ADHD with PDD

Posted by Ellen Kolman on April 27, 1999 at 14:06:33
We just recently started seeing a new therapist for my daughter who is currently diagnosed with ADHD.  She was being treated with Ritalin but because of her difficulty in social situations wherein she will sometimes physically lash out at people, the therapist started her on Buspar feeling that anxiety control would be helpful.  Ritalin was decreased and Buspar increased.  Then, when that wasn't working we started my daughter on Adderall (adderrall) while decreasing the Buspar.  The therapist is also thinking along the lines of Depacot, probably not in conjunction with the Adderall (adderrall).  The therapist is also thinking along the lines of Pervasive Developmental Disorder only because of her social interactions.  I don't know what to make of all this.  This therapist is new because we just moved into the area in September.  This past month has been horrible for all of us.  My daughter is upset, confused, angry and our whole household has been turned upside down.  My daughter is very intelligent, athletic, has everything going for her except interpersonal relations as well as her own self esteem.  I've read up on PDD and ADD, Adderall (adderrall) vs Ritalin, Buspar and have millions of books on raising kids with good self esteem and dealing with their behavior.  It's difficult to remain calm when your child is running around the house screaming and blaming everyone else for her problems.  What does all this sound like to you?

Posted by HFHS M.D.-JK on May 03, 1999 at 21:34:49
Dear Ellen,
It appears that you and your daughter's therapist have good communication concerning your daughter's mental health.  I encourage you to keep this up.  
The first thing that needs to be determined is her diagnosis.  ADHD may not explain all of her symptoms.  She may have a type of impulse disorder, social anxiety disorder, or a mood disorder, such a bipolar disorder.  On top of these, she has the stress of moving to a new home.  Once the diagnosis is clear, the treatment challenges will be easier.
As far as using various medications, sometimes it is almost a "trial and error" situation; what works for some children does not always work for others.  Perhaps your daughter's therapist thinks a mood stabilizer such as Depakote (generic name valproic acid) will help alleviate your daughter's symptoms. It is not uncommon for children to be on Ritalin, for example, and Depakote.  Many children will need more than one agent.  You can always seek a second opinion if her progress remains slow.
Good luck.

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