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Post by Dakotah on Nov 3, 2003 14:04:08 GMT -5
My son was diagnosed with ADHD, OCD and Sensory Integration Disorder one year ago. He has been on Concerta for a year and all has been well. At school this year he is having problems with impulsivity and aggressive responses to other children. He has many obsessive thoughts and always has. He also makes a lot of noise. At home we have our life down to a science but outside of our home he has many difficulties. I think we didn't realize the problems because we have adapted our lives to help him stay calm. I didn't want to add another med. but I think we might need to. His hyperactivity is okay but is there something that will stabalize his mood so he doesn't overreact all of the time? If it isn't yelling, it is throwing or pushing... I am in tears about this so any help will be welcomed
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Post by Mayleng on Nov 3, 2003 14:09:33 GMT -5
. He also makes a lot of noise. What kind of noise? Just talking,yelling type noises or involuntary type noises?
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Post by Dakotah on Nov 3, 2003 14:17:11 GMT -5
YES
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Post by Mayleng on Nov 3, 2003 14:38:21 GMT -5
YES Which type of noises, the yelling or the involuntary noise?
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Post by crillmom on Nov 3, 2003 15:18:18 GMT -5
dakotah, your son sounds like mine, except he isn't aggressive just reacts inapropriatly for his age, like cries if thing donot go his way or if he thinks he is right and he clearleyis not, he will continue to insist he is. Anyway, I am at the same place you are at. trying to decide if I should add another med to the concerta. I have been using supplements and they have been working for anxiety but not for the emotional aspect of things. I am also wondering if it is the stimulant that is making my son this way. have you thought of that? I would be interested in what others have done.
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Post by Dakotah on Nov 3, 2003 15:33:17 GMT -5
Mayleng My son yells, talks nonstop and makes noises that appear to be out of his control. Out of the blue he yells or blurts out the word lie. For no reason. He also bites his thumb and says lucka lucka lucka... I am laughing as I write this because it sounds so strange. He will make kind of grunting noises as well. There is no question that the Concerta is helping but he still does it, especially when our routine has changed. Anxiety?
Crillmom What is the difference between anxiety and emotional? What kind of anxiety does your child have? My son was actuallly like this before meds. so I am thinking the Concerta is not to blame but might be enhancing it a little bit. He is so immature for his age and it is, and I am sorry to say, getting embarrassing to take him places. I love him very much and only want to help him be successful but I am running out of ideas. It felt so good to read you are at the same place as I am. Adding medication is almost harder for us than making the decision to medicate period. What supplements are you using? Thanks for your support.
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Post by crillmom on Nov 3, 2003 15:53:48 GMT -5
the anxiety my so had was obsessional thoughts. he would get a thought in his head that really made him nervous and he could not shake it. Things that made him nervous were not really rational kind of things, because the typical stuff that make kids nervous did not frighten him. he is very confident and has no problem going places and doing things, likes to try new thingds, but a person we see in a store that freaks him out, he would get stuck thinking of this and it would really make him anxious. Anyway he was on paxil for 18 months and it worked great. We wanted to take him off and see how he does. I now give him becalm'd , a supplement, that naturally raises his seritunums (sp) levels which is what the anti-depressents do. It has been working great. he is not anxious anymore. He is also on concerta which is working great for adhd. Getting A's and B's calm, not so impulsive. But after talking with his teacher we learn that he is crying when things do not go his way and gets angry at stupid little things. we may have lost the obsessional thoughts but now we are dealing with this. Sorry so long but I wanted to give you athe whole story. I am researching giving him 5 htp which is an ingredient in the becalm'd.
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Post by Mayleng on Nov 3, 2003 16:13:17 GMT -5
The yelling of words for no reason, the sudden sounds. It sounds like vocal tics. Vocal tics are common on concerta or any stimulant, did he do this before the concerta? They are also common for ADDers and they are very closely related to OCD, they come from the same neuro malfuntion. There are very safe meds like Chlonidine and tenex that have been around for ages. They are originally heart medications but in small doses can help surpress tics. They are very safe to use and have a nice side effect of also helping with hyperactivity and sleep issues.
