My son took Strattera, prescribed by the psychiatrist and monitored by the PA at the mental health clinic that encompassed all his care: testing psychologist, counseling, psychiatrist. When they first prescribed it, he was seen briefly once a week to see how he felt. His GP was in on the paperwork so it is in his medical records there. Strattera was perceived to be better with attention- and EF- deficits. He had some heart racing, and insomnia, but they were tolerable for the months he used them to help him finish his degree via online courses, living at home, after he was evaluated and treated. If Strattera had been intolerable there were other choices, but he felt like it was not so bad he wanted to start over with something new. After he was done with classes, he talked to his psychiatrist and counselor and they all agreed he would probably be okay in the real world without the meds. (He works in a very open-ended, flex schedule, minute-to-minute creative field job).
It also took us a long time to get the new appointment, referral, assessment, testing, results, report, and debriefing done. I’m not sure why people are surprised; it took my son almost a 10 week wait just to get a screening at his university mental health clinic because the waitlist was so long. He was never identified as a child or teen as needing to be screened, so there was no history to submit, which made things more complicated; the university would not accept the diagnosis because it did not include a childhood history and a particular test; the psychiatrist said the test was arcane and not useful, medically. My son decided the accomodations would not be worth the bother, and he was right.
He has gone on to be happy and healthy, if not somewhat distracted and disorganized. One thing that he later said was very helpful? A support group on campus of students who also were new to ADHD. It made him feel less “like a loser and a freak”. They also had some of the best practical suggestions for daily life.
Yes, my son get lots of exercise, both outdoors and indoors, including weight training and calisthenics. He is very health-conscious and has a healthy diet that is low in sugar.
I actually think your son will land in a good place, @baseballmom, so chin up and be glad the situation isn’t much worse. Do reassure your son, too! Praise him for being actively involved in dealing with his condition. And for staying physically active: that’s so important! Let him know you’re confident in his turnaround – parents’ support is so, so crucial to the kid’s ability to navigate this hurdle.
My son (diagnosed after a nervous breakdown as a college freshman) has really come a long way since finding the right meds and the right psychological support for his near total loss of self-confidence. He’s on Vyvanse, which he and his doc prefer over Adderall, tried an anti-depressant as well, but concluded he could live without it.
My son has left school, but is working full time, living with a bunch of good/supportive friends, and is happy for probably the first time since he was 14. Will he go back to college? Don’t know; I’m not sure he knows either. What I do know is that I have a newly confident kid who actually sees a future for himself. And that’s huge. (Or, as Trump would say, HUUUUUGE 
@katliamom Isn’t a “happy” kid the whole point of everything we do as parents? It’s easy for us to lose sight of that during the journey from childhood to adulthood.
If you can get an appointment fairly soon with a pediatric psychiatrist, I think it may be best. They would have the most up to date knowledge about treatment, medications and monitoring the effectiveness of medication, co-morbid disorders, etc. They are helpful with other issues that may come up in school as well. Another suggestion is to see if there is a local chapter of CH.A.D.D. in your area, (Children and Adults With Attention Deficit Disorder).
Another vote here to be careful about monitoring meds.
Several of my relatives, including one of my kids, have run into serious issues with ADD meds when they were not adequately monitored, including a profound and dangerous loss of appetite leading to scary weight loss, and worsening ADHD symptoms.
Sometimes a change in medication has done the trick, but only after some disastrous school issues.
Congratulations on having a diagnosis that now allows you to move forward! I notice that your original request asked for input on both meds and behavioral therapy…while meds may seem like the easiest route, I’d encourage your son to explore the behavioral route as well. I suspect he’s already developed lots of coping mechanisms, but a specialist may be able to help him - and you? - fine tune those strategies.
(not opposed to medication, so please don’t pile on!)
I think the OP’s son might be too old to see a pediatric psychiatrist. Where I live, these appointments are very hard to make because demand outstrips the number of doctors.
Your son sounds like he has many positive attributes and habits, and he is very fortunate to have such a supportive parent by the way. The medication could make a huge difference in your son’s ability to stay on task especially with “boring” assignments. But I agree with the above poster to also look at behavior therapy and also career testing. Your DS might be better suited for a different career or educational route than what was originally planned. People with ADHD have both strengths and weaknesses. It is best to make full use of those strengths IMO.
