Question about ADD,PDD-NOS and meds.

iVillage Member
Registered: 06-26-2004
Question about ADD,PDD-NOS and meds.
19
Sat, 08-05-2006 - 8:19pm

Hi all.. I have posted here before but I think it was too long ago for me to even remember.. My DS is 6yrs old and has been evaluated 3 different times before getting a dx of ADD and PDD-NOS (They believe he has AS but he needs to go to a seperate place for further evaluation) And along with therapy they are recommending medication.. The psychiatrist recommends concerta or another stimulant for his ADD, while my pediatrician recommends stratera a non-stimulant.. Even though both agree that either medication can have ill affects on my son (he has anger issues and they are afraid it could become worse).. I am just wondering if anyone out there has a child with both ADD and AS (or PDD) and has any advie on medications or treatments..Thanks in Advance..

Jennifer.. mom to Patrick (6), Autumn (4), and Timmy (9 months)... (yes, I have my hands full!!)

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Avatar for cathby
iVillage Member
Registered: 05-16-2003
Sat, 08-05-2006 - 8:54pm

Hi Jennifer,

My DS is only just 5 (PDD-NOS) and hasn't been on any meds. But I thought I'd share what I learned from our dev ped.

There is a HUGE overlap of spectrum kids who have ADD. About 2/3 of them. As for meds, the ones that often work for just ADD kids usually don't work for ASD kids. They don't know why.

HTH,
Cathy

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Registered: 03-26-2003
Sat, 08-05-2006 - 10:31pm

Many, Many (in fact I would say most) ASD kids also meet the criteria for ADHD. Both of mine have had those as diagnosis at some point in the past. The difference is what is causing the attention troubles. Is it true ADHD or is it a effect of thier challenges with ASD. For Cait, she has horrific executive functions which look a whole lot like ADHD inattentive type (ie ADD). Mike has sensory integration problems and auditory processing problems which help him to meet just about every single ADHD criteria.

I have tried ADHD meds with both with poor results though some folks who use ADHD meds with ASD kids do have good results. It depends child to child. However, with an ASD child you need to be extra watchful as it can make them more irritable, inflexible, withdrawn, obsessed, etc.

Mike has tried stimulants, SSRI's and stratera (oh yeah and welbutrin). Stimulants start by helping his attending but he became more obsessed and rigid. Soon he became more withdrawn and irritable and before long he was unbearable. SSRI's helped for a while and then had an opposite effect after quite a while causing his behavior to become much worse. Weird paradoxical effect that happens to some, not all. Kind of like why they have the warnings on SSRI's about it causing depression in some teens. Stratera and welbutrin didn't really do much at all for him. I noticed no difference even going up to the max dose and there were other side effects like nausea.

Cait has only tried stimulants for the ADHD once when she was little. She instantly stopped sleeping and became a monster. Horribly aggressive which she had never done before in her life. Thus she has been on ADHD meds only once and only for 3 days. She has tried other meds for things but nothing else for the ADHD. There is no med to help her organizational skills and constant flakiness.

Renee

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Registered: 02-21-2006
Sat, 08-05-2006 - 11:34pm

Hi. I am mom to a 7.5 year old. He has been dx'd with SID since he was just 2 and after years of getting conficting ADHD dx's (which I never believed were correct), last year he was "officially" dx'd with AS, although we had worked with a wonderful doctor who said if it were still available as a dx, a right hemisphere brain disorder seemed to classify it perfectly. Unfortunately they updated the DSM IV, and that is no longer a diagnosis. Anyhow...

So my son was dx'd and I finally, after many years of school telling me to put him on meds, agreed to try something. He is very petite, and I was not thrilled with putting him on meds to "mask" his issue, so I tried everything in my power to help before taking this step.

He began on a bi-polar medication last year, Risperdal. It is not approved for as, or any spectrum disorder, but it is commonly used off-label by psychopharmacologists. I've been so far very happy with the results, although he's gained weight (increased appetite is a side effect of the meds, one we certainly saw as a positive), and we've adjusted his medication dose, I feel like he's reached his max with it, but I and his counselors and teachers saw an immediate response at the lowest dose. I'm certain not all doctors recommend this drug, but after careful thought and research I decided to try it.

Best of luck to you!

Nicole
mom to Dominic (7) and Nathan (4) and Bonus-Mom to Lauren (6)

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Registered: 04-11-2003
Sun, 08-06-2006 - 8:55am

My son has AS and was never given an ADD diagnosis but would certainly qualify for one. I think the doctor thought the AS covered that. No one ever suggested medications for him suprisingly, school or doctor. Maybe they just knew they'd be wasting their breath. For my son what helped the most with attention was Theraputic Listening and OT/PT. His ADD is mainly caused by autitory sensitivity and sensory integration issues.

