Gifted Issues Discussion homepage Forums Twice Exceptional ADHD-Vyvanse vs. Concerta

I think they recommend "testing" for Tourette's before using stimulants b/c stimulants can exacerbate or bring on tics that a child is already predisposed to. I'm not sure if it's true that the stimulants actually CAUSE the Tourette's. It is my understanding that the meds do not cause the tics, they just increase the chance that they will actually manifest. Sounds convenient though, huh? We haven't seen anything like that so far, but it's only been a week.

This is such scary stuff for me, and for many others. I'm scared to death to give ds the meds, but then I feel that I'm not meeting his needs if I withhold it. He was simply not functioning in a classroom despite changes in setting (home-school, Montessori) and increased difficulty level of work. We've tried accommodations at home and interventions in the classroom. It's just gotten to the point that the ADHD is evident, and it's so frustrating that there's no great treatment. I guess it's like that for many families dealing with ASD, depression, anxiety, and other physical and psychiatric disorders as well.

I'm keeping my fingers crossed that the Vyvanse will work for us. I hate the thought of countless medication and dosage changes. Right now, ds seems to be doing well for the most part. He's completing his work at school and is able to focus. The downside is that we have to really push the food intake. He doesn't have much of an appetite. He's starving every morning, so he eats a huge breakfast, but he's still not really hungry by dinner. He eats a decent amount at dinner, but not enough to make up for eating very little lunch and skipping snacks. I think this is why he wakes up between 5-6am every morning. His tummy is empty.

Also, he is still emotional on the meds. Two days this week, he had just two or three emotional moments at school. Yesterday, he cried off and on all day at school. It's like a sadness rather than frustration and anger (his usual M.O.). The teacher said it's like how a child acts when they are really tired. He doesn't seem tired, but stimulants do slow down the brain in people with ADHD.

Speaking of, DS sometimes complains that his brain isn't working right. He actually said, "I wanted my brain to slow down, not stop!" Other times he says he feels great because he's able to shut out all the noise around him and concentrate on what he's doing. On those days, he says he can think "better" than usual. I'm going to give it another week or two and see if things balance out a little more. If not, I guess we'll be reducing the dose (already on the lowest dose, so we'd have half it) or changing meds. Patience is not my strong suit.

Right this minute I am cracking up laughing. DS just walked out here all dressed and ready for the day, bed is made, breakfast dishes are in the sink, teeth brushed, and room clean. He even made his bed and carried his dirty clothes to the laundry room. This is the same kid that I usually have to tell at least 5 times to do just one of those tasks, and I often have to go in and physically help him get started. He's happy and pleased with himself for doing those things. But, in a couple of hours I'm afraid he's going to get sad. : (

What a roller coaster! Thanks for "listing" to me vent. I have rambled on and on here, but sometimes it just helps to get it out, right? Thank you for all of your responses. It helps me to put our situation in perspective when I hear others' experiences. Misery loves company...safety in numbers...something like that.

Definately not rambling. Many of us have been there and completely understand.

You're not kidding, CFK! LOTS to worry about. I'm about to worry myself sick over this whole med issue. While my ds6 is certainly able to complete more work, is more compliant, and is calm most of the day, I feel like there are too many moments that I'm missing the essence of his personality. I am really hoping there's some balance somewhere, some magical medication or dosage that will not only allow him to be himself but also allow him to excel. He still has a period of time during the day when he's sad, a part of the day when he's really tired, and a time of day where he's almost euphorically happy. Then he gets manic when it wears off. These are not drastic mood swings. In fact they are quite subtle, but it's enough that I certainly notice them. When he doesn't have the medicine, he's absolutely unable to focus and concentrate on much of anything these days. But, I do get to see his personality more. I can't decide if it's his personality that's so different or if I'm just not used to him being so calm and unintrusive. I'm used to him being stuck to me every minute we're together, saying, "mom, mom, mom, you know what....listen to this...can I?...." Now, I look around and he's in him room playing alone silently...and it makes me kind of sad. Usually, his mouth doesn't stop. He literally thinks out loud. Well, before Vyvanse. Am I crazy? Am I just mourning the "loss" of my immature, inappropriate boy instead of embracing the mature, motivated, loving young man that I am currently living with? Ahhh...rambling again. Why does this have to be so hard? I know many other people deal with much bigger issues than this, so please don't think I'm feeling sorry for myself. Just want to figure this out and help my little man.