The obsessive type behavior you mention could be hyper focusing which is often a trait of ADHD. Because of the name, many people think ADHD is simply about lack of focus. Actually, many people fluctuate between lack of focus and hyper focus. You most often see it when a kid with ADHD is watching tv. They don’t hear or see anything else around them because they are so hyper focused on the tv. For some, they do it with a few interests (often new interests, but not always) but are unable to either balance that focus or bring the same intensity of focus to other areas.
Having been involved with special ed for 16 years, I am not surprised by the amount of time involved in the testing and results, and after OP started the process, and it involved a grad student and delays, there was little she could do but wait–unless she wanted to start the whole process over.
D was diagnosed ADHD inattentive in 6th grade, after extensive testing by a psych ed specialist. Our GP worked on the meds with us–be prepared, it can take more time than you want to get the right medication and best dosage. I hear great things about Vyvanse, D hasn’t tried it. Ritalin did nothing for her;Adderall changed her educational life. She has significant dyslexia, and the interplay between the two is a source of frustration.
In my state one can fill a Schedule II drug (which ADHD drugs are) for 90 days. That is very convenient compared to physically going to the dr.'s office every 30 days for a script. As others mentioned, appetite suppression is an issue, so be aware.
I’m really, really happy he is home this semester, and through the summer, at the very least. Finally getting an answer as to what is wrong has been a relief for all of us. And, this feedback from all of you is so welcome! Thank you so much. I know this is just the beginning of us finding solutions and I am hopeful we’ll find the mix that will help him.
I know I’m bumping a slightly old thread here, but as a PhD student who’s currently doing a practicum at what sounds like a very similar assessment clinic to the one the OP used, I’m surprised that it took 6 months from testing to a final report. Our clinic does very comprehensive, interdisciplinary assessments for ADHD, LD, autism, etc., and it takes 2-3 months from initial interview to the final report being sent out. I’m not meaning to insult anything about the OP’s clinic at all–it sounds like they prepared a comprehensive report and the OP is happy with it, which is great–but just noting that so that other posters who are considering psychoeducational evals know that they don’t necessarily take that long.
@baseballmom , how is your S doing?
@psych_ Thanks for asking. I will spare everyone the details of the frustrating comedy of errors we’ve been through with S’s GP. Long story short, the GP finally prescribed an ADHD drug, Strattera, although the recommendation is for a stimulant med. and Strattera is not. The GP has little experience with ADHD and simply will not prescribe a stimulant.
We are waiting for an appointment with a psychiatrist to review the report and adjust/prescribe as needed - 3 month wait for appointment! We have a psychiatrist shortage in Vermont and it is a serious problem.
S also has an appointment scheduled to begin behavior therapy that will be a continuous/monitoring relationship.
Wow. 3 months. That’s a bummer. Did the recommendation state which med was preferred? If it was a different one is there any possibility of getting a new GP that would prescribe it?
No specific recommendation, but it was for a “stimulant ADHD medication”. I believe Strattera is the only non-stimulant med. He is also on the lowest dose prescribed, which is quite low for a 180 pound 22 year-old. They usually start at 18mg and start increasing after 2 weeks or a month, but none of that will happen with his GP. He pretty much washed his hands of any meaningful treatment and chose the most conservative path. I have heard from others that Strattera can have positive results, so we’ll have to wait and see. S has only been on it for one week. I may ask the GP for a referral to a doc who might be more comfortable prescribing a stimulant.
Why do you have to wait for a referral? Why can’t you just make an appointment with another doctor?
^ I agree with @conmama - Unless you have some kind of HMO insurance where you pick your GP for the year you shouldn’t need a referral to see a different GP.
JMHO, but I think that special care needs to be made to encourage the ADHD child/person to seek a career that really interests them and motivates them. When an ADHD person has “just a job,” that does nothing for them, it seems that they can become lazy, poor employees, etc. Again, this is JMO, but some/many ADHD people seem to thrive when there is more of an immediate reward for hard work (a sale, commission, warm fuzzie). They also seem to do better at jobs that allow them to hyper-focus.
ADHD is often just “tip of the iceberg.” Be aware that many with ADHD also suffer from something else, such as OCD, anxiety, depression, Bi-Polar, Personality Disorders, etc.
We have to choose a PCP-primary care physician under our insurance, so we either need a referral from the current PCP or choose another doctor to designate as PCP. The current PCP may know which docs have more experience with ADHD treatment. Otherwise, we’re just playing hit or miss calling random docs and asking questions. My niece is a psychiatric nurse (in another state) and she suggested asking the current doc as the quickest path while we wait to see the psychiatrist.
This is all beyond frustrating for a helicopter mom.