5yr old w/ ADHD, OCD, ODD and Anxiety

[Sue438]

My five year old son was diagnosed with ADHD, OCD, ODD and Anxiety last year after he was BAKER ACTED for saying he wanted to kill himself. They started and currently have him taking Zoloft 25mg and Metadate 10mg, they are not working. When he takes the two together whether at the same time or at separate hours he is worse off then when we started. It seems like they counter act each other. If I give him just the Zoloft, then he is fine, his anxiety is down and less violent, but climbs the walls and has to be given a benadryl to calm him down. If he is only given the Metadate then he is not as hyper, but very dangerous to be around when he "snaps". He was suppose to start Kindergarten this year, but because I don't feel he is safe to be around or even ready I have chosen to home school him instead. The psychiatric that he sees won't give him anything other than Zoloft and Metadate...though he did mention Ritalin (which from I read could make him more violent). I need to know of what other meds are out there that might help him so i can at least suggest them to the doctor at our next appointment.

[Jason C Bourret, Ph.D., BCBA]

Zoloft is an SSRI that is typically used in treating anxiety and Metadate is, actually, an extended-release version of methylphenidate, which is Ritalin.  A primary concern that I have is that you do not seem comfortable with the psychiatrist treating him.  There are a number of meds that have been used as treatment for the symptoms of the disorders you describe, but your psychiatrist should be willing to sit down with you, describe all of the options, and make a case for why he or she believes that a particular medication is the best choice.  You and your psychiatrist should also have a plan for evaluation of the medications including developing criteria for when doses will be increased or decreased and when a change from one drug to another is called for.  If you are not comfortable with the decision making of the psychiatrist or if you feel that you are not being sufficiently incorporated into the decision making process, find a new psychiatrist.  I would also like to recommend, given the severity of the behavior problems that you are describing and because you are concerned about sending him to school because of them, that you seek out a behavior analyst in your area with experience treating children who display behavior problems similar to you son’s.  While medication can help with behavior problems, research has shown that medication combined with behavioral treatment is more effective.

[therese83]

Do you have behaviour modification programmes in place?

They worked so well with my son and we were able to avoid medication.

Here is Austria a 5 year old would never ever be given these drugs, and we have an excellent health care system.  

I mean how come we have no children on these drugs here and we have a much lower rate of adolescent crime etc, we have a safe society?  We use other therapies and intesive work with these kids as a team.