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Post by Dakotah on Nov 3, 2003 16:17:15 GMT -5
Thanks Crillmom. My son checks under tables and beds to make sure there are no squirrels hiding under them. I understand the anxiety piece you are talking about. Maybe it is a side effect of the Concerta. He really does obsess on things that are not a "real " concern to others. You've helped, thanks.
Millermom thanks to you also. Just when I thought I knew it all... I have never heard of vocal tics. He did it before the meds. but it is better now with Concerta. We thought he would out grow it but he has not.
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Post by crillmom on Nov 3, 2003 16:44:01 GMT -5
Dakota all those anxieties are ocd behaviors. I just got off the phone with the dr. She suggested lexpro, an anti-depressent. Did you ever here of this med?
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Post by Mayleng on Nov 3, 2003 16:48:17 GMT -5
Thanks Crillmom. My son checks under tables and beds to make sure there are no squirrels hiding under them. I understand the anxiety piece you are talking about. Maybe it is a side effect of the Concerta. He really does obsess on things that are not a "real " concern to others. You've helped, thanks. Millermom thanks to you also. Just when I thought I knew it all... I have never heard of vocal tics. He did it before the meds. but it is better now with Concerta. We thought he would out grow it but he has not. Have you spoken to the Doctor about the vocal tics, it could be Tourettes, especially since you said he did this before he started on medication. I would suggest you take him to a neurologist to be checked out.
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Post by Dakotah on Nov 3, 2003 17:33:06 GMT -5
What exactly is Tourettes? What would a Nerologist do? I have never heard of Lexpro. I am assuming it must help with OCD? Are you considering it? We are going to our Child Psych tomorrow and I can ask him more. All these questions... Do any of you have kids that chew/bite their thumb? Just wondering!
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Post by katykersh on Nov 3, 2003 19:27:35 GMT -5
I am no expert but I would agree with Mayleng. It sounds like Tourettes to me. Boy, someone should give us a medal with the things we have to put up with. Dakohta, I really feel for you. This is the place to be though. Lots of information and support here. Millersmom is very informed. I just realized something as I was reading your posts. My son has become more anxious about things since upping his dose of Ritalin. He worries about things like death and whether he is going to throw up when we are out etc. I wonder if I should mention this to the Dr. I think I need to take him to the shrink again. My family Dr. doesnt know anything. The thing about Canada is....although the heathcare system is free for most things, you cant get in to see a shrink unless you are at risk. I don't know how long it will be till we will be seen. Oh well, when I listen to some of your stories I feel lucky because my son is relativly mild ADHD
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Post by Mayleng on Nov 3, 2003 19:28:15 GMT -5
What exactly is Tourettes? What would a Nerologist do? I have never heard of Lexpro. I am assuming it must help with OCD? Are you considering it? We are going to our Child Psych tomorrow and I can ask him more. All these questions... Do any of you have kids that chew/bite their thumb? Just wondering! Tourette syndrome (TS) is an inherited, neurological disorder characterized by repeated involuntary movements and uncontrollable vocal (phonic) sounds called tics. In a few cases, such tics can include inappropriate words and phrases. Go to www.Tourettes.com , there's lots of info there. A Neurologist will be able to dx Tourettes Syndrome.
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Post by tailspin59 on Nov 3, 2003 20:30:21 GMT -5
Dakota and Crillmom. My DS also developed obsessive fears when he first started on Adderal XR. He was could not enjoy a movie or an amusement park because he obsessed over the fact that the place would close and we would be locked in. We would go to the movies and we would have to check to make sure that the theater was not closing several times during a show (we only go to early matinees!). He also was extremely explosive. In kindergarten he kicked another child because she was standing just out of the circle.
