Wednesday, October 05, 2011

The Medication Dance

Ok... bear with me, I'm going to go through some history here... Nolan was diagnosed with ADHD in September of 2009. His presenting symptoms being issues with impulse control and hyperactivity. (You can also have a focusing problem with ADHD but at 4 years old I didn't notice that as much as the others.) He was like a live wire... a pinball unable to stop. He was happy and joyful for the most part (some fits etc) but was unable to sit still ... could not follow directions to save his soul and was just really really hard to try and parent. Constantly into stuff he shouldn't be (when he definitely knew better)... being waaaayyy to aggressive with his brother, other kids, the cats... not always on purpose etc. Being in public with him was a full fledged nightmare. He'd run off, skip around shrieking at the top of his lungs, throw stuff, knock stuff off the shelves. AWFUL.

Anyhoo. He was put on Focalin... the change was immediate. He was calmer and able to follow directions... he didn't run laps around the living room screaming at the top of lungs anymore. But he was also sullen, teary, angry and withdrawn. He was not my boy.

He was switched to 5 mg of Adderall extended release and we saw an immediate improvement in his mood. He was still controlled, but not so withdrawn or sullen. He still had some mood swings, but overall it was eons better than before. July of 2010 he was switched to 10 mg of the same medicine. We didn't feel like the 5 mg was cutting it anymore.

He started school that fall - Kindergarten. I was so worried how he would handle it. SO. WORRIED. But he did great. Focusing was definitely not an issue... in fact, his teacher voiced to me several times that she would like to see him unmedicated since he was so quiet and reserved in class. There were a few times he went to school unmedicated and she saw no difference. But the minute he would get home it was balls to the wall craziness. I couldn't believe the difference.

Towards the end of the school year... that would be June of this year we went through a really REALLY rough patch. He started lashing out at us and at his brother... violent angry outbursts. Fits that would last the better part of an hour. Screaming so loud I was afraid people were thinking we were skinning him alive... it was awful. We immediately got him into counseling - once a week.

During this time I had been diagnosed with ADHD as well. I was put on Adderall as well since it seemed to work well with Nolan the doctor theorized that I would probably do fine with it.

I took 10 mg at first and then 20mg and then back to 10 and then I quit taking it. I had the basic side effects of loss of appetite and crazy energy. I also would have these pretty awesome moments of intense rage where I hated everyone... and wanted to rip people's faces off. It was tolerable at first but then I was just feeling angry and bitchy all the time.

In August the counselor suggested moving Nolan back to 5mg... in the studies that she had both me and Nolan's teacher fill out in June my answers scored him being impulsive and hyperactive (shocker!) and his teacher scored him as being depressed and withdrawn. She thought perhaps he was being over medicated.

So we did switch back and he did do better. It got a bit touchy when school started and he backslid with the lashing out a bit (but not nearly as bad as it had been when school let out.) He was prescribed 5 mg of extended release to be taken in the morning and 5 mg immediate release for the afternoon. I haven't had the school start giving it to him in the afternoon yet, but he gets it on the weekend. He still has lots of moments of being a bit wild and unable to chill, but if we can get him into an activity he does much better. I don't know if it's that he's matured or what but he definitely seems able to focus even when not medicated and not in school, but it does take quite a bit of parental involvement to get him there. He also shows a lot of remorse when he's behaved inappropriately and will apologize profusely. But I am still finding him to be cranky and moody and sometimes downright rude when on the meds.

So with all this in mind, these are the conclusions I've come to.

1. Perhaps it's time to switch meds. After my experience with Adderall I really do think it's affecting his mood negatively. Maybe it's time to try a non-stimulant.

2. I'm tired of yelling at my child because he's either out of control with hyperness or he's got a shitty attitude. There doesn't seem to be a middle ground with this... one extreme or another, maybe a nonstimulant will help that.

3. He is a good boy. A sweet boy. I don't want his childhood to be riddled with memories of being yelled at, being repremanded, being punished. (at least, no more so than a typical kid.)

4. I don't understand why he is completely able to be in control at school... and then have it go completely out the window once he gets home.

5. At 6 years old the pediatrician said 5mg is an extremely low dose, especially for a kid who has been medicated for 2 years. This to me is telling that he is probably more capable of controlling himself than we give him credit for. Or maybe I'm wrong and I'm setting him up for failure. Or maybe I'm right and we're drugging him unnecessarily and turning him from my nice sweet boy to my sweet boy with awful mood swings.

At this point I just think it's at the very least worth a discussion. I'd love any thoughts or experiences on this topic... I feel kind of lost sometimes figuring this out.

Photos below are from when we went to the zoo with my friend Heather and her family A MONTH AGO. GAH. I mean to be better about updating!








No comments:

Post a Comment

Leave a Comment