Special Needs

Treat severe anxiety or ADHD first?

My 5 year old has been DX with severe anxiety and just this week, he received the DX for ADHD.  He started Zoloft a month and a half ago for the anxiety. This is after years of working with a psychiatrist, doctors and counselors.  Our son needs meds for the ADHD....he is not functioning in school.  Our prescribing doctor feels that the Anxiety is more important to treat rather the ADHD, since both present themselves with the same symptoms. She said to wait and see how the Zoloft helps his Anxiety and ADHD and IF he is still having trouble with his attention and applying himself at school, then she would put him on a stimulant.

Are we better off having our son on a stimulant instead of a psychotic drug?  If the symptoms are the same, would the stimulant work better than the Zoloft?

Our son started on 0.5 ml of the liquid Zoloft.  After a month and seeing no change, he is now on 25 mg (pill form) or Zoloft.  The change that we are seeing now is patients BUT he is more impulsive, overly quick to react in an extremely mean way.  If he wants something, he now GRABS it and SCREAMS "Give it to me!"  He never did that before.  He is also VERY tired and his appetite has decreased.

Not sure what to think.  Any advice? 

Re: Treat severe anxiety or ADHD first?

  • I am mostly a lurker. I have one son with ADD and another with severe anxiety.  I can't really help much as my son with anxiety hasn't shown signs of ADD or ADHD but wanted to say I could relate in a way. My five year old has severe anxiety. For awhile he couldn't enter a house, even when it was all family present.  School was a disaster, sports out of the question.  He even gets upet if we comment on something he did, or tell him he did a good job on something. He uses his older brother as  a crutch, only able to function in the world outside of our house if his brother was with him and doing the interacting for him. We went back and forth on whether to medicate him, my husband has severe anxiety and add and was only first put on meds about two years ago, they have made a world of difference for him.  Whether to test him for autism or not has been thrown back and forth as anxiety mimics autism and autism mimics anxiety.  We ended up changing schools which has helped a lot.  The new school and teachers we've had so far know how to work with him, whereas his old school outright told me they didn't know what to do with him. I have worked with the adjustment counselor and warn his teachers ahead of time the best ways to handle him (for instance, don't make a big deal over anything with him.  Just say hi and move on.  If a person mentions his haircut or the shirt he has on he dropped to the ground and covered his head.

    This year he is in kindergarten and is doing amazing (for him) with the new independence of his first "real" school experience.  We also started a sticker chart, for every social event that he handles himself well he gets a sticker.  Once the chart is full he wants a lego set. A few months ago I decided to try to find a social avenue for him that will also help him build up his confidence level (he constantly tells me he is awful at everything) as well as gain control etc. I read great things about martial arts and he said he wanted to do it. The teacher told me that "they could absolutely fix this problem" after he threw himself on the floor and covered his head. Within 15 minutes they asked us to leave b/c they couldn't help him. I cried the entire way home.  We've tried group sports and he can't handle all the kids or coaches.  Well last week he asked to take a skating class (his brother plays hockey).  I brought him to the first class and he balked at first but went on the ice.  This weekend I brought him again and he not only got on the ice right away but spoke to one of the coaches (this is huge for him). Another kid skating up to him and hit him in the helmet and grabbed his facemask...rather then drop to the ground he skated over to me and told me about it (I saw it happen but being off the ice couldn't do much about it).  But that was huge for him!  He is already talking about going next week and can't wait until he can "play hockey". I've heard kids with anxiety like hockey b/c they can keep the stick between themselves and others, who knows if thats true but he is excited about getting his own stick :) So basically though I can't help with your question I can say that in our case anxiety can come a long way in a year!  I hope that you can find the right mix of meds for him, I know how heartbreaking it can be parenting a child with anxiety.  

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  • Yes to all above, and one extra thought, which I'm sure your son's psychiatrist will be looking for (but is good to keep in mind)-- antidepressants and anti-anxiety meds including Zoloft can sometimes cause anxiety and symptoms like decreased appetite, and are usually prescribed with caution to teens and children.  This is sort of the catch-22 of these medications, because they're prescribed to treat anxiety. 

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