It was this combination of behaviors that led or psychiatrist to start him on anti-psychotics in combination with the stims. He is a different child (although he still has his issues- but they show up at home, not in public, and I can deal with that). Sorry so wordy!
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Post by crillmom on Nov 3, 2003 21:18:44 GMT -5
my son had his obsessive thoughts way befpre he was on a stimulant so I know it is not stim related what i think is happening is he is relapsing. he has been off paxil for almost 6 months and that's when they say a relapse generally happens. we are starting him on lexapro tomorrow and going to disney. should be an interesting day.
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Post by Dakotah on Nov 4, 2003 8:48:02 GMT -5
I am going to ask our psycho today and see what he says. This may sound silly but.... Things are actually going pretty good for our family and I don't want to be greedy and want to much for our son. I know it is not being greedy to want our son to be able to interact with others but at the time the Concerta is working wonders!
Good luck Crillmom! Let me know how it goes!
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Post by Mayleng on Nov 4, 2003 9:18:45 GMT -5
Dakota Testing for tourrettes is a lot like test for ADD, it is mosty observing him and Q's to you. They might also want to rule out other things so they may refer him to have an EEG, very harlmess, non-invasive, actually kinda fun, Brain response testing. While there is no cure it will help you to know he might not be in control of these sounds and words. The tics get worse as puberty approaches, as I said, some nice safe meds to help reduce them and there are things you can do at home to help as well.
both multiple motor tics and one or more vocal tics must be present at some time, although not necessarily concurrently; the tics must occur many times a day (usually in bouts) nearly every day or intermittently over more than 1 year, during which time there must not have been a tic-free period of more than 3 consecutive months; the age at onset must be less than 18 years; the disturbance must not be due to the direct physiological effects of a substance (e.g. stimulants) or a general medical condition (e.g. Huntington's disease or postviral encephalitis).
The anatopical location, number, frequency, complexity, and severity of the tics change over time. The tics typically involve the head and, frequently, other parts of the body, such as the torso and upper and lower limbs. The vocal tics include various words or sounds such as clicks, grunts, yelps, barks, sniffs, snorts, and coughs. Coprolalia, a complex vocal tic involving the uttering of obscenities, is present in a few individuals (less than 10%) with this disorder. Complex motor tics involving touching, squatting, deep knee bends, retracing steps, and twirling when walking may be present. In approximately one-half the individuals with this disorder, the first symptoms to appear are bouts of a single tic, most frequently eye blinking, less frequently tics involving another part of the face or the body. Initial symptoms can also include tongue protrusion, squatting, sniffing, hopping, skipping, throat clearing, stuttering, uttering sounds or words, and coprolalia. The other cases begin with multiple symptoms.
If any of this fits your son, I would check out that website Mayleng recommended. While not every child with ADD has Tourettes, a large enogh % do, there is definetly a connection.
The best news is that most kids symptoms disappear after puberty or reduce so significanltally that they go on to lead very normal lives. My school psych is getting me information on self hypnosis that can reduce/nearly eliminate tics by using the technique only a few times a week. It is easy enough for even a young child to do. He is very pro-med and usually balks at these types of treatments, but he said he was so impressed by the effectiveness, he is recommending it to everyone. I'm still waiting for him to get back to me. I hope to hear from him in the next few days with more info.
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Post by Dakotah on Nov 4, 2003 10:02:53 GMT -5
Thanks so much Millermom. I will ask today at our psychologists about Tourettes. It is interesting- here we thought our son's wierd issues were "cute" at age three and four but as he is getting older it is so much more inappropriate He sniffs everything and does this weird twirl with his thumb in his mouth... This all may be part of his Sensory Intergration Dysfuntion also. Thanks again the support is so very helpful!! You are all life savers and I feel like there is a light at the end of the tunnel!
