J. is 5 years old and we now know he has ADHD. He has struggled with being hyper and controlling his impulses for a while now. He is the oldest child of 3, so his mother and I had no frame of reference on how a 4 and 5 year old should be behaving. J.'s mom had a feeling something was not right about his behavior. I on the other hand, chalked it up to just being a boy and likely a phase he will grow out of.
He was enrolled at 3 in preschool for a few days a week and the teacher there could not or did not want to work with him. At 3 years old, he did not like school. That is very difficult to handle as a parent. But nonetheless, he went on to the 4 year old class and he had a much better time, since the teachers there were great. They really put the effort in to working with him and find out what works for J. Things like making him sit up front in circle time and giving him a 5 minute warning about the next thing the class was going to do to help him with transitioning to the next task, etc. We found that it helps him at home as well. Something like "Okay J., in 5 minutes it's time to get ready for bed."
Over the summer break, we worked on getting him diagnosed. It was clear to the psychologist J. was ADHD. By this point it was obvious to us as well. J. was given an I.Q. test and tested off the chart in the Perceptual category. In most other areas he is above average as well. The child is almost too smart. It is hard to trick him sometimes. And he has a memory like an elephant.
Eventually we got him on 10mg of Adderall. It controlled his heperactivity, but made him very, very irritable and we saw what has come to be known as 'Adderall Rage.' He would get very angery over the simplest and smallest things. Of course they were very big things to him. So we quickly had his medication changed. His Dr. prescribed 18mg of Concerta, which had almsot no effect at all. So she bumped it up to 27mg. Again no effect, just more irritable. However, we gave it a try anyway. Finding the right medicine is not a science but rather an art. We scrambled to find the right medicine before school started back. Unfortunately, we were not able to do so.
However, this year do to various reasons, J. had to go to a new school. This school is one of the best private schools in the area. However, the teachers in his class are not trained (why would they be) to work with ADHD. So the first week was a tough one. Of course the first week was viewed by the teachers as getting used to everything, so they let a lot of things slide. The second week, we were called at home by the teacher and the next day he was sent to the office to sit until school was over. The time at the new school was almost all on the Concerta.
One of the things with these stimulant types of medicine is that you should see some improvement or at least effects at some level or another within 30 - 45 minutes. However, with the Concerta that was not the case. And with most of the drugs, there is no generic brand so it costs us $25 a pop for a 30 day supply in which we were using only 4 - 5 pills/capusles before switching. So within a two week period, we had spent $75.
Finally, I spent some time talking with J.'s Dr. and she decided it would be best to try the newest and very promising Intuniv. She provided us a 'Starter' kit with enough medicine for two weeks and a $50 coupon.
Intuniv is a 24 hour non-stimulant unlike most extended release stimulants that are only up to 12 hours. We started J. out with the recommended Intuniv 1mg dose at around 6pm as the Dr. suggested. Intuniv can have a drousy effect. J.'s Dr. also prescribed .05mg Clonidine to help with the behavior until Intuniv begins to work, which can be up to 2 weeks. Clonidine also has a drousy effect. However Clonidine has not been approved by the FDA to treat ADHD. But many doctors use it to treat the side effects of ADHD medicine such as the irritablity.
Intuniv looks like it can be promising in J.'s case. We are praying that God helps him out and this medicine works. J. really loves school but has a hard time. J. even told us that it is too hard for him to be good. He is loved by all his teachers and everyone who gets to know him. J. is a really sweet and loving boy. He loves his baby Sister N. and even tolerates his younger sister R., who is almost 3 and she lives to annoy him. I guess that is what siblings do. I know I annoyed my older sister. Since J. has been on Intuniv he has not been fighting with R. much at all. Still has occasions, but no more than any 'normal' siblings. Probably less.
-Dad2ADHD
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