A

Ash

Guest
Hi! My son just got prescribed Intuniv for his ODD. He was diagnosed about 4 months ago and fits every single criteria. Every symptom of ODD he has. I was so glad to finally get a diagnosis. We tried for months with therapy but decided finally to go the medication route as he was not even willing to talk with his therapist. He would literally just sit and stare at the wall.

We were given Intuniv and we are on day 1. It took me an hour to get him to even take the pill. I tried everything. Yogurt, apple sauce, bribery with money, bribery with staying up late, bribery with soda ( which he never gets ) Finally he was able to put the pill in his mouth and take some big huge drinks of soda and get it to go down. After he refused to open his mouth and let me see if it was really swallowed and stomped off grumbling at me. I think it went down, im pretty sure it did. I mean he is an oppositional child after all, hes going to oppose the medications as well !

He is on 1mg and we will go up to 2mg. His doctor mentioned him being on 3mg by the end of week 2. He is 6 years old and weighs 48 lbs. Do you think 3mg is too much? Does it really depend on the child and the severity of their symptoms? The 2mg pill is going to be harder for him to swallow I think so I may be ok with the 3mg for only that reason but I just worry that is too high of a dosage? What should I look out for to be able to tell the dosage is too high?

Thanks so much!

Ash
 
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GoingNorth

Crazy Cat Lady
First of all, most of us here don't consider ODD to be a real diagnosis: it's more a set of symptoms caused by an underlying disorder (and there are a bunch of them). The medication you have is usually prescribed for ADHD which can be an underlying disorder for ODD.

Who diagnosed this child? Was ODD given as the working diagnosis? What we recommend in these cases is a thorough neuropsychological evaluation. That is done by a psychologist with speciall training in the workings of the brain.

It's too easy for some doctor to spout "ADHD/ODD" and have it turn out to be something completely different.
 
A

Ash

Guest
his Psychologist is who diagnosed him with having ODD. And when reading about ODD it is like you were reading about my child. He fits every single criteria. Im not sure why you guys here ( those that do) do not feel that ODD is a real disorder but it is. Sure the majority of kids have an underlying disorder. My son has Anxiety just like me, but he does not have ADHD. He does have Obsessive behaviors though and acts compusively at times but not enough to diagnose him as Obsessive Compulsive Disorder (OCD) right now.

We have done tons of therapy with many therapists and he is so set in his ways he just refuses to allow himself to get help and to gain the skills needed to grow. Therefore we have chosen to do the medication route. Trust me its very very difficult for me to medicate my 6 year old. But, if the medication can take the edge off enough for him to be able to take in some of these skills then it will only benefit him. From the medical journals I have read Intuniv has gotten rave reviews with children who have Defiance type behavior. That is my son.

I totally am aware how easy it is for a doctor to shout ADHD and maybe possibly ODD. But the simple fact is my son IS the definition of ODD. 100%

Sorry if I am coming off a bit defensive here. I have worked for over 2 years to get some sort of answers for my son and finally something fits him and now im being told it isn't real. It is a bit annoying especially since it is listed specifically as a real disorder.
 
H

HaoZi

Guest
Those of us that deal with it in our own children tend not to believe it is a stand-alone diagnosis, that it is occurring because of other things going on, and those issues need to be addressed as well. My daughter is also listed as ODD, but in exploring further and using techniques from "The Explosive Child" along with medications, a lot of her ODD behaviors are triggered by frustrations with herself and others. A few months ago I was ready to give up hope and resign myself to having a kid that was smart but more likely to land in jail when she got older because of her violent acting out tendencies. I'm still pushing to get her to a specialist, but it's also become very obvious to me that whatever is going on with her is VERY complicated, and every layer adds more things that complicate. She's also text-book ultra-rapid cycling pediatric onset bi-polar, which can also express itself in ways very similar to ODD. The fact that my kiddo responds to medications so strangely tosses some more wrenches in the mix and adds to our stress and makes me question her diagnosis's, because if she's wrongly diagnosis'd she's obviously not going to respond to those medications normally. If she's on the autism spectrum that can also cause her to respond to medications abnormally, and I'm pushing to get her tested for that, too. Intermittent Explosive Disorder also fits my kid. So does Borderline Personality Disorder. But only when she's triggered - and I'm learning to see her "vapor lock" and know when to back off ahead of time so she doesn't have a meltdown. The medications help her tolerance in this area so we can work on it, but it's a process, not a magic bullet.
While you do have to listen to your mommy instinct, it also helps to be open to any and all information, and if you feel there is more going on and the doctor just isn't looking or seeing, you have to push for what your child needs.
 

smallworld

Moderator
Please understand we're trying to help. I'm confused why a doctor would prescribe a medication for ODD when there are no medications for ODD. Furthermore, Intuniv is prescribed solely for ADHD. That's it's on-label FDA-approved use.