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Post by Mayleng on Nov 4, 2003 10:37:33 GMT -5
Thanks so much Millermom. I will ask today at our psychologists about Tourettes. It is interesting- here we thought our son's wierd issues were "cute" at age three and four but as he is getting older it is so much more inappropriate He sniffs everything and does this weird twirl with his thumb in his mouth... This all may be part of his Sensory Intergration Dysfuntion also. Thanks again the support is so very helpful!! You are all life savers and I feel like there is a light at the end of the tunnel! Dakotah, you do know that with Occupational Therapy, it would "cure/help" his sensory intergration dysfunction, if it is SI.
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Post by Dakotah on Nov 4, 2003 10:59:18 GMT -5
He has been in OT for over three years and we love his therapist. She has been very helpful to us. I have been told by several people that OT should really help him so maybe it is something more than just SI? I feel very strongly that his therapist is doing a great job with him and he has made improvements... I really don't know that much about SI and still struggle with what is normal. Do you know if medication can help SI? Thanks Mayleng!
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Post by Mayleng on Nov 4, 2003 11:35:01 GMT -5
He has been in OT for over three years and we love his therapist. She has been very helpful to us. I have been told by several people that OT should really help him so maybe it is something more than just SI? I feel very strongly that his therapist is doing a great job with him and he has made improvements... I really don't know that much about SI and still struggle with what is normal. Do you know if medication can help SI? Thanks Mayleng! No I have not heard of any medication for SI. I have heard of lot of successes of OT for SI.
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Post by Dakotah on Nov 5, 2003 9:20:01 GMT -5
I asked our OT about any meds helping SI and she didn't know of any...
OKAY- our psychologist said that everything our son is doing right now sounds anxiety related and feels that getting rid of his tics and anxious, impulsive behavior would really help him to interact with others. He suggested Concerta and Straterra. The Concerta has been doing wonders for his hyperness and he said the Staterra will help with his anxiety (tics and impulsivity)? I know NOTHING about Straterra. At any rate I have been following posts about dosing and I am wondering if our doctor is starting our son on the right dose. He is 33 pounds and building up to 25mgs. Should I ask the doctor to keep him at 18mgs for the fist four weeks? 18mgs. is at the lower end of his target dose. This forum has really helped me. I would never of had the strength to add Stretta but I knew from reading that a few of you out there really feel comfortable with it. Thanks friends ;D
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Post by TheirMom on Nov 5, 2003 9:55:37 GMT -5
my oldest also suffered from obsessional thoughts....not too extreme- or so I thought. he would obsess about sharks (?) one time could not take a shower because sharks go in water and there is water in the shower. huh? Anyway, it is not unusual for obsessional thoughts to accompany ADHD. "Deficit" in ADHD is somewhat misleading. Our children often vacillate between low focus to hyper focus, and when an idea gets stuck in their head....... I tried everything, spoke to psychologist about behavior mod, etc. Nothing worked. Finally, this past summer, at 18 years old my son looked at me in the psychiatrists office and said "Mom, I'm so tired of worrying about things. Please let me take something for the anxiety?". I felt like the worst mom in the world. he is on Straterra and neurontin and seems better; we'll see...........
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Post by Mayleng on Nov 5, 2003 10:22:03 GMT -5
I asked our OT about any meds helping SI and she didn't know of any... OKAY- our psychologist said that everything our son is doing right now sounds anxiety related and feels that getting rid of his tics and anxious, impulsive behavior would really help him to interact with others. He suggested Concerta and Straterra. The Concerta has been doing wonders for his hyperness and he said the Staterra will help with his anxiety (tics and impulsivity)? I know NOTHING about Straterra. At any rate I have been following posts about dosing and I am wondering if our doctor is starting our son on the right dose. He is 33 pounds and building up to 25mgs. Should I ask the doctor to keep him at 18mgs for the fist four weeks? 18mgs. is at the lower end of his target dose. This forum has really helped me. I would never of had the strength to add Stretta but I knew from reading that a few of you out there really feel comfortable with it. Thanks friends ;D D,
Strattera has been known to reduce tics. It needs to be ramped up, so I would ask the doctor to start at 10mgs (first) for 4 days, and the up to 18mgs (his minimum target dose) and see how it goes. Your son's target zone is 18mgs (minimum) and 27mgs (maximum). So I would not go to 25mgs just yet as it is on the higher end of his target zone. Also give it with food, if you find that he is tired/sleepy give it to him at dinner time until he gets up to 18mgs for a couple of days then switch to morning dosing. Since he is already on Concerta, this might counter the initial side effect of tiredness.
