Trying Something New

As I've posted before, my son has Asperger's Syndrome and ADHD. To keep him focused and earth-bound, we rely on medication until he grows up, gets to know himself and physically/mentally matures enough to learn to handle himself.

From kindergarten through second grade, MLB has taken Focalin, a stimulant used to treat ADHD.  It's worked very well, but has left him with a blunted appetite.  He's more than a bit undersized for his age.

I gave him a "vacation" from his meds this summer and he didn't do half badly.  Bouncy, of course, but more social and less anxious. Every now and then I'd give him some Focalin if I feared he'd be socially inappropriate or would drive someone nuts.  But, when I did give him his meds, he'd become "zombie like," and withdrawn.  He'd seem shy and reticent.  He responded like this even on very low doses, like 5 mg or a half of a 5 mg tablet.

Poor kid has always had what I've called "anticipation anxiety."  If he knows something is coming up, he'll get all twitchy.  Most kids do, but they don't get so excited that they hide under tables or wipe their faces off on their mothers' shirts.  Whether it's waiting for a special day to arrive (field trip) or an uncertain sort of day (cleft clinic), he's a handful and not at all calm.  I finally figured this out when he was three, so we refrain from telling him much until the last possible moment.  Yes, talking about something before it happens makes for better transitions, and is encouraged for his "population," but his preemptive moodiness drives us nuts.

With the start of the school year, I thought some changes were in order.  I did my research and MLB's psychiatrist agreed with my request.

First off, Focalin is no longer his primary ADHD medication.  We have him started on Strattera, an SNRI (Selective Norepinephrine Reuptake Inhibitor.)  Works like the antidepressant SSRIs except on norepinephrine, which seems to have some effect on ADHD.

MLB has responded well to it; he's not sedated, and if he gets derailed, I can redirect him.  It is one of those things that is a constant value in his system, so if we're late with it on a day, or he's over whelmed, we can still give him a bit of Focalin.

Ah, if he's overwhelmed, that's the rub.  Even with his ADHD manageable, he still has his anxiety, and poor social skills to express it.  Which leads to that goofy behavior (made worse when he's tired.) While SNRIs were developed to treat depression, SSRIs are still more effective for depression and the attendant anxiety.  So, after more research and concord with the doctor, we've added Zoloft to the regime, as well.  We've only been on it a few days, and it can take up to six weeks to see full benefits.

Cross your fingers for this.  Meanwhile, some more art!