- advertisement -

Use Pediatrician or Psychiatrist for ADHD?

Discussion in 'Parents Off Topic' started by DsMom, May 3, 2011.

  1. DsMom

    DsMom Approved members

    Joined:
    Nov 9, 2010
    Messages:
    1,700
    Still do not have a great handle on my son's ADHD. I go through periods thinking it's going okay, and then things change. We started him on Adderall in December, then upped the dosage and added a small dose of Ritalin for late afternoons. Then, I wanted to try the Daytrana (methylphenidate) patch, which seemed okay for a while, but his symptoms seem to be getting worse again. He is much better than when he was not on meds--and for certain hours during the day, he is great.

    My main complaint is how long it takes for the medication (all of them so far) to take effect. I give him his med (apply his patch) around 7:30 am--but, on the days he's home and definitely when he's at school from teacher's report--it doesn't really take effect until around 10 or 10:30. Does anyone else have this problem? Have you found any med that works faster? The ped. said that the patch should work faster because it didn't have to go through his system first, but nothing has changed since we started it a couple of months ago. Also, he often seems to get very sleepy after dinner. We take the patch off at 4:30p. I know we will probably not get a "perfect" effect with any med, but I have read a lot that people find their meds to be effective within an hour. I don't know why this isn't so for my son.

    Right now, we are relying on his pediatrician for medical advice on this, but I'm wondering if we should switch to a psychiatrist, who I'm sure has more expertise on the medications. I feel like we need a more refined approach to his meds. Does your child with ADHD see a pediatrician or a psychiatrist?
     
  2. Heather(CA)

    Heather(CA) Approved members

    Joined:
    Jun 18, 2007
    Messages:
    10,153
    The Ped. sends you to the Psychiatrist. The Psychiatrist does the testing and has you and his teachers fill out paperwork to see if he has it....
     
  3. selketine

    selketine Approved members

    Joined:
    Jan 4, 2006
    Messages:
    6,055
    In our experience, the pedi has handled the whole thing - from the paperwork to diagnose to prescribing the meds. I think if your pedi seems to have hit a brick wall with what to do and it isn't working - the next step could be another doctor - seems reasonable.

    My son uses concerta (he does not have D) - have you tried that? It seems to start working within 30min to an hour - he eats around 7 and takes it so it is working when school starts at 8. It lasts until close to dinner time - so through homework time it is working but he has to do homework right after school. If anything it makes him too awake at bedtime but so far this hasn't been a problem.
     
  4. DsMom

    DsMom Approved members

    Joined:
    Nov 9, 2010
    Messages:
    1,700

    Oh no, he definitely has it. We did all of the questionnaires and stuff in December, and the pediatrician diagnosed him and he started meds. Just wondering if a switch to a psychiatrist would help fine tune his meds.
     
  5. DsMom

    DsMom Approved members

    Joined:
    Nov 9, 2010
    Messages:
    1,700
    They originally suggested Concerta, but Daniel doesn't like to swallow pills yet. They told me that Adderall was basically the same thing, and it comes in a capsule that you can open up and sprinkle on applesauce--which is what we did when he took that. Your son's experience is what I was hoping and aiming for--we just can't seem to get there.:rolleyes:
     
  6. selketine

    selketine Approved members

    Joined:
    Jan 4, 2006
    Messages:
    6,055
    Ah - I'm not well versed in the differences between the add meds - we were fortunate that the first one we tried worked for us.

    I hope others with experience will have some suggestions as well.:cwds:
     
  7. Gracie'sMom

    Gracie'sMom Approved members

    Joined:
    Aug 26, 2009
    Messages:
    1,039
    We are a mixture of both, DS1 and DS2 both started with a neurologist who put him on meds, the ped continued to fill them and change them until we encountered problems and now he is seeing a psychiatrist. DD sees the ped for hers.
     
  8. bibrahim

    bibrahim Approved members

    Joined:
    Jan 31, 2011
    Messages:
    396
    My daughter is on concerta too. It is a coated pill and he might be able to learn to swallow it. I notice the effect fairly quickly and it wears off in the evening. She can take it as late as 12pm if she forgets but after that she will be up all night. I notice when she forgets the pill her response is almost worse than before meds so I think maybe the lack of the med in her system throws her brain off. Also, dosage adjustments are needed to find the right dose so maybe his patch dose just needs increased.
     
  9. Lakeman

    Lakeman Approved members

    Joined:
    Nov 10, 2010
    Messages:
    956
    In theory the psychiatrist would be able to fine tune the meds best. In practice it depends the artistic talents of the doctor.

    Don't forget about non-pharmaceutical treatments too.
     