Good Luck, and let us know how it goes. If you find after a while that 18mgs (after 4 to 6 weeks) is not enough than I would adjust the dose up to 20mgs and if that is not enough then 25mgs. I have a feeling 18mgs would be enough.
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Post by Dakotah on Nov 5, 2003 11:34:46 GMT -5
Theirmom thanks for the post. It brought tears to my eyes. My son worries aobut EVERYTHING. You have helped make this transition a little easier. I can't imagine how hard life would be if you worried not only about real concerns but to add "unrealistic" concerns also...
Thanks so much Mayleng. I will call the doctor and ask if we can switch his dosage. You've been a huge help!
Okay- I called the doctor and he would not switch it. He said you need to trust me, we are starting him on the right dose...blah blah blah. In four weeks I guess we will know. If our son is having problems I will ask him to lower the dose before quiting it. Is it safe to assume that no results means to low and problems could mean to high?
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Post by Mayleng on Nov 5, 2003 14:34:06 GMT -5
Theirmom thanks for the post. It brought tears to my eyes. My son worries aobut EVERYTHING. You have helped make this transition a little easier. I can't imagine how hard life would be if you worried not only about real concerns but to add "unrealistic" concerns also... Thanks so much Mayleng. I will call the doctor and ask if we can switch his dosage. You've been a huge help! Okay- I called the doctor and he would not switch it. He said you need to trust me, we are starting him on the right dose...blah blah blah. In four weeks I guess we will know. If our son is having problems I will ask him to lower the dose before quiting it. Is it safe to assume that no results means to low and problems could mean to high? D, No, either too high or too low you will get mood issues. I think too low you get the whinny, crying, emotional type of moods and too high you get the rage/anger type of mood issues. How is the Doctor ramping him up. He is not starting him immediately on 25mgs is he? This meds needs a ramp up period, or you will get alot of side effects. If he is doing that he is going against everything Ely Lilly says. Good luck and let us know how it goes. Rooting for you.
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Post by Dakotah on Nov 5, 2003 22:17:17 GMT -5
Mayleng- the doctor is starting our son on 18mgs. and then to 25mgs. What is the SOONEST I could see some kind of reaction in him? I know the full effect comes in four weeks but I wondered if we would see any changes before then. Thanks!
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Post by Mayleng on Nov 5, 2003 22:24:57 GMT -5
Mayleng- the doctor is starting our son on 18mgs. and then to 25mgs. What is the SOONEST I could see some kind of reaction in him? I know the full effect comes in four weeks but I wondered if we would see any changes before then. Thanks! Some have seen results within the 1st week, but it really depends on each child. You will probably see some side effects like sleepiness/tiredness unless you give it at dinnertime, hopefully no tummy problems if you give with food. Improvements are gradual, so don't expect to see instant results like stims.
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Post by Dakotah on Nov 5, 2003 22:39:51 GMT -5
Thanks again. My son is super hyper at night. I really didn't think it could be the Strattera but I thought I would ask. (it has only been two days) It is kind of funny though- he is hyper and happy. Usually he is hyper and destructive. Thanks again for all of your help. It really has made a difference in how I am dealing with all of this. No one wants to hear about all of this because they don't understand, especially since our son is so young. We are "bad" parents for using meds. with a five year old. I can finally say that is not true ADHD really is a lonely disorder not only for the kids but for the parents as well...
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