ADHD MEdications

[ABelle]

I am wondering about other parents' experiences with meds for ADHD.  Our D16 w/BPD is going through some major med changes, one of which was the removal of ADHD meds.  After her most recent hospital stay, she was put on lithium and seroquel and removed from Vyvance and lamotrigine.  The idea was that she has bipolar II rather than ADHD.  Since being home, after being in a very depressed state for several days, she seems to be exhibiting what I have always thought of as ADHD - loud outbursts, lack of concentration, and terrible edginess.  She sings almost non-stop, which sounds silly to complain about, but it gets old and she is terribly offended when asked to stop.  Does anyone have any experience with stimulant medication making BPD worse or better?  I know these drugs are not used to treat BPD, but I am wondering if it might have been contributing to her symptoms of suicidal thoughts or self-harm.  Her psychiatrist is open to starting the meds again, and I can see them making a difference for her, but I don't want to make anything worse by doing so.   

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[jellibeans]

Abelle

It is really hard to compare... . what works for my dd might not work for yours. If they suspect she is bipolar then you should see an improvement on new meds. One thing for sure it does take time for the drugs to work and for the dosage to be increased... . during this time is can be very unsettling... . I have seen my dd at her worse when meds were changed.

My dd is on lamotrigine 200mg... . it took months to get her to full dosage... . and she is on adderal for ADHD... . have have seen good results from this combo... . she was on ritalin but I never saw an improvement on that and I think it irritated her to some degree. She also takes celexa for anxeity... . I really find it is her anxiety that causes some of her biggest problems at times. My dd was at one time on prozac... . again I think this meds also didn't help much at all but it is hard to say... . how mush of it depends on her and how she is able to cope with issues.

I had a nurse say to me one time while my dd was in the hospital to not put her on ADHD meds... . she just didn't believe in them... . she looked at ADHD as something the person just needed to learn to deal with naturally. I don't think my dd will be on ADHD meds forever but right now she feels they help... . again I am not sure if they do or not... . she also likes them because they keep her weight down.

Hang in there Abelle... . meds changes can be really hard on everyone

[ABelle]

Thanks, jellibeans.  The med changes are really hard to deal with for sure.  She was such a mess when she got home from the hospital.  Her psychiatrist is transitioning her back on to lamotrigine.  She was working her way up to in her dosage when she was last admitted to the hospital - had been up to 50 mg at that time.  The psychiatrist at the hospital attributed a lot of behaviors we have seen with her (rapid speech, not sleeping, etc.) to bipolar, while in the past these have been attributed to the ADHD.  She seems to have most of these behaviors still except for sleep issues (due to taking seroquell at night). A part of me really wants her back on stimulant meds, especially to help her focus in school (she is in serious danger of having to repeat this semester) and to contain her overall behavior.  To be blunt, she is annoying everyone (teachers, friends, family), but I am afraid it will bring her mood down and make her more irritable.  I would rather have her be annoying than depressed!  Although annoying people is one reason she gets depressed!  Anyways, your advice is wise, I'm sure.  It is going to take awhile to get to the right place with the meds. 

[jellibeans]

Dear Abelle

My dd is on 200 mg of lamotrigine... . and it took months to get there but I really think it made a difference.

I would not sorry about school right now... . I know that seems easy to say but really if I could go back in time and give myself advise... . it would be stop worrying about school. Is your dd on a 504 or IEP? ARe you getting support from your school? I would sit down and have a meeting with them so they are well aware of the problems you are having and ak how they can support you. It is their responsibility to educate your dd... . so I would ask how they intend to help with that given her emotional disability.

Have they DX? is she bipolar? I do think it is important they try and come up with a DX for her. The meds changes are rough and sometimes you just have hold on tight and get through it. What kind of ADHD meds was she on in the past?

[ABelle]

She has been on Adderall, Vyvance, and Concerta.  She switched between meds at times rather than increasing the dosage due to side effects (she has a bit of OCD and sleeping trouble). 

I actually am a teacher at the school she attends, so that part has gone really well.  They are in the process of getting her a 504 plan.  Even without that, we changed her schedule so that she has a period to work directly with the math teacher with a small group so that homework is being done in school.  That has helped her stress level some, which helps my stress level, too.  I am going to have all of her teachers meet so that we are all on the same page.  They are

I believe the aim is to get to 200 mg of lamotrigine with her.  The psychiatrist is really looking for feedback from me about her mental state as to whether or not we should restart the ADHD meds, and I don't want to make the wrong choice.

