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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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How To Deal With Child Tantrums In A ADHD Patient?

My 2 and a half year old son has been diagnosed with severe ADHD. He is very defiant and throws constant tantrums. He is delayed in speech and gets very angry easily. He throws his toys and hits my husband and I when he s upset. If we bring him in public he has a meltdown 90% of the time. He will make himself so upset he vomits and has a hard time sleeping every night. My husband and I are on our last thread of sanity. Our pediatrician recommended anti psychotic drugs to calm him down but we don t feel comfortable putting such a young child on this. What other advice do you have? We feel helpless.
Tue, 27 Jun 2017
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Pediatrician 's  Response
It’s not uncommon for children with ADHD to struggle with anger. Kids with ADHD may have trouble with impulsivity or expressing their emotions, which can lead to angry outbursts.
Medications which may reduce aggression in ADHD are
1. Antihypertensives
Antihypertensives, including clonidine (Catapres), guanfacine (Tenex and Intuniv) and propranolol (Inderal) are most commonly used to treat high blood pressure but also are used to treat ADHD. Antihypertensives are the ideal treatment for patients with ADHD and aggression, The antihypertensives may work by inhibiting norepinephrine release from the locus ceruleus, a brain region associated with aggressive behaviors,
2. Antidepressants
Antidepressants can help to stabilize mood and reduce aggressive behavior. Classes of antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), norepinephrine reuptake inhibitors (NRIs), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). An atypical antidepressant, bupropion hydrochloride (also known as Wellbutrin), may not be the best choice for those with ADHD and aggression, as Wellbutrin inhibits the reuptake of the neurotransmitter dopamine back into the brain cells, therefore acting as a stimulant.

3. Benzodiazapenes
Benzodiazepines are normally prescribed to treat anxiety and can be useful in conjunction with stimulants to treat patients with ADHD and aggression. Benzodiazepines include clonazepam, diazepam (Valium) and triazolam (Halcion)

Stimulants such as methylphenidate (Ritalin) and dextroamphetamine and amphetamine (Adderall) are not normally recommended for ADHD with aggression. Stimulants may increase anxiety and aggression, and they have the potential for addiction.

You need to consult behavioral pediatrian to finalise the medications which suits best for you patient.
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How To Deal With Child Tantrums In A ADHD Patient?

It’s not uncommon for children with ADHD to struggle with anger. Kids with ADHD may have trouble with impulsivity or expressing their emotions, which can lead to angry outbursts. Medications which may reduce aggression in ADHD are 1. Antihypertensives Antihypertensives, including clonidine (Catapres), guanfacine (Tenex and Intuniv) and propranolol (Inderal) are most commonly used to treat high blood pressure but also are used to treat ADHD. Antihypertensives are the ideal treatment for patients with ADHD and aggression, The antihypertensives may work by inhibiting norepinephrine release from the locus ceruleus, a brain region associated with aggressive behaviors, 2. Antidepressants Antidepressants can help to stabilize mood and reduce aggressive behavior. Classes of antidepressants include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), norepinephrine reuptake inhibitors (NRIs), tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). An atypical antidepressant, bupropion hydrochloride (also known as Wellbutrin), may not be the best choice for those with ADHD and aggression, as Wellbutrin inhibits the reuptake of the neurotransmitter dopamine back into the brain cells, therefore acting as a stimulant. 3. Benzodiazapenes Benzodiazepines are normally prescribed to treat anxiety and can be useful in conjunction with stimulants to treat patients with ADHD and aggression. Benzodiazepines include clonazepam, diazepam (Valium) and triazolam (Halcion) Stimulants such as methylphenidate (Ritalin) and dextroamphetamine and amphetamine (Adderall) are not normally recommended for ADHD with aggression. Stimulants may increase anxiety and aggression, and they have the potential for addiction. You need to consult behavioral pediatrian to finalise the medications which suits best for you patient.