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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 12 of 12. This is the beginning of the thread.
Posted by Lorenzo05 on October 11, 2008, at 18:37:13
Hi
I am brand new here but I need some advice about my sons medication. The Dr diagnosed him with ADHD a couple months ago. He already has Acute stress disorder and PTSD. When his hair started falling out and he chewed his fingers to the point of infection they thought it was time for meds.
They put him on Zoloft to start out but it made him so agressive and angry. They put him on Strattera. It has been a wonder drug for him. His fingers and nails have healed and his hair is growing back. The Dr was hesitant on putting him on Strattera because my son is small to begin with. He wanted to watch his weight.
He has been on Strattera for almost 3 months now and has lost 5 lbs. He is almost 8 and is weighing in at 45 lbs. I have to make a follow up appt for him soon because he is almost out of meds. I am so afraid the Dr is going to pull him off this med that is working so well for him.
My friend was telling me to give him weekend breaks from the meds but I am afraid he would have withdrawls. I know I need to call the Dr about this but I wanted to try and get opinions because my Dr is a pain to get ahold of.
Has anyone ever not given your kids their meds for weekends? Or skip a day? Just to try and get them to eat. I am so confused about these meds.
Posted by Phillipa on October 11, 2008, at 20:05:31
In reply to ? about meds for my son, posted by Lorenzo05 on October 11, 2008, at 18:37:13
Well I know my Granddaughter when young was on ritalin and she went off summers. Yes she was miserable and miserable to be around. Actually with her it was horrible. Love Phillipa adults I think sometimes take breaks don't know too much about the little ones. And welcome to babble bet someone pops on here with a great answer. My best to you and your Son.
Posted by Phillipa on October 11, 2008, at 20:12:47
In reply to ? about meds for my son, posted by Lorenzo05 on October 11, 2008, at 18:37:13
Lorenzo might want to chek out WebMd also found this. Phillipa
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Posted by yxibow on October 11, 2008, at 20:23:33
In reply to Re: ? about meds for my son » Lorenzo05, posted by Phillipa on October 11, 2008, at 20:12:47
Might want to put in a URL, Jan -- that's a rather long verbatim instead of an excerpt.
Anyhow, I know you're trying to help, just a comment.
-- tidings
Jay
Posted by yxibow on October 11, 2008, at 20:38:41
In reply to ? about meds for my son, posted by Lorenzo05 on October 11, 2008, at 18:37:13
> Hi
>
> I am brand new here but I need some advice about my sons medication. The Dr diagnosed him with ADHD a couple months ago. He already has Acute stress disorder and PTSD. When his hair started falling out and he chewed his fingers to the point of infection they thought it was time for meds.
>
> They put him on Zoloft to start out but it made him so agressive and angry. They put him on Strattera. It has been a wonder drug for him. His fingers and nails have healed and his hair is growing back. The Dr was hesitant on putting him on Strattera because my son is small to begin with. He wanted to watch his weight.
>
> He has been on Strattera for almost 3 months now and has lost 5 lbs. He is almost 8 and is weighing in at 45 lbs. I have to make a follow up appt for him soon because he is almost out of meds. I am so afraid the Dr is going to pull him off this med that is working so well for him.
>
> My friend was telling me to give him weekend breaks from the meds but I am afraid he would have withdrawls. I know I need to call the Dr about this but I wanted to try and get opinions because my Dr is a pain to get ahold of.
>
> Has anyone ever not given your kids their meds for weekends? Or skip a day? Just to try and get them to eat. I am so confused about these meds.It's not a good idea to stop someone on any psychotropic, especially any with any significant effects -- and he has been on it for three months.
Is your son smaller than average heightwise or at what a pediatrician would say is a normal height.
I realize your concern and at that age weight drops are a concern, but not as much a concern as if he was a toddler.
5 lbs can still merely be a loss of water, but yes, I would get in touch with your doctor as much of a pain as it is if it is more than that, remembering that weight varies from day to day.
You can't force feed anyone, even if they're not taking medication, but if you are really concerned, try to feed him just anything that he's ever liked, even if its peanut butter or ice cream temporarily
Putting on a little fat will probably counteract this anyhow if it burns it off in the first place.
Of course, multivitamins, chewable, without iron (although he's probably leaving that danger age to some extent), are a must.