Samantha

Samantha
iVillage Member
Registered: 06-03-2006
Sun, 08-06-2006 - 9:11am
My son 8.5 has AS -PDD and was recently dx with ADHD. Prozac helps with the anxiety he has. Recently he started depakote. Not sure about the results. Son is stll busy and he "touches" everything. He had stopped that for a while. I'm not sure if this is due to summer schedule, change in school, etc. His anger issues seem to have quieted with the prozac and therapy.Dr did mention ritilin and stratera as a next possible step.
Best wishes with whatever you decide.
iVillage Member
Registered: 11-07-2004
Sun, 08-06-2006 - 10:03am
My son is 6 years old also and has been diagnosed with AS and ADHD. He has been on Adderall 10 mg for about a year or so. While I am not a fan of medicating him, we know it is necessary for him to succeed in school. We have taken him off it for a week here and there to see if it "really" works and let me tell you it works. The week he was off the medicine, he was a nightmare at school. Now, the only side effect that concerns me is the loss of appetite. My son only weighs 38 pounds and is literally skin and bones. One thing we have been doing recently is not giving him the medicine on the weekends (just to torture ourself-LOL) so he will eat more. He does seem to eat more but he isn't gaining weight. He is 6 1/2 and wears a size 4 (and sometimes that is big).
iVillage Member
Registered: 02-20-2001
Sun, 08-06-2006 - 10:07am
Have you ever tried Adderrall XR??

 


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iVillage Member
Registered: 11-07-2004
Sun, 08-06-2006 - 10:49am
We have only used XR and my 12 y/o daughter does as well. My son (6) takes it and we always do the applesauce bit. However, a week ago he decided he wanted to swallow the pill like a big boy. Milk works best on swallowing and he has been doing it ever since. He never really complained about the applesauce, but after he started swallowing the pill he said it was way better than the nasty taste before.
iVillage Member
Registered: 09-12-2004
Sun, 08-06-2006 - 12:07pm

My older son has ADHD and is also AS. We've had a little different experience than some of the others here. First, his then psychiatrist put him on Adderal XR and it was truly horrible. He was okay at school but when I would pick him up I dreaded it. His tantrums lasted hours and he was on occasion violent. I had visions of having to put him in some kind of institution. That psychiatrist kept wanting to increase the dose or give doses toward the end of the afternoon because of the "let down" but that only postponed things until bedtime, which was disastrous. I finally decided to take him to a psychologist and he was dxed with AS. The psychologist suggested a different psychiatrist and recommended looking into Concerta because he had noted that a lot of younger kids had trouble with the Adderal (but then during adolescence they did better on Adderall vs. Concerta). We decided to ask the first psychiatrist about Concerta and the AS dx, and he said he doesn't believe in Asperger's. That's when I realized if he can't prescribe a pill for it, to him it doesn't exist, and frankly, he was just not listening to me at all about Ian's symptoms so it was not a hard decision to change doctors. We went to the psychiatrist our psychologist recommended. Now Ian is on Concerta and it has made a wonderful difference for him and for us. Now that his ADHD symptoms are under control we can work on the social issues, impulse control, learning consideration for others, etc. He's not so overwhelmed by inattention and all that comes at him, which helps his AS symptoms because it reduces his stress. He doesn't have the tantrums and inconsolability that he had on Adderall. Not to say we don't have ANY ISSUES, LOL! We still have plenty, but we can work with them now, where before Concerta it was impossible. He was just too distracted and agitated and we literally could not do anything with him.

My other son, now 5, has been dxd with PDD-NOS. He has absolutely no trouble paying attention and I wouldn't dream of putting him on ADHD meds.

When structure, positive parenting, and working with a therapist who understands ASDs does NOT help much and a child is still unable to control impulses, or pay attention to a bed time story, or any other task -- even those they enjoy, cannot sit still and is bouncing off the walls, furniture, hanging on cabinets, etc. ADHD and meds should be considered.

My opinion is keep an open mind. Don't determine that meds are the answer, but don't rule them out, either. If you decide to do meds and the first doesn't work, maybe go ahead and try another. Make sure you have great doctors who thoroughly understand autism spectrum disorders as well as ADHD and use your own parental radar -- if you don't like the doc, no matter how well recommended, find another.

I hope this helps a little and you get to the bottom of it very soon.

Kelly

Avatar for littleroses
iVillage Member
Registered: 03-28-2003
Sun, 08-06-2006 - 12:13pm

My oldest daughter was on adderall for a couple of years when she was younger. The results were that she lost a lot of weight and she was already skinny. She looked skeletal. It improved her ability to write neatly. It improved her school work somewhat. It did not help her behavior though and the behavior was the real problem for her. I decided to take her off it because I wasn't seeing the results as being greater than the side effects.

I've had luck addressing her allergies and reducing phenols tho. And she's mellowed out a lot when she turned 12. You might consider taking him to an allergist for environmental testing. I had noticed over the years her behavior was doubly worse at certain times of the year and it turned out she was allergic to specific things(weeds in the fall and trees in the spring).

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