Petrified about starting teen on ADHD medication

[Neurotic1000]

Son is 13 and really struggling with the work secondary school brings
Getting sent out of class for silly things like laughing when another pupil pulls a funny face etc
I am a primary school teacher so aware how distracting it can be but equally think humiliation is never the answer
He asked to trial medication to see if it meant he could concentrate more and now the appointment is on Monday and I’m really struggling with worrying about possible side effects - the heart in particular as my dad died of a heart attack suddenly aged 30 with no warning signs.
Can anyone who has been through this guide me a little? Thanks

You are not YANBU being through everything you have been through with your own Father. 💐

The medication could potentially be life changing for your Son for the better, and in-fact improve his life expectancy in many other ways.

The risk are very minor and outweigh the amount of stress that it could be released from his day to day tasks and interactions.

The Dr will reassure you on the appointment on Monday and know more than anyone here about it. They will most likely start on a very low dose and build up tolerance during his trial, so not a large mg to start 👍

But you have been through something very traumatic in your life that most have not, presumably at a young age. So the anxiety is bound to creep in. Goodluck and you are doing the best for your Son x

It is highly monitored. My DS started at a low dose of 10mg with the idea to increase to 20 after one week then 30 after another. He had such bad stomach ache after a few days that I emailed the neurologist (who had given me his email for this very reason) who advised extending the 10mg for a 2nd week and then increasing.

It worked and soon he no longer had stomachache even after increasing the dose.

I did ask DS if he wanted to stop and he replied no absolutely not! He could see a difference even on a low dose.

It's a medicine that is easy to stop and start. We stop every summer holiday and sometimes at half term. I know someone who doesn't take it at the weekends.

For DC its often a slow release dose. DS' works for about 8 hours. You can set a clock by when it has worn off! My parents thought I was exaggerating until they had him to stay....

The risks are really very minor, but the assistance it could give your DS may well be huge. I know several children who struggled massively before medication, both academically and socially, who blossomed after as they were finally able to focus.

They ask if there is a family history of heart conditions and there are certain types that they would prescribe if this was an issue. It is very carefully monitored.

They do medically monitor children on meds like these as they are controlled drugs and side effects need to be reported. I’m a nurse, my son is on meds and the first lot he found made him feel sick and we changed to a slightly different preparation of the same drug and he appears to be managing fine. Has his Obs/bp height and weight done regularly and if I have any concerns I can get him reviewed.

The nurse practitioner who saw him was very good, lots of knowledgeable and helpful. Try not to worry and have lots of questions for the appointment.

Thank you for all your comments
I have a lot of guilt about hard he finds school and socially he’s pretty isolated in secondary compared to the bumbling along he did in primary so I can’t have his self esteem any further lowered.
Its going to be a very expensive trial as he was assessed privately but I can’t watch him finding things so tough if I can help in any way at all.

I struggled with what has finally been diagnosed as ADHD all my life. Going on the meds has made a phenomenal difference to not just my behaviors but my state of mind in general.

Monitoring is strict, but unless your son has untreated high BP then there shouldn't be any real risks. In fact both I and my brother have found that our BPs have gone down since starting ADHD meds, as we are much less stressed due to the treatment.

Once he has completed titration (where they try them on the different meds and work out the best doses) then you should be able to get him transferred to having them on the NHS through his GP.

Thank you so much

There are several types of ADHD meds. Stimulants, non-stimulants, and a new one which is Guanfacine (also non stimulant).

It doesn’t have to be Ritalin (the stimulant amphetamine one)… speak to the psychiatrist/ paediatrician about your concerns and talk through the options. If you google ADHD medication types there are helpful tables and charts.

My DS10 has ADHD but also tics and anxiety- stimulants were terrible for him, as were the non-stimulant option we tried. He is now working up to full dose of guanfacine and thank goodness no side effects and it’s actually helping… we’re private too and the prescriptions are £150 (ouch) but once he is on the right dose they will do a “shared care agreement” with the GP who can then take over repeat prescriptions on the NHS.

Hope this helps!

Be wary of stimulants, my son was sectioned due to a rare side effect and can never take stimulants again, he is now on guanfacine as an adult

my dad died of a heart attack suddenly aged 30 with no warning signs.

Sorry that happened. Did he have high cholesterol and have you been tested?

I'd be nervous too OP, look into the long term side effects of any medication it is suggested he take, especially if they expect him to take it long term.

All my dc take adhd medication. Some stimulants and some non stimulant. Honestly life changing. Grades went up, made more friends.
Ask for ecg if your worried before stating medication

Further to what Hankunamatata said check to see if ongoing monitoring of his heart will be part of his treatment plan. I listened to a psychiatrist talk about the differences between stimulant medication and therapy / coaching for ADHD and he said that research shows that support through therapy / coaching is shown to be just as effective and longer lasting than the medication and it doesn't create dependency. Meds get used because it is cheaper than providing real support.

It’s honestly so stressful to be responsible for such a major decision which is why even though he was diagnosed at 8, we haven’t tried any medication until now when he suggested it because he’s tired of not listening / understanding the work / getting into trouble for little things that he can’t control etc.
Im just very concerned about all the risks because he’s not needing it for behaviour reasons or to help sleep etc - it’s purely for schooling and that doesn’t feel massively natural to me 😢

The private practice that diagnosed DS asked him to be tested for any heart issues that could make medication a risk, as I understood it, and he was clear, so it never occurred to me to be concerned. As others have said, side effects are carefully monitored - I can see in your situation it might feel hard not to worry, but the risk is not high, it's just something they have to warn you of.

DS also only needs it for schooling - behaviour and sleep is basically OK, but I really don't think he would have kept up with his first year at secondary school without it. I was seriously expecting there to be detentions for forgetting things etc in Y7 but the whole time there was actually only one all year and I'm sure it would have been more without it, which would have been very disheartening for him and could have led to disengagement with school - which was something I really did worry about.

Bear in mind, effects old ADHD can get less marked towards adulthood https://chadd.org/attention-article/how-adhd-sometimes-improves/ and I think to sometimes people don't need the meds as much outside of an education setting, so people don't necessarily need to medicate their whole lives

The prescriber will take a medical history before they give anything. Once they know about your dad they will arrange an ECG before starting a stimulant, which will really help to judge whether there is more risk in his case or not.

Or you can opt for a non-stimulant that doesn’t affect the heart at all.

Please try not to worry too much, this is just an opportunity to talk about the options and find out more.

Treating ADHD can make a huge difference to a person’s quality of life.

@Neurotic1000 What other things have you tried has he had one to one support to help him specifically with the issues his ADHD causes? I know not everyone can afford this, I can't but in my view medication should be an absolute last resort.

My son was sent to see a cardiologist before they prescribed ADHD medicine, probably due to a family history of heart disease (his grandfather) so push for that if you are worried.

He didn’t qualify for an EHCP so whilst he was in the intervention groups constantly at primary school, secondary he is largely left to keep up which he can’t
It’s heart breaking to see his face when he discovers he’s in the bottom sets for everything each term

Does anyone know if the non stimulant drugs that are safer heart wise are less effective than the stimulant type?

OP ask for one that he only takes on school days. My DD14 is on Elvanse.
They monitor their growth, blood pressure etc.

The day ones means they are not taken at the weekend or holidays unless specifically you need him to.

It has made a huge difference to my DD in terms of concentration in school.

Thank you so much for taking the time to reply

Did you appeal the EHCP refusal?

DS only takes his on school days as well