Stimulant medication Reaction Questions

[EB67]

Good evening... 2 quick questions.

Seb took his Daytrana (Ritalin) today and I noticed after school that he was talking a mile a minute. It looked vaguely manic to me. He was giving me a long winded explanation about something and was talking so quickly that I could hardly follow his thought process.

So my first question is this: Has anyone ever noticed that stimulant medication produces rapid speech / thoughts?

I suppose my eyes are extra open as Seb is being eyed for possible BiPolar (BP), and anything that looks like mania concerns me.

Question #2 concerns stimulants and loss of appetite. What can be done?

Many thanks!

 

[smallworld]

Stimulants do affect appetite, no two ways about it. We've given a big breakfast in the morning before medications and allow lots of eating when the stimulant wears off. I've never worried too much about lunch when difficult child 1 is taking stimulants. Is weight gain an issue for Seb?

Pressured speech is a symptom of hypomania/mania. Stimulants can produce hypomania/mania. Did the pressured speech occur as the stimulant was wearing off? Has Seb ever exhibited pressured speech before?

 

[EB67]

Is weight gain an issue for Seb?

Yes! He's such a slim boy and ordinarily he eats like a horse! He's shy of 50 pounds at age 7 and when not on stimulants can eat as much as a hungry adult male. Wacky.

Did the pressured speech occur as the stimulant was wearing off? Has Seb ever exhibited pressured speech before?

Not exactly. The pressured speech occurred right after school while the ritalin was still active. Sometimes if he is passionate about something Seb will speak quickly and excitedly but his speech today was marekdly different and speedy.

I want to mention to that Seb's general approach to homework seemed somewhat hyperfocused and manic today as well. On non medicated days, Seb is quite explosive about even the easiest homework. It takes an eternity and many reminders-- I strain to reinvent Plan B over and over again. Homework is a nasty explosion trigger. There are often tears and outbursts. It's not my favorite time of the day.

Today though, for example, while on Ritalin... he came right home, started to tell me all about the Bermuda Triangle at a mile a minute-- refused a snack, opened his backpack without being asked to do so and then whipped through 3 worksheets. He paused only to show me the 4th sheet-- a (too easy) phonics sheet that his teacher gave him the option of not doing in favor of doing research on the topic of his choice. She often tries to accelerate his work but he almost always opts out of anything.

He proceded to go online and research the Bermuda Triangle-- he printed what he thought were the most interesting points and then HAND WROTE a summary (he has dysgraphia and loathes writing). He hyperfocused on this homework for two hours, refusing to play outside with frolicking neighbors on a slip-n-slide. UNHEARD of. This is a boy who FIGHTS me and homework every single living day. But there he was, plugging away on google and summarizing. Whose kid is this?

Out of the blue he's Mr. Homework on Daytrana. I'm not sure whether to be grateful or worried. It does seem awfully manic to me...

 

[Marguerite]

I wouldn't worry too much. What you describe is also what I've observed with difficult child 3, when he's enthusiastic about something. Also, when talking on his pet interest areas, I can't shut him up, he just keeps talking. All his early years, I prayed for him to talk. Now I feel guilty wanting him to shut up!

Pressured speech is also seen in autism.

In Seb's case, it sounds like he's extremely focussed and wanting to get things done NOW, as if he's trying to catch up time-wise and make best use of this new-found ability to stay on task.

What he's doing/saying DOES sound on task, he's not going off on a total tangent. This is a good thing.

There IS a possibility with stims of rebound, where there seems to be a reaction as the medications are wearing off.

Re appetite - this is a tricky one, both my boys are lightweight. Risperdal put weight onto difficult child 1 (too much weight), but also sedated him. It didn't have either effect with difficult child 3. I agree with the suggestion to pour calories into him for breakfast.

This could also be a dosage thing - if he's still so focussed after school, he may be on more medications than he needs. My kids' medications had worn off by end of school, so homework was always a fight. Even now, with difficult child 3 working at home - he does his best work before midday. He can continue working until about 3.30, but from about 2 pm he begins shutting off all noise and possible distraction.

Marg

 

[Wiped Out]

I remember when easy child first started on Adderall. She was speaking very fast and a lot that day. After the first day she was more back to normal for her. She did stay focused to do homework which for her was great as that had been one of the big problems she had experienced.

 

[smallworld]

I forgot to ask: What dose Daytrana is he taking? How long are you leaving the patch on? And did he have trouble going to sleep last night?

Marg is right -- the dose could be off. Or Daytrana may not be the right medication for Seb. It sounds to me as if Daytrana may have given him too much focus.

Homework has always been an explosion trigger for my son as well. When he first took Concerta at age 9, we were absolutely shocked when he did his homework without a fight. Unfortunately, it hasn't lasted -- he now fights daily about doing homework -- but his mood issues have progressed significantly since his first diagnosis.

I'd recommend watching Seb's reaction carefully. If this behavior continues, I'd definitely check in with the prescribing doctor to tell him what you're observing.

 

[BusynMember]

When I was given Ritalin for myself, it made me "high." Then it plunged me into a depression. I have bipolar II. But remember it's speed. Stimulants can wreak havoc with your moods, especially if prone to mood disorders. I've experienced it first hand. I don't know if it helped my focus or not, but I quit taking them fast as I didn't like the "rush" it gave me, then the plunge.
My son, who is mild-mannered and not bipolar, got aggressive and mean on stimulants. He is on the autism spectrum. We decided not to worry about his focus and that we didn't like the changes in his personality. We got a "no homework" clause in his IEP. We didn't want to fight the BAD fight at home every night and felt it was not worth it to have our son's happiness and the family peace disrupted by homework wars.