Medication for ADHD in High School

Parent Q&A

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  • Our daughter was medically treated for ADHD with 3 variants of the one class of compounds that worked for her from 3rd-12th grade . This was the right solution for her, and enabled her to have a happy childhood with social and academic success. Now a young adult, she finds that none of the medications that she took through high school nor any others that she has tried since are effective. She is struggling terribly to stay afloat academically at UC. She has a psychiatrist, a therapist, and an ADHD coach provided through student health. The psychiatrist believes that Daughter has developed a tolerance to the medications in the general class of compounds that used to work, Daughter has not experienced significant benefit from other classes of ADHD compounds. Psychiatrist reports that there are no other medications to try. Has anyone else experienced anything like this? Any recommendations for medications that have worked in similar situation?  If anyone has recommendation of a doctor accessible through UC SHIP or Kaiser would be greatly appreciated. Lectures about medicating children to manage ADHD would not be appreciated. Thanks.

    Hello and this sounds hard. I’m so glad your daughter thrived on her treatment — and I agree that it is strange that the treatment no longer has an effect. I’m a family medicine doc with a focus on adolescent health and I’m currently in a psychiatry fellowship — I will pose the question to my mentor re: Neurocognitive changes in youth around 20 years old and ADHD treatment. 
    In the meantime, in case this hasn’t been covered by her treatment team:

    is it possible that she’s using THC?

    is it possible that depression and or some kind of manic mood disorder is newly emergent?

    as a young adult newly living alone, is it possible that she is inadvertently not taking the medication regularly?

    I’ll post any response I get from my mentor.

    good luck and I’m glad she has such a supportive mom!

    I do think (& worry) this can happen but I’d be irritated if the doc isn’t willing to try meds even if your daughter has tried them earlier in her life. Also, I understand from my sons psychiatrist that it is state of the art treatment to augment a daytime stimulant with a non stimulant guanfasine (?) & similar med to take in the evening. My son took Foccalin XR 5th through 10th grade & it stopped WORKING & we’ve spent 18 mos finding a replacement. Now he’s taking a pretty high dose of Adderal short acting twice a day. If this works for the next month we’ll add guanfasine. He’s off to college soon & need to get this worked out.

    good luck!

    I am a retired teacher and have an 18 year old son who has been taking Prozac for anxiety for some years.  Within the past couple of months, I've had him do some weekly neurofeedback sessions (33 minutes each) and they seem to be helping him be more focused and calm.  I've done about 5 sessions myself and feel more focused and calm, too.  Apparently, the neurofeedback can also be effective for providing relief from ADHD symptoms.  This is a non-medical solution and I thought I'd mention it, just to give you another option.  We go to a place called the Bay Area Brain Spa, on Solano Avenue (one block below San Pablo Avenue).  The two owners are very helpful -- Carleigh and Angela.

    We had a variation of this happen and tried the Daytrana patch which, even though it's the same class of drugs, was like trying an entirely new thing. Like you, medication enabled my kid to succeed academically and socially in a way that was impossible before.  I cannot say enough how different the patch experience was for our teenager, who said they didn't realize how much of their day they spent feeling weird going on/off the medications.  It changed their ability to interact in such a positive way for so much more of the day.  Our dr, an "expert", said he'd never prescribed it in decades of practice. Might be worth a try.  Most dr's don't seem knowledgable about it.

Archived Q&A and Reviews


Questions

Child/adolescent psychiatrist for ADD meds management

Oct 2011

I am looking for a child/adolescent psychiatrist for medication management for my child who has ADHD. I would prefer someone in the El Cerrito/Berkeley area, but I will also consider someone in other areas. Thanks! anon


Hal Bornstein, MD, is a very experienced, skilled child, adolescent and adult psychiatrist who recently retired from Kaiser and started a private practice in Oakland. 510 658-1877 Kate


I have feedback regarding psychiatrist Hal Bornstein that differs greatly from the previous poster. I have seen him with my child as the patient. Dr. Bornstein had such an objectionable bedside manner that I, my husband and my child walked out of the office before the appointment was finished. He is abrubt, not compassionate and gave us an overall bad feeling. We never went back. He may be good at the science part of psychiatry but definitely not at the art. Not a fan


Doctor to manage meds for teen with ADD

March 2010

Re: Need new Dr. for teenage boy with ADD
My son sees Dr. Paul Abrinko for his ADHD. Dr. Abrinko is a psychiatrist, he relates very well to both parents, teens and children. He is also very knowledgeable regarding the wide variety of ADHD/ADD treatments available. He is not covered under all health plans, so can be expensive out of pocket ($250 per visit). My son sees him twice a year and his expertise is worth the expense. His office phone is 510-496-6014. East Bay Mom

 