  10. bibrahim

    bibrahim Approved members

    Joined:
    Jan 31, 2011
    Messages:
    396
    so glad you brought that up. Exercise is huge for my DD. It really helps her stay calmer. Also, stress often comes out as misbehavior so if we can address what is causing the stress things improve. Counselling also helps and honestly a psychiatrist usually has the ability to spend more time with you than a ped. We actually started with a psych then changed to a general practitioner when the psych moved out of state.
     
  11. timsma

    timsma Approved members

    Joined:
    Sep 1, 2007
    Messages:
    421
    Our son had been treated for ADD by his pediatrician, but when we discovered he also had Tourette's, we started seeing a pediatric neurologist for both conditions. While our pediatrician thought he knew a lot about the meds for ADD, in reality, he really didn't. He got much better care and dosing from the neurologist who has specialized training in these meds and conditions. I wonder if the reason it takes the meds so long to seem to work in your child is due to the capsule being opened and sprinkled on food rather than taken whole like it is intended? Just a thought. There are a whole variety of meds to try. I would recommend seeing a pediatric neurologist for care.
     
  12. sammysmom

    sammysmom Approved members

    Joined:
    Oct 30, 2005
    Messages:
    1,635
    We got the diagnosis and written report from my son's ped. We are not medicating though. If we decided to use medication I would go to a psychiatrist that specialized knowledge of ADD meds.
     
  13. OSUMom

    OSUMom Approved members

    Joined:
    Sep 10, 2006
    Messages:
    5,324
    I would go to a medical professional who specializes in adhd. That could be a specialized psychologist too then they communicate with your pediatrician on medicine and dosage. I suppose there may even be pediatricians who specialize as well, but we never came across one. I think the key is to see someone who is up to date with current medicine information, side effects, and dosages.
     
  14. DsMom

    DsMom Approved members

    Joined:
    Nov 9, 2010
    Messages:
    1,700

    It could have been--but he's been on the Daytrana patch for 2 months now (the med is absorbed directly through his skin), and we have the same problem--a really delayed effect.:confused:

    I never even thought of a neurologist and did not know they treat ADHD. Now I wonder--is there a difference in treatment approach between psychiatrists and neurologists?
     
  15. timsma

    timsma Approved members

    Joined:
    Sep 1, 2007
    Messages:
    421
    I don't know if there is a different approach between psych. docs and neurologists. It was recommended to us to see a pediatric neurologist for his Tourettes AND ADD so we did. I have seen a psychiatrist before for antidepressants, but wouldn't think of taking my kids to one (since the one I went to was for adults). Tim's neurologist was extremely knowledgeable about ADD and ADHD though and knew of all the different meds out there. Very knowledgeable. Perhaps if you found a child psychiatrist, they may be just as good. No clue. I just know I was extremely satisfied with his neurologist. She also helped with self help strategies in dealing with the ADD. My sister's son has severe ADHD and saw the same neuro doc. Was extremely pleased as well. I do wish you good luck with it all. It can be so hard, I know.
     
  16. skimom

    skimom Approved members

    Joined:
    Jan 16, 2008
    Messages:
    735
    You could try and find a developmental pediatrician - they are well versed in dealing with ADD, ADHD etc etc- try contacting one of the agencies/schools that supports kids with learning and behavioural issues and ask for a list of names
     
  17. DsMom

    DsMom Approved members

    Joined:
    Nov 9, 2010
    Messages:
    1,700
    Thanks again to everyone!
     
  18. etringali

    etringali Approved members

    Joined:
    Mar 27, 2008
    Messages:
    1,678
    My godson and son have ADHD/Aspergars. Neither are on meds. my Godson responded beautifully to a technique called Wilbarger deep pressure brushing protocol. http://www.ot-innovations.com/content/view/55/46/ It's time intensive the first 6-8 weeks. They get brushed and have deep joint compressions every 2 hours. But it was like night and day with him. He went from sensory overload and unable to cope with anything to relatively calm and focused. could have a conversation with him. He could actually work out issues with playmates rather than scream and have a meltdown. not saying things are perfect, but it was quite a turn around.

    He also has accommodations at school.. He sits in back so he doesn't disturb others when he needs to wiggle. Has fidgits. There is an area he can retreat to when he needs downtime. He generally doesn't join circle time directly but sits off by himself. Still gets everything that is being said.

    We saw developmental pediatrician for dx. Not sure if she or a psych wold monitor meds if we were to put Alex on em. But rather think your basic pedi shouldn't be the one doing the adhd meds. They are mood altering so I would think a psychiatrist would be best.

    Best of luck!
     

Share This Page

- advertisement -

  1. This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
    By continuing to use this site, you are consenting to our use of cookies.
    Dismiss Notice