Neurology Forum
This expert forum is not accepting new questions. Please post your question in one of our medical support communities.
Avatar universal

Re: ADHD with anxiety

Posted By mom who doesn't know the best course of action on July 21, 1999 at 09:14:38
What is the medication most often prescribed for ADHD and anxiety in a ten year old 75lb. girl?
I've tried ritalin which has just made her depressed.  We then switched to Dexadrine which seemed to work well twice a day but when we switched to a time released capsule, there seemed to be an inconsistent release of the medicine into her system.  We upped the dosage to 35mg. per day and she went through a paranoid pschotic state with possible hallucinations at night.  Should we have lowered the dosage instead of upping it?  Thank you.

4 Responses
Avatar universal
Posted By CCF Neuro[P] MD, RPS on July 21, 1999 at 12:08:31
Dear "Mom who doesn't know the best course of action"
What was the dose of Dexedrine that you used, as a twice a day dosage?  Yes, it might have been better to have lower the dose.  I think that I would make sure that the twice a day dose worked, gave no side effects, and then retry the extended release.  Sometimes there is not the same dose:effect relatiionship between the extended release form and the regular form.  When you are sure that things are back to normal, then try the extended release form again, I would suggest that you do this over a weekend day.  This way you will be around to see how well and how long the medication works.  In addition, you will be around if side effects happen as before.
CCF Neuro MD

Avatar universal
Posted By mom who doesn't know the best course of action on July 21, 1999 at 12:45:54
My daughter was started on 15mg. twice a day of Dexedrine.  We then switched her to 30mg. spansule once a day.  She is impulsive and does not know how to handle social situations well. In fourth grade, she started showing significant signs of anxiety. When we try to talk to her about the best way to maintain friendships, she says we're being mean to her or misconstrues the main points something awful.  We had her tested for ADHD by Conners.  Are there any other tests we should consider?  Is a stimulant such as Dexedrine the best course of action for ADHD and anxiety or is there something better?

Avatar universal
Posted By CCF Neuro[P] MD, RPS on July 21, 1999 at 17:17:05
Dear Mom who doesn't know the best course of action:
Did a behavioral pediatrician or pediatric neurologist evaluate your daughter at the time of diagnosis of ADHD?  Other than her ADHD she is a healthy normal child without any other neurological problems?  We, at the Cleveland Clinic use more than the Conner test to assess ADHD.  This is not to imply that your daughter was misdiagnosed.  The conner test only evaluates the teachers observation of the child and may be biased by his/her perception of you daughter.  I would return to the 30 mg a day of dexedrine and have a long talk with your pediatric neurologist about the behavioral issues of relationships, etc and see if there are other things to be concerned about.  Added types of counseling may help.
CCF Neuro MD

Avatar universal
Posted By Mom who doesn't know the best course of action on July 21, 1999 at 21:08:10
Your comments have been very helpful.  My daughter is in counseling with a Social Worker.  She has seen a neurologist because of questions I have had concerning humming she has had since she was two or three and her habit of putting her finger in her mouth.(sort of like a nervous habit)  I myself have some twitching of the muscles at times. Tics are common in my family.  The Neurologist did a routine exam and felt there was nothing to be concerned at this point.  With the dexedrine, my daughter's humming stopped and she did not put her finger in her mouth anymore.  She also stopped hitting her four year old sister and inappropriate laughing stopped.  She did develop some eye blinking on ritalin and started chewing her tongue repetitively at higher doses of dexedrine. At times, prior to the medication, she would jump on other kids shoulders when she got excited or couldn't handle certain situations.  The neurologist recommended trying the dexedrine again at the lowest possible dose unless the tics recurred.
You mention other types of testing but I would appreciate it if you could tell me the name of the tests you would suggest for my daughter.  
Kids have been giving her a hard time since she was in Kindergarten.  Could the anxiety have resulted from that?
Also, I live in the Pittsburgh PA area and if you could refer me to some professionals in the area that would give my daughter a thorough evaluation, I would appreciate it. What type of counseling would you advise?  Her Social Worker suggested that we pick out very specific behaviors and work on improving them with her.  I am not so sure of this type of therapy because I am not so sure that my daughter can control these behaviors although she tries hard. Two behaviors we chose were laughing at inappropriate times and being persistent.  Do any of the Cleveland Clinic Satellite sites provide testing?  Which site would be the closest to my home?  Thank you.

Follow Ups:

Re: ADHD with anxiety CCF Neuro[P] MD RPS 7/22/1999

ADHD with anxiety Robyn 7/28/1999

Re: ADHD with anxiety CCF Neuro[P] MD, RPS 7/29/1999

Popular Resources
Find out how beta-blocker eye drops show promising results for acute migraine relief.
In this special Missouri Medicine report, doctors examine advances in diagnosis and treatment of this devastating and costly neurodegenerative disease.
Here are 12 simple – and fun! – ways to boost your brainpower.
Discover some of the causes of dizziness and how to treat it.
Discover the common causes of headaches and how to treat headache pain.
Two of the largest studies on Alzheimer’s have yielded new clues about the disease