My son met all the criteria for ODD as well. But he has doctors who believe that his oppositional behaviors were fueled by an underlying cause. When the underlying cause was identified and treated, the oppositional behaviors subsided. He's not oppositional at all now, by the way.
 
Hi Honey,
Well just so you know you are not alone. I myself have a 7yr old son. He was diagnosis with ADHD to start. Then January of this year my child was suspended from school every single week that month. He was biting teachers, students, hitting, defiant all of it. We were at the doctors offices every week! I am super involved with my child's medications!! I am very vocal as to the dosages of his medications. I will not allow my child to become a "zombie child". Well he was diagnosis with ODD and anxiety. He has been placed on Intuniv. From the way the doctors and psychologist have explained this to me it can also be used to help control his mood swings. He was already on Adderall XR for the Combination ADHD. They started out at 1mg also and have SLOWLY increased his medication. The way my doctor has his medications set up is that my child takes 1mg morning with his Adderall and 2mg at night before bed. The pills are relatively small. This has been a blessing! My child went from sad faces on a daily basis to Happy faces daily with only one straight face thrown in there. no more suspensions. I have also worked closely with his school. He has a mentor that checks in with him 3 times a day, he sees his school psychologist weekly and has a social class with her weekly, he has also been set up on a rewards program during class time. The teacher walks by him every 10-15 minutes or so and if he is on task, doing his work, and no out bursts he gets a sticker for every five stickers he gets to choose a reward. They are not big rewards just things like extra computer time, a treat from the treat jar, or something called Koala Cash. The same goes at home. He has also been placed in a resource class ONLY for his reading. He is only one level behind but it will help him catch up and boost his confidence. He also receives tutoring twice a week. He is a very smart child, his math science and social study skills are actually above average! My son has had a lot less outbursts at home since on this medicine. For my child routine is the key. Competition is completely out with him. He can not handle it. Only one major out burst since being on Intuniv and that was Saturday before Easter. It all comes down to you knowing your child, being informed, working with your doctors, and doing what YOU believe is best for your child. Like I said my child is now seven years old and weighs only 48lbs. So good luck!
 

Bunny

Active Member
Furthermore, Intuniv is prescribed solely for ADHD. That's it's on-label FDA-approved use.

That's not necessarily true. We have been dealing with aggression in my difficult child. The doctor has discussed with me adding Intuniv as a medication because it helps with this. Once medications are approved by the FDA they are very often prescribed for off label uses if it is found that they are helpful for other things.

As far as whether 3 mgs. Is too high a dose for your son, only you can really say that for sure. See how he does on the dose that he's on. Do you see a difference on his behavior? Is he better able to control his temper and aggression? If he is doing well on a lower dose then I would leave him on that dose for awhile. You don't want him to be taking such a high dose that he's a zombie, and you need to leave room to increase the dose as he grows
 

IT1967

Member
Hi there. My son has ADHD, ODD and Generalized Anxiety Disorder (GAD). He is on 3 mg. Intuniv (along with-other medications). He's 8 y.o. He started on the Intuniv last year. My understanding from our friend who's a psychiatrist as well as our own psychiatrist is that Intuniv is one of the "cleanest" in terms of side effects, etc... I question them upping your son to 3mg. so quickly. Our therapist did tell us that 3 mg. is typically the right dosage level for effectiveness. But it makes you VERY tired. This side effect went away very quickly for us (in a matter of weeks), but each time we increased the dose, the sleepiness recurred until he got used to it. We increased to 3 mg over many many weeks, maybe a couple months, even. I'd be hesitant to go up to 3mg. in 7 days. You might want to talk to your pharmacist about that. I hope that this medication helps your son.
 

BusynMember

Well-Known Member
ODD doesn't stand by itself. The definition of ODD would fit almost all of our kids, but that defiance is not the reason they misbehave. There is a bigger diagnosis than ODD driving the diagnosis. Most of us feel ODD is unhelpful. There is no cause and no treatment because it is attached to other things. I am puzzled why a doctor would say a kid has ODD and give him an ADHD medication. Can a psychologist prescribed medication in your state? In our state it has to be the medical guy, the Psychiatrist. And I'd trust the Psychiatrist a lot more to make a diagnosis. Actually, I recommend a complete evaluation so you know all about your child and what drives him and causes his symptoms.

If the medication helps, I'd be more inclined to believe he may have undiagnosed ADHD. Can you tell us more about your son? Maybe we can give you fresh ideas from the trenches :) We've all been there.


Welcome to the board. So sorry you had to be here though.
 

Malika

Well-Known Member
Hello... I understand your confusion. I realise many people on the forum say this same thing, that "we don't believe in ODD"... but, playing devil's advocate, do they say it because others do?? Does everyone here who says that really, truly believe it for themselves, independently? For myself, I would feel ODD pretty well describes my son also and of course it may be due to other things as an underlying cause but still the manifested behaviour is of opposition and defiance... so it's a rather subtle point, I feel. Of course it's useful to look further for those underlying causes... but I think ODD is meaningful to me.
 

