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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For ADHD In A Child

My son is 9years old and was forced out of his school last year he now attends a private alternative school Wordsworth Academy after I was forced to send him to partial hospitalization at Horsham Clinic for 2week where they diagnosed him with adjustment dysorder ,which I believe was just to say he had something. The doctor at Wordsworth Academy I requested a second diagnosis he told me he has ADHD and all but tried to sell to me to let him prescribe him aderall I immediately denied due to that being a street drug in our area sought after and if perhaps there was a test to say he had this 100% then I d consider another medication. Now I have taken Widen to Child and Family focus and unfortunately b/c there working with him and mybolder son who has asbergers disorder the entire paperwork n eval.process not to mention Magellan unable to find workers for my 2boys which by the way Aidens brother Anthony had services years ago and the behavior specialist stated to me he showed signs also of asbergers for when he s excited he flaps his hands and arms has done this since he was a baby he still does this and jump s up and down all at the same time. I mentioned this to Horsham and Wordsworth.Horsham at a point in his 2weeks there I am certain did this as he does whenever he s happy or excited but that doctor said he did it out of anger,which I have not 1time in all his life seen. Dr.Hodus at Wordsworth has said he rules out autism as well ,he is probably correct because as he may do things to be a follower of his older brother who is very high functioning and shows a lot more signs as years pass if as Berger s I still don t see all symptoms or even half most times Anthony makes friends but I think has trouble keeping them b/c of the asbergers and he shows no emotion really except anger he s the most angry 11year old ever and it seems for zero reasons. Widen on the other hand is loving always writes ,I have found journals where he speaks of me(his mom)brother and father and Anthony tends to be very mean I d say 90%of the time to Widen but in the journals were all praised mind you this is a locked journal please keep that in mind. I myself have had issues in the past with Auden s dad and got in a bad car accident found myself liking the pulls far to much and admitted myself but when Widen dad n I were fighting I haste to say but I often said oh I m gonna kill myself I didn t mean I really wanted rto die I never did but I know Auden has heard that on more than 1occassion and I only said it in hopes his dad wld stop talking down to me or stop hitting and realize what he d lose and I am ashamed to say I did take a whole bottle of Tylenol 1ce after he hit me not to blame him my therapist said at the time when he hurt me I wanted to hurt me. When the attempt happened Auden was only about almost 4maybe and I don t think he really remembers until daddy gets mad at me and tells my boys all the wrong I have ever done things they should not remember but are drilled.Anyway alrpthough that was the last of trying I still said it when we gpfaught,which brings me to Auden saying this at school and then was kicked out and they waited an entire month after he said that to do anything. The only thing I see with Auden and its been since a toddler is if he doesn t get his way hell cry n throw a fit for hours no exaggeration at all. I know he repeated that phrase from mevwen not getting his way he still says it now n again only wen he doesn t get his way ,that s the only ever it occurs . Well I just received the evaluation from Dr.Horus from school which this eval.lasted alm.3months long at the meeting he said ADHD mentioned adderal I denied he even tried convincing me it wasn t addictive,isn t it an amphetamine or so!merging like that? Point I am trying to get to is not 1time did the say pediatric bipolar rapid cycling disorder.This he mentioned when corresponding with Child and FAM focus saying he wanted to put him on lithium. Am I crazy or what but that s extreme and all I know of bipolar is patients have highs and lows .Get depressed won t get out ohf bed then there high on litre shopping and running around carefree. This is not Auden I don t jknow where he got this except for him saying things sabout suicide but Dr.Horus even says he shows no signs of trying it. I guess my question is what do you think from just hearing all this he may have? Also do you think I should get Dr.Horus out of the loop since he is determined to over drug my sweet boy???
Thu, 12 Jul 2018
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Pediatrician 's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.


