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I am supposed to go pick up Strattera right now...

torrey111torrey111
in Special Needs

but I just feel like it's going to be another fail.  And, I am super worried about the side effects.

I feel like it's going to be another fail because I feel like it's being prescribed under the premise my DS has ADHD, only.  Is it wrong to wait on giving him another med until I get a new eval done?

I've contacted the U. of M  neuropsych clinic where I hope to get some answers.  I feel like it's going to be a comorbid dx- and the other issues may be SID or NLD.  Reading about non-verbal learning disorder sounds exactly like my son and explains so many of his issues.

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Re: I am supposed to go pick up Strattera right now...

  • MummyGruetzieMummyGruetzie member
    IMO, stopping a med right before an eval. is something we definitely try to avoid, but not starting one right before an eval and seeing if what that eval gives you information that either re-affirms the med or offers an alternative makes good sense. And I hear you on the meds. DD clearly needs something to keep her behaviors in a place where isn't a danger to herself, but the last two we've tried have been major fails: major allergic reaction and huge regression. Luckily, our neuro is on board with her needing it and also on board with realizing that we have to tread really carefully with these types of changes. 
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  • torrey111torrey111

    for the record, it's a med we haven't even tried yet.  We just failed with 2 stimulants, and now we're prescribed a non-stimulant- Strattera.  Reading about it made me worried- that it is an SSRI that in my mind, seems to treat more of the emotional side of things (depression?)- which is not our issue.

    Also, currently our pediatrician is prescribing these meds which, I know, doesn't make any fing sense.  I can't even get him on the phone for pete sakes, and I can only imagine he sees the notes and goes to himself "ok. ADHD. Stimulant med.  oh, that didn't work.  stimulant med #2.  oh, that didn't work.  try non-stimulant." Not one moment on his part has been spent thinking about our son specifically.  Scary. 

     

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  • torrey111torrey111
    image-auntie-:

    It's a completely different kind of medication from what you have tried before so you can expect a different outcome. The major side effect for this drug seems to be GI upset that stops immediately when the drug is discontinued. One plus over the stimulants is that Strattera is supposed to improve anxiety as well as attention.

    I think you're wise to get a second opinion from a teaching facility. What sort of NLD red flags are you seeing?

    omg Auntie.  I read this article today and thought, holy crap, this is my kid. 

    https://www.additudemag.com/adhd/article/724.html

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  • torrey111torrey111

    What sort of NLD red flags are you seeing?    

     

    and to answer your ? in case you don't read it- what I'm seeing is: poor visual, spatial, and organizational skills, poor motor performance (both fine and gross) difficulty recognizing non-verbal cues- yet he has a huge vocabulary, fantastic memory and auditory retention, and average to above average intelligence- as evidenced by his IQ score. 

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  • torrey111torrey111
    image-auntie-:
    imagetorrey111:

    for the record, it's a med we haven't even tried yet.  We just failed with 2 stimulants, and now we're prescribed a non-stimulant- Strattera.  Reading about it made me worried- that it is an SSRI that in my mind, seems to treat more of the emotional side of things (depression?)- which is not our issue.

    Strictly speaking, it is not an SSRI, it's a norepinephrine reuptake inhibitor. SSRI are used for more than depression. Most are very effective against anxiety which can be the antecedent to inattention. Many kids on spectrum, for instance, take a SSRI to damp down anxiety and what if/compulsive thinking. A teacher observing a child may assume they're distracted by thing around them when in fact they're unable to turn their minds away from internal distractions. That stimulants didn't work makes this the next likely scenario. Depression in boys this age doesn't look like the ads for Cymbalta either. Pre-puberty, depression in boys usually breaks through as irritablity and sometimes aggression.

    Also, currently our pediatrician is prescribing these meds which, I know, doesn't make any fing sense.  I can't even get him on the phone for pete sakes, and I can only imagine he sees the notes and goes to himself "ok. ADHD. Stimulant med.  oh, that didn't work.  stimulant med #2.  oh, that didn't work.  try non-stimulant." Not one moment on his part has been spent thinking about our son specifically.  Scary. 

    It's scarier that you are not seeing a psychiatrist or developmental pediatrician as a primary prescriber for psychoactive medication. Your pedi is out of his depth. A psychiatrist will have treated many kids and can better anticipate which might meet your son's needs based on his expertise.

    Yes, it is scary that I'm not seeing a psychiatrist or dev. ped for this issues.  I am working on it, now, but honestly, if it weren't for this board, how in the heck would I know to do so?  That is what is so screwy and makes me so mad!  Why doesn't my health care provider tell me this?  How is someone who is just starting to get into this whole world supposed to know how to navigate it???  What if the parent doesn't know anyone IRL who has experience here in the land of dev. issues, dx, and everything else?

     

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  • torrey111torrey111
    image-auntie-:

    imagetorrey111:
    https://www.additudemag.com/adhd/article/724.html

    I read the article; I've read others like it before. It's very odd that the piece goes into considerable depth around differentiating NLD from ADD/ADHD and ODD but doesn't mention Aspergers. It's a pretty glaring omission especially given that the author actually quoted Hans Asperger in the very first paragraph.

    Pretty much everything the author uses to identify NLD is also a common trait in AS-

    Speech at 15 month? it's called hyperlexia and is typical of Aspergers. My kid did this.

    Preference for adults over peers? Diagnostic

    Lots of questions? Usually a function of poor language pragmatics

    Auditory retention? I saw a girl once repeat an entire episode of SpongeBob from memory.

    Poor central coherence? Got it.

    Literalness? Clumsiness? Flat affect? Social difficulties? Ditto. Ditto. Ditto. Ditto.

    VIQ higher than PIQ? BTDT.

    JMHO, Marci probably has parents who shopped a dx. But perhaps this is more a function of being seen by a neuropsychologist rather than a developmental pediatrician or a clinical psychologist. FWIW, Marci's in school services are identical to the ones most kids with Aspergers get in elementary school and in the middle school self contained program where I live. I don't know any IRL high school kid with an AS dx who gets as much, or need as much, in the way of services as Marci does which would suggest she has a more significant degree of impariment than they do.

    If you really believe NLD is your best fit, understand that it is a difficult condition for which to advocate since the district probably won't recognize it. Like I said, this dx has been suggested to me for DS though I quibble over the spatial piece- it just doesn't fit. DS tests in the upper percentiles around spatial reasoning.

    This is a terrific resource for NLD.

    https://www.nldontheweb.org/home.html

    What is the AS quote in the first paragraph?- I'm missing it- please excuse my lack of knowledge here...

    also, when you say "diagnostic" when thinking about preference for adults over peers, what do you mean exactly?

    I don't think that he has a NLD more than AS- I don't know what the heck is going on- but it's something and the NLD fits in line with what we've seen.  I don't plan on telling the person doing the next eval "what I think"- I'll fill out all the paperwork honestly and answer any question, but, in an effort to get at the truth I just want him to take all the information and think critically about it and hopefull give me an answer. (And be right!)

    Oh, and just for clarity- clinical psychologist or dev ped over a  neuropsychologist?  Why exactly?  I feel like someone who has studied and research extensively the neurodevelopmental part of the brain would be really well suited to think about this stuff.

     

     

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