You shouldn't have to make a follow-up appointment merely because someone is running out of medications, that is a physician's responsibility and they should have a pager or voicemail to call in things (I do realize it is a controlled substance and I don't know how it works in your state, it varies). I realize the doctor is too trying to make decisions, but nobody should be left without medications.
Make the follow up appointment rather to discuss strategies that both you and the doctor feel is comfortable, and if your son is able to have a rational conversation, I think it would be good to include his feelings and input.It is hard to tease out what really is the primary condition, as sometimes what seems like a cluster of conditions is really one thing. I'm not saying that's the case here.
And, if your insurance allows or you feel that you need to, a second opinion isn't a bad thing -- that doesn't mean a second doctor necessarily, but just perhaps a look at the diagnose(s).
-- best wishesJay
Posted by azalea on October 11, 2008, at 22:09:53
In reply to ? about meds for my son, posted by Lorenzo05 on October 11, 2008, at 18:37:13
Your son is lucky to have a father who is concerned. A few questions . . . what dose of Zoloft and Straterra? Is his appetite decreased? Or is he eating the regular amount but losing weight? How long has he been taking the medications?
A few comments: Taking drug holidays off Zoloft and Straterra is probably not a good solution. Sometimes drug holidays are used for traditional stimulant ADHD meds like Ritalin and Adderall, but not Straterra. Straterra is a non-stimulant med for ADHD. It should not be abruptly discontinued.
> Hi
>
> I am brand new here but I need some advice about my sons medication. The Dr diagnosed him with ADHD a couple months ago. He already has Acute stress disorder and PTSD. When his hair started falling out and he chewed his fingers to the point of infection they thought it was time for meds.
>
> They put him on Zoloft to start out but it made him so agressive and angry. They put him on Strattera. It has been a wonder drug for him. His fingers and nails have healed and his hair is growing back. The Dr was hesitant on putting him on Strattera because my son is small to begin with. He wanted to watch his weight.
>
> He has been on Strattera for almost 3 months now and has lost 5 lbs. He is almost 8 and is weighing in at 45 lbs. I have to make a follow up appt for him soon because he is almost out of meds. I am so afraid the Dr is going to pull him off this med that is working so well for him.
>
> My friend was telling me to give him weekend breaks from the meds but I am afraid he would have withdrawls. I know I need to call the Dr about this but I wanted to try and get opinions because my Dr is a pain to get ahold of.
>
> Has anyone ever not given your kids their meds for weekends? Or skip a day? Just to try and get them to eat. I am so confused about these meds.
Posted by bleauberry on October 12, 2008, at 15:33:15
In reply to ? about meds for my son, posted by Lorenzo05 on October 11, 2008, at 18:37:13
If your son, or anyone, is doing a lot better on their med, don't mess with. Don't change dose, time of day to dose, or anything. Definitely don't change the med or add another one. I say this because it is so common to change something, mess it up, and never be able to get back where you were. These meds often do not work the same a second time around after stopping or changing doses. If stable, keep it stable.
The appetite is a tough side effect to deal with. I am real skinny so I can relate to that. The best thing I can think of is to get foods packed with calories and proteins into your son when he eats. A tablespoonfull of peanut butter for example, twice a day, is loaded. When he does eat, make sure he eats quality. Veggies, mostly raw or slightly cooked, proteins, and carbs that have nourishment (whole grain pastas/breads/cereals). A multivitamin/mineral would be a good idea, though it doesn't have to be a megavitamin. Something with 100%RDA is fine, or even half that. Maybe spend some time in a google search to find the highest calorie foods you can, for people called "hard gainers" (too skinny and can't gain weight). Good oils are also loaded with calories. Things like capsule fish oil, spoon flax oil. Contrary to what today's trendy advice is, pure butter and cream are actually good for you, with lots of good oils and calories. It's the bad oils, such as hydrogenated oil (check ingredient labels) and anything except olive oil for cooking that do the heart clogging and cholesterol damage. Eggs also are very good in calories and nutrition, but make sure to get the grain-fed free-roaming ones at the supermarket, which are loaded with good oils and have no antibiotics or chemicals. Regular eggs provide a lot less nutrition.
Some things taste better than others even if there is no appetite. Find out what he likes the most, and use those more often.
In the herbal category ginger root might be worth google searching and trying. It is known for calming nausea and stimulating appetite.