First, about ADHD, Adderall is a short-acting amphetamine . It also is made in a long-acting formulation, Adderall XR. The other class of stimulant medication taken for ADHD is Ritalin and Ritalin XR.
There are other ADHD medications, but it is generally agreed by physicians prescribing these meds that the stimulants are the first-line treatment for ADHD.
One of these medicines is initiated at the lowest dose and increased at one week intervals. Should a stimulant from one class not be effective, then the physician changes to a stimulant from the other class.
There is currently no blood test for the diagnosis of ADHD. The best way to make the diagnosis, after the doctor takes his/her own history and performs his/her own physical, is to obtain the observations of the child's behavior from as many responsible adults as possible. When I was making this diagnosis in a previous clinic, I gave the parent two copies of an ADHD Rating Scale(the Vanderbilt). One for the parents and one for the teacher. The teacher's copy could be copied and handed out to child's other teachers. Coaches, librarians, adults teaching hobbies, etc. were also asked their opinions.
Each questionnaire was then rated. If there were high scores for hyperactivity, impulsiveness, and inattention(the three behaviors that characterize ADHD) which was in agreement with what mother told me
and the (6 year or older)child had no learning problems nor difficulty with hearing or vision, then I would recommend trial of a stimulant.
And continue follow-up in the subsequent weeks.
I am providing you with these details to show you the diagnosis of ADHD is not made lightly.
A child who has Asperger's syndrome can also have ADHD. I don't feel we need to discuss your sons' other behaviors now because I am most concerned about how YOU are being treated.
Ma'am, you are in an abusive marriage! And you must get out of it. Until your own life is safe and stable you are not going to be able to do much to help your children.
If you are receiving therapy, you need more or a different therapist.
Please contact your city/county social services department or the social service agency of the religion to which you belong NOW. An informed, compassionate, up-to-date psychiatrist or LCSW can be the professional who is on your side.
Hope I have answered your query. If you have any further questions, I will be happy to help.
Arnold Zedd, MD, FAAP





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Suggest Treatment For ADHD In A Child

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. First, about ADHD, Adderall is a short-acting amphetamine . It also is made in a long-acting formulation, Adderall XR. The other class of stimulant medication taken for ADHD is Ritalin and Ritalin XR. There are other ADHD medications, but it is generally agreed by physicians prescribing these meds that the stimulants are the first-line treatment for ADHD. One of these medicines is initiated at the lowest dose and increased at one week intervals. Should a stimulant from one class not be effective, then the physician changes to a stimulant from the other class. There is currently no blood test for the diagnosis of ADHD. The best way to make the diagnosis, after the doctor takes his/her own history and performs his/her own physical, is to obtain the observations of the child s behavior from as many responsible adults as possible. When I was making this diagnosis in a previous clinic, I gave the parent two copies of an ADHD Rating Scale(the Vanderbilt). One for the parents and one for the teacher. The teacher s copy could be copied and handed out to child s other teachers. Coaches, librarians, adults teaching hobbies, etc. were also asked their opinions. Each questionnaire was then rated. If there were high scores for hyperactivity, impulsiveness, and inattention(the three behaviors that characterize ADHD) which was in agreement with what mother told me and the (6 year or older)child had no learning problems nor difficulty with hearing or vision, then I would recommend trial of a stimulant. And continue follow-up in the subsequent weeks. I am providing you with these details to show you the diagnosis of ADHD is not made lightly. A child who has Asperger s syndrome can also have ADHD. I don t feel we need to discuss your sons other behaviors now because I am most concerned about how YOU are being treated. Ma am, you are in an abusive marriage! And you must get out of it. Until your own life is safe and stable you are not going to be able to do much to help your children. If you are receiving therapy, you need more or a different therapist. Please contact your city/county social services department or the social service agency of the religion to which you belong NOW. An informed, compassionate, up-to-date psychiatrist or LCSW can be the professional who is on your side. Hope I have answered your query. If you have any further questions, I will be happy to help. Arnold Zedd, MD, FAAP