Medication ADHD teenage DD advice!

[lucydaniels4658]

DD drifted through primary and managed to keep her head above water and no major issues and she quite enjoyed it.
Secondary school has been awful from word go she has been suffering with terrible anxiety which has meant quite a bit of time off school.In school she has refused all work for a year and is disruptive and VERY angry . It has been a real battle keeping her in school . School have tried to manage it in many ways but I think now she needs medication.When I mentioned it to her she is desperate for medication to as I feel she genuinely can't manage herself anymore and it really upsets her.
My worries are the appetite surpressant bit she has issues with food already . Are there any that don't have this affect and can someone give me advice on what to expect .I know it will be different for everyone but just want few pointers really .
Desperate for things to be better for her

I know you know dd best, and I am afraid I know nothing about medication for ADHD teens.

But I do have a relatives who had ADD and ADHD respectively, and who could not cope with mainstream any more. One school refused - either didn't get in, or inched in and then later bolted out. The experts said he was voting with his feet.

They both went to special school where the environment was calm and quiet and the classes small. Sensory stuff was well understood.

They could learn in that environment, got their GCSEs. If they overloaded/had a melt down they could go to the calm room. Then they learned to anticipate a meltdown and go to the calm room. And they learned to self regulate.

One is now earning and married, the other will finish college later this year and has already had successful work placements.

Sorry if you have considered this and drawn a blank, but I jst wonder, at first glance, if the school may be the root of the problems that have got so much worse since she joined it.

Thanks. She has become way more impulsive with age I thought it might go the other way or maybe it just notices more against her age. She is very very keen to start medication so she clearly finds it hard controlling herself. Moving school is not really an option no suitable local schools more ASD and SLD .There is one EBD but she would hate it as only two girls in whole school none her age and she is very sociable .

DS1 takes Strattera partly because it has less of an effect on appetite than methylphenidate.

It's not generally the first step on the treatment protocol, as it's more expensive and tends to be less effective than the various forms of methylphenidate, but DS1's psychiatrist skipped a trial of methylphenidate altogether because of serious concerns about anxiety and appetite.

Has it been a positive thing for him?

fingers and toes crossed for you and dd lucy

My DD1 is 23 tomorrow...and still on meds (Ritalin for ADHD and also Prozac for anxiety)

She was on them from 6- 13, came off for couple of years but then went back on them (her choice)

I'm guess she is the one Poltergoose has mentioned, as she is in her final year of medical school , and unbelievably will be a doctor this summer!

It hasn't all been plain sailing, but I have no doubt that without the meds she could not have functioned, let alone got where she is now. She was always skinny and the meds didn't really change that. However she was not treated for her anxiety until she was 19, and after a hideous homesick first year at Uni, she became anorexic... came home weighing 5 stone 9 (and she is 5 ft 10)... it was truly awful, but the Ritalin ahd nothing to do with it, it was her untreated anxiety that spiralled out of control.

However, she had help, her anxiety is now under reasonable control and her body weight is normal (still skinny but ok BMI) and she is carefully monitored and supported at Uni..they have been fabulous all the way.

I think meds are worth a try, but please ensure they look at all aspects of her medication, anxiety is terribly disabling, at least as much as ADHD.

Incidentally my DD1 is in the process of being reassessed as they feel she may have bipolar disorder rather than childhood-into adulthood ADHD. Which makes sense to me as she has huge highs and huge lows and at times her impulsive behaviour has put her at risk to herself.

On the plus side, having these difficulties herself and a disabled brother, she is SO much more empathetic and knowlegeable about special needs than your average junior doc is ever going to be !!!!

He can't function without it, lucy

Thank you . I just wish the process was a bit quicker DD really dangling by a thread in regards to being excluded. Been awaiting this appointment for months!

My dd1 has ADHD and she is currently in year 6 we are considering medication for secondary

Have any of you had to deal with an exclusion from school? They say she disrupts the learning of others which I understand isn't on but she has never had a serious incident (bullying,fighting,truanting,swearing etc) its just low level noise chatting and being a bit oppositional when challenged !

My DS 13 has been on medication since he was 7. His appetite in the earlier part of the day was suppressed for the first couple of weeks but ok after that which I think is quite usual. Recently we changed from equasym to concerta and again there was a short term impact on appetite.

What are they doing to try to meet her needs, lucy? Are they aware of her condition?

And did they go through the proper process with the exclusion? It seems a bit of an extreme reaction to a chatty pupil. Oppositional when challenged is so often part of the ADHD package.