I guess the best I can say is be happy you have found stability and improvement with your son, as there are thousands of people who cannot find that welcome place. Deal with the appetite side effect with strategic choices of foods. You might even be able to invent a powerful milkshake that has favorite fruit, veggies, peanut butter, raw organic egg, etc in and tastes good because of the strawberries or bananas or whatever flavoring you use.
Ahh, and I forgot chocolate. Dove dark is actually healthy stuff and high in calories.
Posted by yxibow on October 13, 2008, at 2:42:49
In reply to Re: ? about meds for my son » Lorenzo05, posted by bleauberry on October 12, 2008, at 15:33:15
I guess my point, and you're right about nutrition, but for the immediate time being, anything that is laoded with calories (besides pure margarine or something like that -- not being flippant) will allow some weight to be placed on, even if it isn't a completely balanced diet, it is better than nothing.
There are medications that can make someone more hungry (including marinol but no doctor in their right mind would give that to an kid unless they had HIV), but I would probably ask your doctor about those sorts of things.
I mean some antihistamines can promote that effect, on the other hand in children can have different reactions than adults.
Plus the panoply of certain small dose antidepressants that generally are a bit more weight gaining than others, but that's an uncharted territory especially considering the disorder at hand.
-- tidings
Jay
Posted by Zyprexa on October 13, 2008, at 6:41:23
In reply to ? about meds for my son, posted by Lorenzo05 on October 11, 2008, at 18:37:13
Maybe you could get the doctor to add a med that will make him eat, like remeron. It also sedates, so with the stimulant it might help that too.
Posted by yxibow on October 13, 2008, at 19:07:36
In reply to Re: ? about meds for my son, posted by Zyprexa on October 13, 2008, at 6:41:23
> Maybe you could get the doctor to add a med that will make him eat, like remeron. It also sedates, so with the stimulant it might help that too.
That's what I meant about uncharted territory, it would probably have to be even smaller than 7.5mg considering the body weight. Pediatric psychiatry is a difficult place.
But that was an idea I was referring to.
-- Jay
Posted by utopizen on October 13, 2008, at 22:38:10
In reply to ? about meds for my son, posted by Lorenzo05 on October 11, 2008, at 18:37:13
> Hi
>
> I am brand new here but I need some advice about my sons medication. The Dr diagnosed him with ADHD a couple months ago. He already has Acute stress disorder and PTSD. When his hair started falling out and he chewed his fingers to the point of infection they thought it was time for meds.
>Okay, I haven't read posters below, but for the sake of your son, and most are likely also echoing this...
please do not listen to your friends. In fact, for the sake of your son I know he's your son, and you're worried, and he's young-- but it's generally not a good habit to get into revealing meds to anyone but his doctor. If you have concerns, seek a second opinion from another _doctor_. Not a nurse, not a soccer mom, and not the lady who cleans your house.
Your son might be young now, but if he's 10 now, in 2 years, he'll be 12. And let's say you'll all agree he'll need Adderall, once he gets behind in his algebra or something. (It's quite possible). Well, telling a gossipy mom your son's med history means odds are pretty good she told someone, if not her own sons, that told someone else's sons. It doesn't take much.
So your son, 2 years from now, switches to Adderall, and some creep at school decides to rifle his bag one day, or hang out with him after school, only to steal his stuff without him knowing. Or, better yet, convinces him to sneak some out to sell. Great. you now have a drug dealer, and the cops just called. (Note: none of these scenarios are remotely rationale for avoiding Adderall, should a doc advise it. 99% of kids don't do any of this).
Worst case scenario? No. I told my friends in school I had ADD all the time. One person who I never knew stole an entire month's supply. (My friends happened to mention to some friend of theirs, innocently enough). I failed classes that summer as a result.
Not to mention, anything happens, ever, and it's not the kid, it's the meds. So any normal, awkward behavior, or eccentric style of the day as he grows up, gets reduced to a chemical by all those judgmental gossipy types who know nothing about meds but love to assume they do and how it must explain all quirks in one's behavior. He gets reduced to a chemical, for things he'd do on or off any med. Awesome.
So don't do it.Oh, and it's probably too late to explain, but, the last person you'll ever want to share medicine info with is a teacher. All they do is gossip about kids. And teachers love to gossip about how the medicine they couldn't spell if their job depended on it somehow is the reason why your kid acts the way he acts.