InsaneCdn

Well-Known Member
Malika - I'll answer your question... from my perspective.

I'm one who believes that ODD does not make a good working diagnosis.
There is nothing you can DO for ODD. No medications, interventions, accommodations, therapies... nothing.

We found it useful as a placeholder diagnosis - at least somebody recognized that it wasn't all in our heads, that our kid really did have a problem.
But... we didn't make progress on changing the behavior until we got dxes that we could DO something about... Developmental Coordination Disorder (DCD), Auditory Processing Disorders (APD), anxiety, depression, and so on.
The more we've addressed the root causes... the less of a behaviour problem we have.
 

Corrie

New Member
Hi, my personal feeling is....if it works for him, then it is a good dosage...good luck:) My boy was diagnosed with ODD along with ADHD.. And started on Concerta...he is on 27 mg and what a difference!
 

canadianmama

New Member
Hi there. My son has ADHD, ODD and Generalized Anxiety Disorder (Generalized Anxiety Disorder (GAD)). He is on 3 mg. Intuniv (along with-other medications). He's 8 y.o. He started on the Intuniv last year. My understanding from our friend who's a psychiatrist as well as our own psychiatrist is that Intuniv is one of the "cleanest" in terms of side effects, etc... I question them upping your son to 3mg. so quickly. Our therapist did tell us that 3 mg. is typically the right dosage level for effectiveness. But it makes you VERY tired. This side effect went away very quickly for us (in a matter of weeks), but each time we increased the dose, the sleepiness recurred until he got used to it. We increased to 3 mg over many many weeks, maybe a couple months, even. I'd be hesitant to go up to 3mg. in 7 days. You might want to talk to your pharmacist about that. I hope that this medication helps your son.
Hi there... I'm currently starting the same process for my boy. ADHD and ODD, this is the medication I have decided to go with. He's 5 y.o. My question for you is, has it helped your son with hyper? Impulse? Aggression? Focus? Curious which symptoms it helped in your case :) Thank you
 

JC RoseWoods

Battle weary
his Psychologist is who diagnosed him with having ODD. And when reading about ODD it is like you were reading about my child. He fits every single criteria. Im not sure why you guys here ( those that do) do not feel that ODD is a real disorder but it is. Sure the majority of kids have an underlying disorder. My son has Anxiety just like me, but he does not have ADHD. He does have Obsessive behaviors though and acts compusively at times but not enough to diagnose him as Obsessive Compulsive Disorder (Obsessive Compulsive Disorder (OCD)) right now.

We have done tons of therapy with many therapists and he is so set in his ways he just refuses to allow himself to get help and to gain the skills needed to grow. Therefore we have chosen to do the medication route. Trust me its very very difficult for me to medicate my 6 year old. But, if the medication can take the edge off enough for him to be able to take in some of these skills then it will only benefit him. From the medical journals I have read Intuniv has gotten rave reviews with children who have Defiance type behavior. That is my son.

I totally am aware how easy it is for a doctor to shout ADHD and maybe possibly ODD. But the simple fact is my son IS the definition of ODD. 100%

Sorry if I am coming off a bit defensive here. I have worked for over 2 years to get some sort of answers for my son and finally something fits him and now im being told it isn't real. It is a bit annoying especially since it is listed specifically as a real disorder.
ODD is a substantiated diagnosis within the DSM-5 and got to that point from the supportive research into the disorder. I also find it odd (no pun intended) that some choose not to recognize the diagnosis. It may evolve with the next DSM-5, but it’s imperative that we utilize the correct terminology and approved DSM-5 diagnostic criteria as this will continue to progress BH into a more consistent medical practice. Be assured that the inconsistency in diagnoses can be frustrating to providers too. I would give this unsolicited advice, the diagnosis shouldn’t be misconstrued as a branding. The most important aspect of a diagnosis of is to identify and support the best treatment options available.

This brings me to Intuniv and ODD. ODD and ADHD are loosely correlated as primarily impulse control disorders. That’s a moderate oversimplification, but this forum isn’t grad-school requiring APA format in this posting. There is some interesting preliminary research about the potential benefits of ADHD treatments also having some success with ODD which isn’t all that surprising giving these disorders having a comorbidity risk (frequently show up together).

Lastly, I’m going to say that BH is rarely a single treatment recommendation. I’ve said the following to most of my patients at one time or another:

There are the primary approaches to treatment. Medications alone. Evidence-based psychotherapy (EBP) alone, and the combined approach which predominantly demonstrates higher efficacy rates and longer periods of symptom remission. Although I’m a prescriber by degree, I see medications alone as the least beneficial and will pretty much always hold EBP in higher regard that psychotropics.

Lastly I will ask you to consider this last thing. I have the background that I do but still feel powerless having raised an ODD son that appears to have progressed to borderline PD, and now our youngest with CD. It’s hard enough being a parent and feeling judged about your parenting because of the choices your children make regardless of rewards or consequences.
 
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