That is what happened with my little man, We didn't know it was tourettes at the time. I have gone natural in the past month wth focus factor for kids and am trying the gummy omega fish oil. something is improving not sure if it is one of these but could be. He is having no side effects from either of them.

Thanks vicam. That's wonderful that you are seeing results! I am going to keep that in mind. We are actually going to try cutting the dose in half to 10 mg. We'll see if he's able to keep the same level of focus without the side effects. I'll post results in a day or two.

I think you probably are mourning a loss here. Ever hear of Stockholm Syndrome? OK, I'm exaggerating for comic effect, but there is a whole kernel of truth to this joke.

It's ok for you to be having feelings right now - you've been through so much. Does he mind the 'sad period?' If not,and if it's no worse than you've described above, then I strongly urge you NOT to play with his medication dose this week. He has a lot to mourn as well, now that he sees how mature he could have been these last few months. For all you know he is still adjusting to the dose he is on, and in another week all these subtle shifts may be gone all by themselves.

Go back to your basic 'Energizing the Positives'
When he is sad say: 'I love the calm wisdom you are showing right now.' or 'I love how you are handling your feelings right now.'
When he is tired, compliment him on how well he is handling himself, even though he is tired.
When he is euphoric celebrate with him how good he feels.

I'm not promising that you won't eventually change drugs or dosages, but I can promise that if you cut his does in half right now, you are sending a message that you aren't sure that you want him to grow up and be this new mature self. Give yourself the gift of a little more time. We don't have to be hypervigilent all the time, yes?

BTW - I'm currently reading Deirdre Lovecky's 'Different Minds' which is about her experiences with Gifted kids of various levels of giftedness who also have ADHD, NVLD or AS. Fascinating!

Love and More Love,
Grinity

Grinity,
Thank you! We actually DID cut the dose in half today based on the doctor's advice. The teacher is saying that he's emotional all day at school (crying, practically hyperventilating with some obsessive compulsive type behaviors). When he's at home, we just see the very subtle changes in mood. At school, apparently, it's pretty drastic. He is getting his work done, though! So, the doctor thinks his dose might be too high. We'll see how it goes over the next day or so. This is not fun, but I actually think he's feeling better about himself in general. You asked if he is bothered by the sad moments, and I honestly don't think he is. He said today, "I hope I'm not so emotional today, but I REALLY hope I can still focus." As for the positive reinforcement, I am praising him when I see him handling things so maturely. He actually came home from school yesterday and spent almost an hour writing in his journal. He's writing a novel about his adventures. If you recall, a few weeks ago we though me might be dyspraxic!
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Do you really think that we might need more than a week for the medication to "balance out"? I am going in to observe later this week. I want to see the "severe emotionality" for myself.

Now that I hear what the school is saying, and that you have 'doctor supervision' I'm totally comfortable. Without those other pieces of information, I was worried that perfectionism, overfocus and isolation were having their way with you. As a group we tend to be vulnerable to those forces.

It did take a few weeks for my son's 'twichiness' and emotions to balance out. It bothered him slightly for 3 weeks and then totally dissapeared. It took us 4 different medications, each slowly being bumped up to the right dose a week at a time - so when I talk about second guessing myself, I speak from experience.

My prayers are with you and your family that you find the 'happy medium' soon.

Love and More Love,
Grinity

Thank you Grinity. I'm dying to hear how ds did today. I wish I could be more relaxed about this.

Well, the verdict is in, at least for today. DS6 took 10mg of Vyvanse (a half dose) today after being on 20 mg for 9 days. He was just as focused as he was on the higher dose, but he didn't have the emotional side effects! Hoping this continues, but for now I'm trying just to be grateful for each good day as it comes.