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Child Behavior (Expert Forum)
ADHD associated with OCD § depression
Answered by
Kevin Kennedy, Ph.D. - Child and Adolescent Psychotherapy, Family Therapy, Crisis Intervention
Harvard Vanguard Medical Associates
This forum is for questions and support regarding child behavior issues such: Child Discipline (behavior management), Normal Child Development, Parent-Child Communications, Social Development
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ADHD associated with OCD § depression
by Baylee's mom, Mar 28, 2004 12:00AM
My son is currently 7 1/2 y.o. & was diagnoised with ADHA 2 yrs. ago. My husband refused any medication 2o to long-term side-effects. For myself, I knew the improvement in his focus, attention, diff. in school by being on treatment would far outweigh any side-effects, as I grew up un-medicated and have difficulties to this day with attention problems.Anyway, finally the severity of obvious known symstoms acerbated to the point of constant uncontrolled hyperactivity in school and obsessive disruptiviness (blurting, as his teacher called it) last year in 1st grade. So before the school year of 2nd grade started the Dr. finally insisted he start on 5mg. of Adderall q. am for him to be able to pay attention and keep his hands to himself and not blurt uncontrollably. Even though he is very hyper with OCD tendencies he is extremely intelligent!! He's very good at comprehending what he reads (which is against the norm), very, very creative, excels in math and reading. His favorite past time is building lego's with 1000 pieces. Also has entered lego contests for most original free-lance designs.
His life as a 2nd grader improved dramatically!! For the 1st 3-4 mos. he seemed like a completely different child. The school evaluated him with marked improvement. He weighs 62 lbs.& the dr. now decides he needs to take his med. bid, which I wasn't in favor of since he had done so well with just the am dose. But after a month or so of increasing the dose he would get very, vey depressed by 3-4pm to the point of a nervous-breakdown!! He just keep saying he needed help, needer to see a dr. as his brain wasn't working right. This episode continuded for nearly an hour to the point of being hysterical, but left as fast as it hit him. He has continued to have OCD tendencies (continuously picking at his nails and lips) which is the only adverse problem his teacher has noted, not the depression). My concern is weather to try AderallXL or Concerta along with Paxil that may help control the underlining OCD tendincies. The dr. is only a GP (as we relocated from a large city 2yrs. ago where a psy. made the dx) and by transfering of records and the recommendation of Adderall being made back then) he went ahead and prescribed due to his severe difficulty noted by the school last year and past drs. notes from Phx., but recommends a child psy. for dx of OCD/depression. I, his mother, was definitely ADHD as a child,with no attention span, never sat still and always disruptive. At 44 I still do not know how to relax, but meds. have helped with attention probs. over last 4 yrs. My husband is very compulsive, has a daughter 21yo dx'd with ADHD/OCD & depression at 12yo. & variation of meds. No other details, as she's in another state. My son is very tender hearted, non-violent,intelligent, but very hard on himself, expects perfection and needs to control situations even when playing. Also he is an only child. He is loved & given much praise. Please advise!
His life as a 2nd grader improved dramatically!! For the 1st 3-4 mos. he seemed like a completely different child. The school evaluated him with marked improvement. He weighs 62 lbs.& the dr. now decides he needs to take his med. bid, which I wasn't in favor of since he had done so well with just the am dose. But after a month or so of increasing the dose he would get very, vey depressed by 3-4pm to the point of a nervous-breakdown!! He just keep saying he needed help, needer to see a dr. as his brain wasn't working right. This episode continuded for nearly an hour to the point of being hysterical, but left as fast as it hit him. He has continued to have OCD tendencies (continuously picking at his nails and lips) which is the only adverse problem his teacher has noted, not the depression). My concern is weather to try AderallXL or Concerta along with Paxil that may help control the underlining OCD tendincies. The dr. is only a GP (as we relocated from a large city 2yrs. ago where a psy. made the dx) and by transfering of records and the recommendation of Adderall being made back then) he went ahead and prescribed due to his severe difficulty noted by the school last year and past drs. notes from Phx., but recommends a child psy. for dx of OCD/depression. I, his mother, was definitely ADHD as a child,with no attention span, never sat still and always disruptive. At 44 I still do not know how to relax, but meds. have helped with attention probs. over last 4 yrs. My husband is very compulsive, has a daughter 21yo dx'd with ADHD/OCD & depression at 12yo. & variation of meds. No other details, as she's in another state. My son is very tender hearted, non-violent,intelligent, but very hard on himself, expects perfection and needs to control situations even when playing. Also he is an only child. He is loved & given much praise. Please advise!
Doctor's Answer
by Kevin Kennedy, Ph.D., Mar 29, 2004 12:00AM
, Mar 29, 2004 12:00AM
Your son has improved on the once-daily Adderall regimen. If there was no iformation forthcoming that would warrant additional dose, Id leave it be. Was the doctor responsing to some request to increase the medication? Why did he bring up such a suggestion? In short, if the current plan is working, leave it alone. There doesn't seem to be any reason to switch to Adderall XR, nor any reason to give a second dose, at least from what you described.
Relative to possible OCD, nothing should be done until your son is re-evaluated. If indeed he displays OCD, it is likely that Paxil will not be prescribed, due to recent FDA cautions. Prozac would be the preferred alternative. But this should be handled within child psychiatry, not pediatrics.
Relative to possible OCD, nothing should be done until your son is re-evaluated. If indeed he displays OCD, it is likely that Paxil will not be prescribed, due to recent FDA cautions. Prozac would be the preferred alternative. But this should be handled within child psychiatry, not pediatrics.
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because of his weight = dosage normally reccommended. I do plan on having him re-evaluated once we return to Phx.in 2 mos. so we can get a child psy. to evaluate the entire situation.
I do appreciate your feedback and I am very impressed with this web sight. At times a non-bias opinion is more helpful the 3 drs. with 3 different opinions.
Thank you again.
P>S> I enjoy reading others questions and input.