Kendall is growing very quickly since being on her ADHD medication. In third grade they originally dropped her time with an aid in the classroom to two days a week. When first marking period grades came in she had a marked drop in her grades. She was still passing and still cognitively up to speed with her peers but her parents met with her teachers and IEP team plan to talk about the next steps anyway. Together they decided that Kendall would have a total of three days with the aid and her parents decided to hire an outside tutor who specializes in children with ADHD to come in occasionally after school.
The rest of the year Kendall passed with flying colors. Socially Kendall is at the top of her game. She has all different friends from school and sports. She is very outgoing and does not hesitate to try new things. Kendall’s parents were once concerned with distracting her from her studies by signing her up for soccer, now they couldn’t imagine not having her involved in competitive extra-curricular activities. Kendall is fantastic at sports. All of the extra energy that seems to be built up in her seems to get put to very good use when she is out on the soccer field. Sports have also helped Kendall learn discipline and focus that has carried over to her academics. At the end of fourth grade, Kendall is invited to join a more competitive traveling soccer team. Kendall and her parents make a deal that as long as her grades stay consistent she can join.
During fifth grade Kendall’s parents and teachers notice that Kendall’s behavior is taking a turn for the worst. She is having difficulty concentrating and her grades started to drop. In addition to that she is experiencing headaches and jitteriness which are affecting her soccer playing. Susan and Leroy take their daughter to her physician and psychiatrist. It is decided that Kendall has built up a tolerance to the Concerta she has been on but due to the fact that she is experiencing the headaches and shakes they are concerned about increasing her dosage.
The doctor’s lay out several options for Kendall’s family to choose from. They can completely remove Kendall from medication and focus on behavioral techniques, they can try a new method in which they use a lower dosage of the drug she is currently on (the simulant Concerta) in combination with the non-stimulant Intuniv, or they can try completely switching to Intuniv. Due to the fact that Kendall does have very severe ADHD they do not believe completely removing Kendall from medication is in her best interest at this point. They want to make sure they have Kendall back on the right track before entering middle school in the fall.
Decision Point: Do Kendall’s parents decide to switch her completely to a non-stimulant medication or do try the new combination of drugs?
Questions:
1. What is the difference between stimulant medication and non-stimulant medication?
2. What are the benefits of non-stimulant medication?
3. What are some alternatives to ADHD medication?
Decision Point: Kendall's parents decide to switch her to a new non-stimulent medicine called Intuniv to reduce the risk of headaches and jitteriness for Kendall. If the medication does not help, they can reconsider the use of Concerta. Non-stimulent medication can be very helpful for children with ADHD and reduce the risk of side effects and addiction/abuse.
ReplyDeleteQuestion #1: Stimulants are more commonly prescribed for children diagnosed with ADHD. They boost and balance levels of neurotransmitters in the brain which improves the signs and symptoms of inattentiveness and hyperactivity. Stimulants can be used as a short term or long acting form of medication for individuals with ADHD. Both types of medication are available. They tend to give the child more energy to stay focused and concentrate. Non-stimulents are a more long term means of medication for individuals with ADHD. They increase the amount of norepinephrine in the brain, which increases attention span and reduces impulsive behavior. Unlike stimulants, non-stimulants do not cause agitation or sleeplessness. They are also not a controlled substance and do not pose the same risk as stimulants to become addictive. Lastly, non-stimulants have a longer-lasting and smoother effect than most stimulants. Non-stimulants also do not have as many risks for side effects.
Question #2: Non-stimulants do not cause agitation or sleeplessness like stimulants do. Because they are not a controlled substance, they do not pose the same risk as stimulants to become dependent or abused. Non-stimulants tend to have a smoother effect than stimulants do on the body. Non-stimulants do not have as many harsh side effects as stimulants and also are longer-lasting.
Question #3: There are many different types of behavioral therapy that can be used in place of medication. Behavior therapy usually includes some type of reward system and timeouts. Behavioral therapy is very common among children with ADHD and can be used as a substitution or combined with medication. Psychotherapy also helps older children learn how to talk about their problems and come up with ways to deal with their symptoms in a positive way. Parenting or family therapy can also be helpful for individuals diagnosed with ADHD to help the family grow as a unit and learn how to deal with the symptoms together.
Citations:
Mayo clinic staff. (2013, March 5). Attention-deficit/hyperactivity disorder (adhd) in children. Retrieved from http://www.mayoclinic.com/health/adhd/DS00275/DSECTION=treatments-and-drugs
Mayo clinic staff. (2013). Nonstimulant therapy and other adhd drugs. Retrieved from http://www.webmd.com/add-adhd/guide/adhd-nonstimulant-drugs-therapy