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Suggest Treatment For Impulsive Behaviour In A Person With ADHD While On Ritalin

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Posted on Thu, 18 Feb 2016
Question: Dear Doctor
I am from XXXXXXX xxxxxx (Colombo) and my son is 24 years. He was diagnosed with ADHD from the age of 8 and was been given Ritalin at that age. But right now he is taking Valparin and Risperidone on the need prescribed by his doctor. Also the dosages are as follows.
1000mg of Valporine (600 in the morning and 400 in the afternoon)
1mg Resperidone( in the evening) if the need arises we give him 2mgs.

The main problem we are facing right now is his impulsive behavior. For example: he gets the urge to kick parked vehicles when we take him out and tries to hit women , he does not touch women, he only wants to hit them two shots on the chest with that he stops, but not all the time. Suddenly he does this without any prior indication. He tells that its coming to him to behave that way. Is this true or is it a planned action? However he doesn't want to hit our own vehicle. He is not worried about this action. He is also happy at times after doing this. As a father I have told him several times of the consequences, but he is not bothered. Why is he doing this? Is there any problem for his erratic behavior? As a parent we are very worried about his future.
On the positive side he can read, write and he has completed his school education (Ordinary Level). And he can play the piano and guitar well, does swimming and cycling well. He also has a very good memory. He is very conscious of his figure and his belongings. He prays every day and does his other work in a satisfactory manner. He helps the mother in the kitchen and also helps in the house chores.
Now he is following a basic computer course at an institute.
The main problem he has is that he kicks parked vehicles (this habit started recently- 3 months) and having a tenancy to hit women occasionally.
This happens when he has a mood swing I believe. That is why he is under Valparin and Risperidone for his aggressiveness. Please advise us how we can overcome this problem so that he can lead a normal life. Also please tell us whether this happens because of his mood swings. If so how we could manage this problem.
Your kind co operation regarding this matter is greatly appreciated.
Thank you

Regards,
xxxxxxx
doctor
Answered by Dr. Neeraj Kumar (25 minutes later)
Brief Answer:
Psychological counselling and therapy

Detailed Answer:
Hi dear,
I have gone through your question and understand your concerns.
Aggressive behaviour is a part of ADHD, and needs to be controlled by drugs, as given to your son.
Mood swings are bound to happen in ADHD, and as the child grows into a adult, these become more prominent. Aggression is a part of mood swings.
Psychological counselling and psychotherapy are the cornerstone of management of such behaviour in ADHD patients.
Proper counselling and adequate psychotherapy sessions will help in calming him down and will teach him also how to control his mood swings and impulsive behaviour.
I suggest you to consult a psychotherapist for his proper and adequate counselling and therapy sessions.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you both good health.
Regards
Dr Neeraj Kumar
Neurologist
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Neeraj Kumar (4 hours later)
Dear Doctor
Thank you for your reply.
Also I want to know whether any particular food needs to be avoided. We are giving him Vegepa (fish oil) a health care nutrition one a day.Is it ok?
Further can you introduce a psychotherapist for us as we do not have one in XXXXXXX Lanka.

Thank you.

Regards,
xxxxxxx
doctor
Answered by Dr. Neeraj Kumar (9 hours later)
Brief Answer:
Consult in NIMHANS or IBHAS

Detailed Answer:
Hello,
No modifications in diet required.
For psychiatrist consultation and psychological therapy NIMHANS in XXXXXXX will be a good option in XXXXXXX or IBHAS in new XXXXXXX if it is not available in srilanka.
Regards
Dr N Kumar
Neurologist
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
doctor
Answered by
Dr.
Dr. Neeraj Kumar

Neurologist

Practicing since :2006

Answered : 2259 Questions

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Suggest Treatment For Impulsive Behaviour In A Person With ADHD While On Ritalin

Brief Answer: Psychological counselling and therapy Detailed Answer: Hi dear, I have gone through your question and understand your concerns. Aggressive behaviour is a part of ADHD, and needs to be controlled by drugs, as given to your son. Mood swings are bound to happen in ADHD, and as the child grows into a adult, these become more prominent. Aggression is a part of mood swings. Psychological counselling and psychotherapy are the cornerstone of management of such behaviour in ADHD patients. Proper counselling and adequate psychotherapy sessions will help in calming him down and will teach him also how to control his mood swings and impulsive behaviour. I suggest you to consult a psychotherapist for his proper and adequate counselling and therapy sessions. Hope you found the answer helpful. Please do get back for further queries. Wishing you both good health. Regards Dr Neeraj Kumar Neurologist