If his ed plan requires extra time, fine, let them infer. But there's all sorts of reasons for that time, so there's no reason to disclose he's on meds.
When I was growing up, lots of kids went to the school nurse at lunch time for their "asthma." Some probably did have it. I doubt it was 100% of the kids growing up in the 90's. Their parents coached them this, so they wouldn't be subject to other kids, teachers and parents gossiping about something that's none of their business.
I could go on and on. If anything, the fact it's ADD is way more of a reason to keep it between your son, you and your doctor.
I advise coaching your son to realize he doesn't ever, ever need to reveal what medicine he takes, ever, unless it's to a school nurse, or his doctor. This includes even close friends. And yes, asthma is a great cover.
And if he ever does anything stupid as a teenager, he should know never to answer to a cop what "he's on." This can be used in court against him, prescribed or not, to imply all sorts of things. And unlike docs, his medicine becomes public record for the rest of his life-- there's nothing to control that info once he volunteers it.Honestly. It's your kid, not your friend's. What grand insight does your friend have that your doctor doesn't? Aside from the fact it's silly advice... it's just a bad habit to gossip about your kid's meds. There's 1,000 more reasons why, and I won't get into them here.
I'm not trying to be harsh, but, how would you feel if your son went around telling folks about every med you were on? Or, while you have some accident, what opiate you are on, spoken loudly to all your co-workers while he visits your office? Every mistake you do would become "Oh, she's abusing her prescription, poor thing."
Seriously. Don't. Do. It. No good can come of it. Like I said, if you have doubts, get a second opinion from another _M.D._and while I'm on soap box: this site is helpful. It's not meant to override the advice of medicine professionals. I do not have an M.D., but now and then I might mention I had a good experience on a med. That doesn't mean my advice is better than an M.D., or should over-ride it. I'm 25. If anyone is going to take advice from me to over-rule an M.D., they need to up their dose.
Posted by yxibow on October 14, 2008, at 1:34:17
In reply to there's reasons to keep your son's meds private » Lorenzo05, posted by utopizen on October 13, 2008, at 22:38:10
> > Hi
> >
> > I am brand new here but I need some advice about my sons medication. The Dr diagnosed him with ADHD a couple months ago. He already has Acute stress disorder and PTSD. When his hair started falling out and he chewed his fingers to the point of infection they thought it was time for meds.
> >
>
> Okay, I haven't read posters below, but for the sake of your son, and most are likely also echoing this...I'm not echoing this
> please do not listen to your friends. In fact, for the sake of your son I know he's your son, and you're worried, and he's young-- but it's generally not a good habit to get into revealing meds to anyone but his doctor. If you have concerns, seek a second opinion from another _doctor_. Not a nurse, not a soccer mom, and not the lady who cleans your house.This all was stated previously, I for one distinctly mentioned second opinions and I don't think we need to go down into a diatribe vernacular of "soccer mom" or denigrating maids.
> Your son might be young now, but if he's 10 now, in 2 years, he'll be 12. And let's say you'll all agree he'll need Adderall, once he gets behind in his algebra or something. (It's quite possible).Whoah. This is getting a bit scary. There's no reason to predict how a person's child will succeed in the future. We're in the Here and Now. And he's 8, not 10 from the poster's initial comments.
Well, telling a gossipy mom your son's med history means odds are pretty good she told someone, if not her own sons, that told someone else's sons. It doesn't take much.No comment.
> So your son, 2 years from now, switches to Adderall, and some creep at school decides to rifle his bag one day, or hang out with him after school, only to steal his stuff without him knowing. Or, better yet, convinces him to sneak some out to sell. Great. you now have a drug dealer, and the cops just called. (Note: none of these scenarios are remotely rationale for avoiding Adderall, should a doc advise it. 99% of kids don't do any of this).Oh good grief.... I mean you have no idea how someone will behave at school or how the parent will choose to manage medication along with the now predicted adolescent.
> Worst case scenario? No. I told my friends in school I had ADD all the time. One person who I never knew stole an entire month's supply. (My friends happened to mention to some friend of theirs, innocently enough). I failed classes that summer as a result.Actually, in my opinion I feel, that it seems a worst case scenario is being posted. It's like setting up a child's entire life by now.