DS1 had a one day exclusion, last term. He'd gone out of bounds (massive school site) and done some damage (not deliberate, but doing something he shouldn't have). It turne dout that he didn't understand the map (easily fixed by his teacher with some temporaru spray pint - he's at a specialist school) and neither DH nor I had remembered his tablet, that morning

She isn't excluded but they have advised for me to prepare by looking at schools as they don't think its the right placement.
TBH they just try and make her do lots of talking about anger which just makes DD more angry!! Tricky !

It sounds like a trial of medication may be worthwhile, especially as DD is keen to try. As far as appetite is concerned with methylphenidate we found Ds (15) had little interest in food during the day (he often brings his school lunch - a roll home with him), but becomes ravenous at supper time. We therefore have family evening meal late, followed by supper before bed if needed. Ds is not really a breakfast eater, but if presented with a boiled egg before his tablet works he will usually eat it. Ds knows he has to remember to eat at lunch time, when he isn't hungry, but because he is not very able he needs adults to remind and cajole him - hence being given a roll for school lunch. Usually if he starts eating, he will find some appetite from somewhere, although it has to be easy to eat and preferred foods.
Anxiety is the other main problem, and it is my feeling (as a Mum) that methylphenidate makes this worse, and agree this needs to be considered. Ds has LD alongside ASD/ADHD so is at a special school, but changing to secondary even with ADHD medication was very difficult, due mostly to the anxiety and confusion. He is much happier since adding medication for anxiety, although it took a terrible year at school (with some serious injuries to himself and a long wait for CAMHS) to go down that path. Ds was begging for help too. School understand him a bit better. He is getting to know when he needs to take himself to the calm room, and is allowed to do so when needed.
Some while ago I found his methylphenidate tablet dropped on the floor after ds had left for school that day, and rang school. Before I had said anything they said they were about to ring me because ds was having a difficult day, and they wondered if he was sickening for something, or something had happened at home as he was so impulsive and oppositional. They wanted me to pick him up, until I explained he was un medicated.
We looked at other schools for ds but could not find a better match that would accept him.
I realise girls are a little different to boys and your dd is much more able but I thought my experience may be helpful. Good luck.

Thank you my DD actually sounds very similar to your DS to she had LD and is incredibly oppositional.
She is always on the edge anger wise and a simple teeny thing can trigger a huge outburst way OTT like me getting a tiny detail of what shes telling me wrong or say pardon!
I am really worried about her at the moment she will always be blameless and all her relationships are very fragile but she won't take advice or even listen its not her everyone else is unreasonable!
Love her to bits but she is incredibly hard to live with at this moment in time walking on eggshells springs to mind. I am currently a shit mum and shes leaving home as I won't buy her a bottle of vodka .

Ds is very similar! But he is much nicer and much calmer and frankly happier on medication. He struggles with all relationships - but has a couple of friends at last- who tolerate his quirks. He seems to have grown up a little at last. Good luck!

she will always be blameless and all her relationships are very fragile but she won't take advice or even listen its not her everyone else is unreasonable!

Sounds familiar :o

DS1 is very able, but emotionally extremely immature. It wears thin, some days.

Thank you. I will look forward to hopefully a little less anger and maybe the very occasional thanks or "yes mum" not heard either for ages!
It is tough how do you all cope? I'd consider myself very patient but it seems to be vanishing.I feel awful for her as it can't be nice being so cross 24/7 but my sympathy occasionally vanishes when shes up all night screaming everything I've ever done to make her angry!

My daughter is 18 and functioning very well indeed on Concerta XL 54mg (Methylphenidate). She has severe dyslexia and was at special schools for 8 years. She had severe anxiety and took medication for depression for about a year which didn't work for her at all. She started on Concerta in year 10 as she couldn't cope with her GCSEs and came off it for awhile when she got depressed a couple of years ago . She is now like a changed girl and understands her own needs very well. She says that she cannot manage without Concerta as she cannot concentrate and has very low energy. In terms of eating she was on the heavy side and she did lose too much weight initially. Now she is very sensible and eats normally. I know for people who lose their appetite it is important to have a very good, high protein breakfast and eat well in the evening, maybe with a protein snack before bed. She also has been seeing a psychotherapist that she really relates to for about 2 years and even though she is doing well now we invest in her seeing her still every couple of weeks. My daughter has gone from being basically a mess to managing herself possibly better now than her non-SEN peers ! It is very hard to get the meds right but listening to our children and getting them to understand themselves and what works from them is perhaps the key.

Journeygirl is right - it can take a while to get the medication optimal- and also a while for the young person to get used to the extra clarity and start to adapt and use the window of opportunity to best advantage. There are people who say their children change immediately and they can see the difference within half an hour, but that was not our experience (and the first medication we tried was not optimal - extended release worked better for our sons metabolism) - more a slow change. Indeed at first - armed with my fears about medication, I saw only the down sides -and we stopped medication for a couple of years. And now-yes Ds does say thank you - sometimes!