[jellibeans]

You know your dd best ABelle... . getting a 504 is really a good step for her. My dd16 also gettings accommodations for the SAT (more time) It has been good and the 504 will follow her to college... . I know my dd will need all the help she can get in College if she makes it there!

I really think the lamotrigine made a huge improvement with my dd but who really knows... . I just know we see less meltdowns and less raging but hat could be due changes we have made with her as well. Your dd is lucky to have you at the same school. I feel it is easier to tell what effects one drug is having if I don't try to change too many meds at the same time... . I really can't say this enough but meds changes have been so unsettling and I have seen some pretty off the charts behavior! Good luck... .

[qcarolr]

It is a very individual process to find the best mix of meds. and the benefits can change over time, and BPD is not helped directly by meds. Hang in there!

My initial puzzle was about switching from the lamotrigine to the lithium? These are both mood stabilizers. I have been on both for my bipolarII and the lamotrigine the past 10 years is the only one I am taking now. I took seroquel for a long time too - it did help with sleep - but became allergic to it. I was dx bipolar at age 35 and am now 58. I have tried many meds. over these years.

My BPDDD27 has tried many meds with very little help. As an adult she benefits from prozac for her depression and anxiety (panic disorder). She claims she needs stimulant to think more clearly -- IMHO she has a substance abuse problem with stimulants. She blames this on taking ritalin as a child -- she never got beyond 5mg of ritalin or any other stimulant without becoming very very aggressive. She is a very complex bundle.

Gd8, that we are raising, has recently been dx ADHD along with some anxiety and PTSD. She responds best to time release versions of meds. both the Intuniv (anxiety and hyperactivity) and now the Adderall XR (inattention). She has responded by leaps and bounds with the Adderall - in school, at home, in neighborhood. She also has increased mood aggressiveness when she comes off the Adderall. We have to watch that effect.

It is so complex. Ask lots of questions about how long it takes to work, wear off, interact with other things. It is also hard to discern how she is impacted when they change more than one med at a time.

The most important result for me is that gd8 is now able to respond to rational and logical parenting strategies, she is able to interact and participate with other kids in her class and neighborhood -- and own her part of issues that come up, and to speak her needs and desires clearly. So many of the tools I have learned here for coping with my DD27 (that don't really work with DD as she refuses treatment and mixes street drugs with the rx meds... . ) WORK with gd8.  I am cautiously hopeful that BPD will not be in gd's mix of dx as she grows up.

qcr

[ilusa26]

My daughter has taken some sort of stimulant for last 15 years. Two weeks ago, new dr decided to do away with simulants.  She is very angry about it.  But doing a little better now.

I read somewhere that if you are bipolar and take any of th ADHD meds, your bipolar symptoms get worst.

This all very confusing.  Drs push meds, therapist says only therapy works.  my daughter takes meds, goes to therapy and still not doing good.  i fee she is not putting as much effort or is not able to put much effort.

[jellibeans]

I try to look at my child this way... . when my dd knows better... . she will do better. I think that helps me not be too judgemental towards my dd... . not to go down that road of "if only she would try harder etc" I have to believe she is doing the best she can right now with the skills she has learned.

It can be very frustrating because we can see what she needs to do and at times it is like watching a car wreck and not be able to stop it. I really try to believe that if given a choice my dd would rather be living a happy and healthy life... . in time she will get there... . it is going to take longer for her but she will get there

[ABelle]

I so appreciate all of the feedback!  I definitely hear from everyone the importance of being patient.  It is so hard to do sometimes! I  also have gotten the message from many different sources that with BPD, the change has to come from the person with the disorder.  Our dd really struggles with that, as she is quite emotionally immature.  She is really having trouble finding the motivation to change herself.  In fact, she has stated that she isn't sure she really wants to get better, because it is easier to do nothing. 

I don't imagine that medication will make her BPD go away, unfortunately.  I am hoping, however, that with the correct cocktail, we can get some of her other issues under control in order to get her to a place where she is open to and motivated to pursue her own recovery.  I guess I am not convinced she has bipolar disorder in the first place, so I hate to be trying to treat with meds the symptoms of a personality disorder that won't respond.

We sat down to discuss it last night, during a very positive and honest mood from her, and she would like to try the Vyvance again.  I am happy that her psychiatrist is moving slowly, so it will be another two weeks before we have a chance to do so.