> Not to mention, anything happens, ever, and it's not the kid, it's the meds. So any normal, awkward behavior, or eccentric style of the day as he grows up, gets reduced to a chemical by all those judgmental gossipy types who know nothing about meds but love to assume they do and how it must explain all quirks in one's behavior. He gets reduced to a chemical, for things he'd do on or off any med. Awesome.
"Reduced to a chemical" ?> So don't do it.
>
> Oh, and it's probably too late to explain, but, the last person you'll ever want to share medicine info with is a teacher. All they do is gossip about kids. And teachers love to gossip about how the medicine they couldn't spell if their job depended on it somehow is the reason why your kid acts the way he acts.
Again, this is an experience with presumably a teacher of yours. True, why share ? But more broad generalizations of teachers, who make some of the lowest salaries in this country for what they have to suffer and endure, including weapons, and all sorts of things I don't need to go into.
> If his ed plan requires extra time, fine, let them infer. But there's all sorts of reasons for that time, so there's no reason to disclose he's on meds.
>
> When I was growing up, lots of kids went to the school nurse at lunch time for their "asthma." Some probably did have it. I doubt it was 100% of the kids growing up in the 90's. Their parents coached them this, so they wouldn't be subject to other kids, teachers and parents gossiping about something that's none of their business.
>
> I could go on and on. If anything, the fact it's ADD is way more of a reason to keep it between your son, you and your doctor.
>
> I advise coaching your son to realize he doesn't ever, ever need to reveal what medicine he takes, ever, unless it's to a school nurse, or his doctor. This includes even close friends. And yes, asthma is a great cover.This is about the only statement I can possibly agree in a list of what seems to be broad generalizations and dissections of a particular school system.
> And if he ever does anything stupid as a teenager, he should know never to answer to a cop what "he's on." This can be used in court against him, prescribed or not, to imply all sorts of things. And unlike docs, his medicine becomes public record for the rest of his life-- there's nothing to control that info once he volunteers it.This is getting really morose. Anybody over the age of 18, or 21 in a few states is considered an adult by definition, and must make their choices as an adult. We've now skipped at least a decade into the future while we're still ignoring the Here and Now.
> Honestly. It's your kid, not your friend's. What grand insight does your friend have that your doctor doesn't? Aside from the fact it's silly advice... it's just a bad habit to gossip about your kid's meds. There's 1,000 more reasons why, and I won't get into them here.
How do you know what friend this is. It seems like a grand character assassination of the friend and scaring the parent in the process. Again, so we don't get into multiple side tangents, this is merely my observation of this entire post.
> I'm not trying to be harsh, but, how would you feel if your son went around telling folks about every med you were on? Or, while you have some accident, what opiate you are on, spoken loudly to all your co-workers while he visits your office? Every mistake you do would become "Oh, she's abusing her prescription, poor thing."This, merely my own opinion, is in fact all coming off as harsh and an unnecessary transference about part of -your- experience growing up.
If you want to discuss your experience growing up, why isn't the tone from, again what comes across to me, a little less crass and a little more with some I statements.
Perhaps this has hit your memory a bit hard, and I can understand that but I fail to see how it is helping this fellow (I assume male, it's irrelevant) about their son.
>
> Seriously. Don't. Do. It. No good can come of it. Like I said, if you have doubts, get a second opinion from another _M.D._Said and done.
> and while I'm on soap box: this site is helpful. It's not meant to override the advice of medicine professionals. I do not have an M.D., but now and then I might mention I had a good experience on a med. That doesn't mean my advice is better than an M.D., or should over-ride it. I'm 25. If anyone is going to take advice from me to over-rule an M.D., they need to up their dose.
"they need to up their dose" ?? That's a little offensive don't you think, or am I taking this wrong.
To me, this appears as a multiparagraph essay that does not serve at all the purpose the original question was, which is questions about medication effects on a child that I believe is too thin for his age (I didn't quite get that part -- or is he too short for his age ?).
Okay, whew. Maybe it was important to get out your frustrations of child development. That's fine, the past helps us all understand our present, in a personal nature, but I still fail to see how all of this helps someone with a few simple comments, which were in there, like a second opinion -- good advice, on how to go about someone in the Here and Now, not 2 months from now, not two years from now, not in their graduation day.
Anyhow fwiw,Jay
This is the end of the thread.
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