A cautionary tale about medication

[germdoc]

I recently had a scare involving my son. He is 17 and has been diagnosed and treated for ADHD for 8 months or so. He is a good kid, very smart, involved in about a gazillion school activities.

He didn't show up for school last Friday. When I found out I was upset and surprised, as this was very unusual behavior for him. I went home midmorning and found him there somewhat agitated and uncooperative. I finally persuaded him to go with me to the doctor, and he told the doc some pretty scary things about not sleeping much, being completely stressed out, obsessing about a variety of trivial things, and seeing and hearing things that might not be real. We had him admitted to the psychiatric unit, which almost broke my heart. I worried about brain tumor, schizophrenia, acute mania and drug abuse, in that order.

After a fast 24 hours of observation, MRI scans, and discussions with the doctor, it seems that he was experiencing adverse consequences from a drug he was taking for his ADHD, Concerta. This drug lasts on average 12 hours and in some people can cause extreme insomnia and hallucinations. I found out that my son was sleeping only 3-4 hours a night when he was on this medication. After we stopped this drug, he improved significantly. We worked out a schedule so he could get his homework done on time and get to bed early. He performed in 2 concerts last weekend that were absolutely outstanding and *almost* made me forget about the trauma of the previous days.

(Not to brag too much, but if you want to hear some amazing music, listen to recordings, especially Marimba concerto, from this site: http://www.lacrosseschools.com/se3bi...categoryID=359. My son plays tenor sax with the Wind Ensemble.)

What I have come to realize after this experience and doing some research on my own is that each person responds individually to medications, particularly psychoactive ones. Ritalin and its relatives are useful for many persons in helping them focus, but they can last longer in the body than expected and lead to progressive problems with sleep and appetite. And, problems can balloon with your kid before you know it. I shudder to think what could have happened if we hadn't recognized the situation before it got out of control.

For now he is taking a vacation from medication and *may* go on a shorter-acting version on a trial basis if necessary.

[Tom Slick]

Glad to hear he is doing better. That must have been scary.

I recently was around a person (early 20's) with a bad case of ADD. Smart guy but you can hardly stand to work with him because he can't sit and focus on work or stay out of anyone else's business, he thinks about 100 things at the same time. He'd take one of his pills (I don't know which one but they were prescription) and 30 mins later he could sit down and work. He was unbearable to work to be around unless on his meds.

[cgallery]

WOW, that was a scary story. Thank God you caught it.

[smorris]

Glad it worked out well.

I've made a habit of always looking up side effects (much to my doctors displeasure) whenever we get prescribed some new drug. The wife had a bout a couple years ago of horrible nightmares she would wake up screaming from, when I looked it up that was one of the potential side effects of whatever the drug she was taking was.

Everyone is different, most people fall asleep on narcotic painkillers, i can't take them because they make me speed my brains out. Give me a vicoden when my back gets real bad and I'm numb but wired for the next 6-12 hours.

[jackellis]

My brother had a similar experience, but in his case it was Dilantin (for epilepsy). Apparently the concentration in his bloodstream was slowly increasing, likely due to an interaction with some other medications he takes to control Crohn's disease. He finally realized something wasn't right and got himself tested. Sure enough, the Dilantin was poisoning him. When your body says something is wrong, it probably is.

One important thing I learned while caring for my other brother as he was dying of cancer is to ask the doctors lots of questions and be prepared to challenge them. If you can't do it because you're too sick, make sure you keep someone around who can. After all, it's your life and the doctors are supposed to be working on your behalf, so you have the right to know what's going on and why.

[WLee]

Do some serious (and I mean SERIOUS) digging on ADHD drugs before even contemplating using them (as in read up on ALL the problems -- then at least you [and your son] will be aware of what problems they can cause, and *IF* he decides to take them again, you can at least be forewarned).

They ALL have serious side effects, but the SSRI's can have some truly "weird" consequences.

Your son may have just dodged a major bullet.


Also, you should be aware that apparently the "benefits" of the ADHD drugs are very short-term -- lots of recent articles on long-term studies:

http://www.newsinferno.com/archives/5338

[footprintsinconc]

wow, that could have been a close call. i am glad that you went home to check on him. it good to hear that he is doing well. best of luck with the new treatments.

[Ed62]

You really had something to be stressed out about. Glad they found the problem, and hope they get things straightened out for him.

Ed

[MilDoc]

UH, just a moment. Your son was diagnosed with ADHD at 17?

That is far beyond the usual age, and makes me question the dx in the first place. Although not impossible, it is highly unusual.

What was the basis for the dx?

Can ADHD meds produce symptoms of schizophrenia? Of course, ESPECIALLY in those that DO NOT have ADHD. Same as speed and crack, etc. Otherwise their benefit with those that DO have ADHD far exceed any problems. In 35 years I have NEVER seen those type effects in ADHD kids.

"After we stopped this drug, he improved significantly. We worked out a schedule so he could get his homework done on time..."

That says a lot. Was that the problem in the first place, at 17? Sorry, that will show up about 1st to 4th grade in ADHD kids, not at 17. So waht was the problem?

I still have to question the original dx. I see kids every month dx with ADHD that are NOT.

[Sid]

Several years ago my wife experienced some tremors of her head and neck. She was diagnosed with Parkinson's disease and given several medications for that. Her condition deteriorated to the point she could walk only with a cane and only for short distances. She also had several seizures in which her whole body shook uncontrollably.

Finally her neurologist decided that her condition and response to the meds weren't typical for Parkinson's, and sent her to a movement specialist. After several tests in his office he said she didn't have Parkinson's. As she was weaned from the Parkinson's meds she returned to normal. The original tremors were then attributed to a side effect from another medication she had been on--something for her thyroid, if I recall correctly.

The side effects of medications took most of a year of her life and nearly forced me to take early retirement to care for her.

Sid

[Knottscott]

You made some excellent and timely decisions. It's so nice to hear about a good outcome.

[germdoc]

Paul, he has had symptoms of ADHD for many years, and in fact his brother was Dx'd with ADHD earlier and took medication for a few years. With his brother, the improvement on medication was remarkable. With Nikolas it's still a little bit of a diagnostic conundrum. We were probably late to to recognize his attention problems.

However, I do trust his doctors. The psychiatrist who saw him in the hospital said she had little doubt about the ADHD diagnosis and she didn't see evidence for any major affective disorders (schizophrenia, bipolar disorder, etc.). Time will tell.

[gsmittle]

UH, just a moment. Your son was diagnosed with ADHD at 17?

That is far beyond the usual age, and makes me question the dx in the first place. Although not impossible, it is highly unusual.

I was diagnosed at age 46. It can happen.

Concerta works very well for me...

g.

[Kristofor]

I'm glad it worked out well for your family. The psychotropic drugs scare me, it seems like they all have nasty potential side effects, like suicide....

What I have come to realize after this experience and doing some research on my own is that each person responds individually to medications, particularly psychoactive ones.

Now you're scaring me, aren't Doc's supposed to pick that up in Med school?

[germdoc]

Now you're scaring me, aren't Doc's supposed to pick that up in Med school?

You don't want to know what they don't teach in medical school...