Tolerance/habituation to ADHD medication?
Our daughter was medically treated for ADHD with 3 variants of the one class of compounds that worked for her from 3rd-12th grade . This was the right solution for her, and enabled her to have a happy childhood with social and academic success. Now a young adult, she finds that none of the medications that she took through high school nor any others that she has tried since are effective. She is struggling terribly to stay afloat academically at UC. She has a psychiatrist, a therapist, and an ADHD coach provided through student health. The psychiatrist believes that Daughter has developed a tolerance to the medications in the general class of compounds that used to work, Daughter has not experienced significant benefit from other classes of ADHD compounds. Psychiatrist reports that there are no other medications to try. Has anyone else experienced anything like this? Any recommendations for medications that have worked in similar situation? If anyone has recommendation of a doctor accessible through UC SHIP or Kaiser would be greatly appreciated. Lectures about medicating children to manage ADHD would not be appreciated. Thanks.
Parent Replies
Hello and this sounds hard. I’m so glad your daughter thrived on her treatment — and I agree that it is strange that the treatment no longer has an effect. I’m a family medicine doc with a focus on adolescent health and I’m currently in a psychiatry fellowship — I will pose the question to my mentor re: Neurocognitive changes in youth around 20 years old and ADHD treatment.
In the meantime, in case this hasn’t been covered by her treatment team:
is it possible that she’s using THC?
is it possible that depression and or some kind of manic mood disorder is newly emergent?
as a young adult newly living alone, is it possible that she is inadvertently not taking the medication regularly?
I’ll post any response I get from my mentor.
good luck and I’m glad she has such a supportive mom!
I do think (& worry) this can happen but I’d be irritated if the doc isn’t willing to try meds even if your daughter has tried them earlier in her life. Also, I understand from my sons psychiatrist that it is state of the art treatment to augment a daytime stimulant with a non stimulant guanfasine (?) & similar med to take in the evening. My son took Foccalin XR 5th through 10th grade & it stopped WORKING & we’ve spent 18 mos finding a replacement. Now he’s taking a pretty high dose of Adderal short acting twice a day. If this works for the next month we’ll add guanfasine. He’s off to college soon & need to get this worked out.
good luck!
I am a retired teacher and have an 18 year old son who has been taking Prozac for anxiety for some years. Within the past couple of months, I've had him do some weekly neurofeedback sessions (33 minutes each) and they seem to be helping him be more focused and calm. I've done about 5 sessions myself and feel more focused and calm, too. Apparently, the neurofeedback can also be effective for providing relief from ADHD symptoms. This is a non-medical solution and I thought I'd mention it, just to give you another option. We go to a place called the Bay Area Brain Spa, on Solano Avenue (one block below San Pablo Avenue). The two owners are very helpful -- Carleigh and Angela.
We had a variation of this happen and tried the Daytrana patch which, even though it's the same class of drugs, was like trying an entirely new thing. Like you, medication enabled my kid to succeed academically and socially in a way that was impossible before. I cannot say enough how different the patch experience was for our teenager, who said they didn't realize how much of their day they spent feeling weird going on/off the medications. It changed their ability to interact in such a positive way for so much more of the day. Our dr, an "expert", said he'd never prescribed it in decades of practice. Might be worth a try. Most dr's don't seem knowledgable about it.