Adderall and facial tics - 17 year old

Nov 2007

does anyone have any info on adderal and facial tics? my 17 yr old was put on adderal for a diagnosed adhd, which he took sporadicaly, maybe a total of 10 times. i removed him when i noticed the facial tics. he has not been on any medication for about 4 months, but the tics have gotten worse, with the neck stretching, grimmacing, etc. thank you kat


It sounds like you need to get back to the doctor and report this, as well as the fact that the first trial of dosage and type of medication didn't seem to work out. Those facial tics sound noticeable enough that they might produce some social fallout and embarrassment for your child. There is really great information about AD/HD and co-occuring conditions on the websites of schwablearning.org and the National Resource Center on AD/HD at www.help4adhd.org. In my experience as an educational therapist who treats adolescents and adults with AD/HD, the road to optimal medication can be a long one, and working closely with your doctor is important. Don't give up too soon. These facial tics are probably distressing, and your doctor may want to change medications because of them. You're an important partner in the treatment because you provide the observations in real time. Good luck. linda times and I really do not understand why people are so hesitant to just TRY something. I do not see what the costs are in terms of trying this drug--it is completely reversible. I think that there is so much angst about medication for mental conditions and some hidden fears of addiction that people do not realize this is NOT really a big decision. You are not getting married to Ritalin, you are meeting briefly for coffee!!! Then if things work out you will date a bit while constantly re- evaluating your relationship!

My one caveat is that you do need a doctor who knows what they're doing and is going to be systematic, knowledgeable and objective about what is really a PROCESS. The MD shouldn't just throw the prescription at you and run. They've got to check in with you and follow up and keep tabs on your kid's growth. best wishes


Having recently seen a therapist who owns a business specializing in ADD/ADHD I must say that I warn you to procede cautiously when sending a child to therapy, ie to meet with the therapist yourself first, and gather your own opinion, before sending a child in. I am still going thru self-esteem issues that arose DUE to his approach, not being helped by his approach. The therapist, himself having a disorder, which was I thought the best part about him, that he admitted his own condition upfront, was often late for the appointments and worst, very negative in his beliefs about ADD/ADHD once you get to the point of ''diagnosis.''Upon ''diagosis'' which consisted solely of appointments with him and costly forms, he then recommended that I continue on with their other ''services''-- such as coaching-- which of course, they so happen to offer. It seemed more of a snag-you-in type of business than working with ones needs. anon


Educating yourselves is essential, so read, read, read and visit reputable websites. I suggest SchwabFoundation.org, helpforadd.com, CHADD.org and ldonline.org for a few to start with. Watch out for emotionally based information. There's lots of good science focused on ADHD and you might as well benefit from it. You can be more of a help to your child if you feel authoritative because you have excellent information. Some big thinkers in this area (and they don't all agree) are Russell Barkley, Peter Jensen, Ned Hallowell, Mel Levine and John Ratey (the last two are my personal favorites). You could drown in the amount of information, but you have to start somewhere. An ADHD diagnosis provides useful information that can avert difficulty for your child. It doesn't have to be sad, although it is a challenge for sure! Best of luck. LL


I have ADD/ADHD.

1. Local resources: local CHADD chapters, support groups etc etc can be found at http://www.chaddnorcal.org. It's a great starting point and you will be welcomed at our meetings!

2. Information: there's a lot of misleading information and scare stories out there. I'm an engineer and like to understand how things really work under the hood. The best book I have read which has real, hard research-based information is by Paul Wender ADHD: Attention-Deficit Hyperactivity Disorder in Children and Adults. Oxford University Press, 2002. It goes into the neuro-chemistry, clinical case-studies etc.

3. Meds.

* I take meds every day and they're helpful.

* Delaying meds will not *harm* your son.

* Ritalin may or may not be the *right* medication - it did not work *for me*. If it makes a positive difference, great. I had BAD sides effects with Strattera which, anecdotally, are experienced by many males although denied by the pharma company. The only times I ever got driving tickets was when I was prescribed amphetamines.

* Meds ''the most effective treatment bar none''? This underestimates the significance of complementing with non-medical support. In my and my friends' experience, meds alone are NOT enough, and you may need to experiment with various organizing strategies and techniques. If you can get him into various habitual daily rituals (making lists and checking them) it will make a huge difference, especially when you and supportive adults are not around.

4. In my experience, many non-specialist educators and medical staff talk very knowledgeably about ADHD although (a) their knowledge comes from third-hand sources and (b) is several years out of date, typically gained through CE credit courses.

5. ADHD is a gift as well as a frustration. Find ways to exploit, develop and enjoy the positive and creative and fun sides of ADHD as well as 'fixing' the disadvantageous side-effects. This will help your son It is important to understand that your child does not have a problem, but a condition. Steve