teh process of getting my 5 yr DD tested because she is beginning to show some of the same signs my son was showing. his doc even wanted to have him tested for aspergers but his father got custody of him at that time and he was never tested. so it will get better just keep faith and thru trial and error you will get teh right combo for your son i am sending prayers and pixie dust your way for yoru family and chad.

[MsMin]

Hang in there. What you describe is common and as mentioned could be tweaked or changed to help. My kids take adderall and are old enough to verbalize the effects more than a 6 yr old. It does sound like the "drop off" effect where the medicine is coming down and the child feels depressed or irritable. Remember that depression in children and teens is often seen as irritability. Sometimes the doc will prescribe an afternoon dose to help the evening and homework.
The thing about medication is we can control it so much more than other stimulants. What is an herb or natural remedy but a drug itself, just not a controlled or sometimes not as tested or refined.
Caffeine is the most common stimulant used as a substitute for ritalin or adderall. The problem with caffeine is that you don't have a controlled dose and you have so much variability and the child is going up and down all day instead of just the afternoon when the child is coming off the medication.
ADD/ADHD is when the brain does not utilize glucose in a typical fashion leaving hot spots if you were to do an MRI. The stimulant helps to distribute the glucose utilization thus calming the child or helping them think or behave. It's like the child can get stuck sometimes, tend to be a bit obsessive or even hyperfocus on an activity. Personally, I prefer something that is more controlled like a pill over something that is not as controlled. I used pain killers at the dentist and would take insulin if I were diabetic. Medications for ADD/ADHD are just as valuable for some individuals as a child needing insulin. Yes, it is over prescribed b/c some professionals do not take the time to do a full screening. I'm glad they did go through a full eval. :thumbsup: My kids take afternoon doses and I fuss b/c I think their doc over prescribes the meds... giving them too much but I think it works best over home remedies. My kids do get tummy aches too especially if they drink a cup of coffee with the adderall (they are all in their 20's). If I can help let me know.

[Jeri]

I have to say like your son, my son (10yrs old now) was "quirky" and very shy, sensitive, and emotional. As a small child he was very OCD. He also would be very impulsive and actually he still is both but not as severe as when he was younger. I never gave any of this much thought untill in 2nd grade and the school said the felt it was someting more. I just thought I had a "quirky" child.

I had him evaluated and they thought ADHD and he was put on Adderall and one other med I forget the name. After 3 or 4 months he became very violent and mean. I took him off all meds told the Dr. that I refused to continue the meds if they were going to change him into someone like that.
After this we were sent to Childrens Hospital here and he under went IQ test along with tons of other tests and evaluations. After 3 months it was determind he had Aspergers, and severe anxiety. He now takes Zoloft ( half the dose for someone his age and size). It made a world of difference. I was very hesitant to go the meds route again but it did help.The only real side effect was he would not sleep. His mind would just be racing at bed time and he couldn't sleep. The poor kid was sleeping maybe 2 to 3 hours a night. We didn't want to get in the habit of giving him a different drug to sleep, and Benadryl was not working even at the max dose. He now takes Melatonin before bed. He is asleep in 20 to 30 minutes and sleeps all night.:cloud9:

I would say go with your gut and maybe see if there is a different drug for him.
I just know I refused to have my son become violent, and mean. And actually in the end the first inital diagnosis of ADHD was completly wrong. I know every situation is different I just wanted to share what we went through, and how I handled it.

[MsMin]

I would say go with your gut and maybe see if there is a different drug for him.
I just know I refused to have my son become violent, and mean. And actually in the end the first inital diagnosis of ADHD was completly wrong. I know every situation is different I just wanted to share what we went through, and how I handled it.
I agree I've seen loads of time when the label of ADD is slapped on and they overlook other symptoms b/c it's too easy to tell the parents it's ADD and let them go. I would want to know what "quirky" means. Is the behavior only after he is coming off the meds (afternoons) or while on it? Remember that the professional is only looking at a small snapshop of your child when they come in, this is part of the reason we like to see them multiple times but it's nothing like your experience knowing your son and his typical behavior.
I look at it if you have a med that uncovers something else earlier than what would have been discovered than we are ahead b/c we can start meds or behavior changes that much earlier to help keep a child on track at school. Anxiety can cause ADD symptoms. :pixie:
let us know how you do!