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12 year old girl with ADHD change in meds

#1

Hi guys
My daughter was diagnosed with ADHD combination sub-type when she was 5 (and medicated at 5 because she started school at 4 years of age)
She has always done extremely well on Biphentin and at her highest peak was on 70mg (10 mg higher than normally is prescribed, because she responded so well to it and has a high metabolism).
She began her menstrual cycle at 11yeats old and immediately we found that we could eliminate the extra 10mg dose, as is common for girls during puberty.
Approximately 8 months later, she began having panic attacks and difficulty sleeping on her own. Her worst panic attack lasted several hours, caused dizziness, shortness of breath, stomach pain, feelings that she would faint, etc.
(Side note: I also have the same subtype of ADHD and can 100% relate to most of the feelings she’s had since she was able to verbalized them).
Shortly after the panic started, I started halving her dose of Biphentin (so roughly 30mg down from 60mg). Initially I did this without telling her , as the power of suggestion is a big thing in my opinion. She thrived. The panic lessened and I actually received an email 2 days later from her resource teacher saying how focused she had been (her resource teacher was unaware of the med reduction).
Fast forward to last week…panic attacks have started again. I totally removed all meds. Prior to doing so, I purchased a lava rock bracelet that absorbs essential oils, infused it with lavender oil. She drinks “calming tea” and takes melatonin prior to bed. Ive tried EVERYTHING.
She is med-free for going on 2 weeks. She is able to focus and stay on task in school so far, but still unable to sleep in her own.
I am 100% pro-medication (when it’s resulting in a happier and more confident child) but I’m also aware of the side effects (increased anxiety, panic, and motor tics). I have not only researched these things, but have experienced them personally.
While I am totally open to holistic and natural remedies, I’m a huge believer in science and western medicine. I whole-heartedly believe in the benefits of meds for adhd kids and am a perfect example of everything that can go wrong when you’re undiagnosed until adulthood. At the same time, if the meds are making life harder, I will do ANYTHING to help my little girl.
Do we need a med change? Do I need to forego meds for now? I have had success with Concerta myself, for going on 9 years.
Aside from all of this (ADHD, puberty, medication), my father has end stage pancreatic cancer. He had a very risky surgery a year ago and it was not curative. He suffered a stroke interoperationally, and it has caused many changes. He has right side paralysis as well as some cognitive delays. He is her grandfather, but he has been more like a father figure to her since she was born. We are a very close family. We share a residence with my parents. They have an in-law apartment in the lower level of our house. She has experienced many changes in her little life in the last year or two.
We have an appointment next week to see a therapist who specializes in adolescent issues, but any advice, in the meantime, would be appreciated. Does anyone else have a pre-teen/teen that has bedtime anxiety and insists on sleeping with them???

#2

As a non-medical person I would say look at everything OTHER than medication for the sleeping problems.

My husband died of cancer and I basically stopped sleeping the last 18 months. My best friend’s spouse died of cancer and he stopped sleeping the last 12 months and his 13 year old son stopped sleeping as well, as did his 9 year old daughter to a certain extent. Not sleeping seems to be a fairly standard reaction to stress for all ages.

I would say therapy is the way to go, I think you’re on the right track.

As for medication, I too, am a big fan of medication. The problem is puberty! Along with the external stress there’s a huge amount of internal stress. I would say rather than stopping the meds that have been so helpful continue your constant tweaking of dosage. A pain, yes. But in the end it should pay off.

Keep in mind, there’s ZERO clincal evidence that melatonin helps with insomnia and minor evidence that it helps with jet lag. You may want to speak to the doctor about something that helps with sleeping as well as anxiety at this point. The issue with grandpa is, unfortunately, only going to get worse. There’s nothing wrong with a little help in the short term, especially because not sleeping just makes everything worse.

azurelle

#3

Thanks so much for your advice. I really appreciate it. The decision to stop meds wasn’t sleep related, but more to do with the added anxiety they can cause. They are both a blessing and a curse (I know from personal experience). She has always taken melatonin, as per our dr’s orders and while, I am too, sceptical of the value, I believe that it’s psychosomatic and if she believes they help her sleep, then its win-win, as they aren’t causing any harm to her.

I’m worried about introducing new meds, although I also wondered about anti-anxiety meds.

I guess I’ll see what the therapist suggests next week on that front.

And yes, things with my dad will only get worse, unfortunately:(