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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Can Mood Swings Be Caused From The Medicines For NF1 And ADHD Or NF1?

my daughter has NF1 and also has ADHD. takes a 15mg focalin xr am and noon and at 4pm takes 10mg focalin xr, and a 50mg trazadone at bed, she is 6. her mood swings have been very severe and is not sleeping. could the mood swings be caused from the meds or the NF
Tue, 18 Oct 2016
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Psychiatrist, Child 's  Response
hello mam,
I can understand your concern. NF is a neurological condition that can present hyperactivity as one of its symptoms. it can also cause temper tantrums. focalin is dexmethylphenidate which is a stimulant drug given for ADHD. it can cause dysphoric reaction commonly.

so our first step is to reduce focalin and see whether this mood swings come down. Also we have to start on behavioral management.

plan:
stop evening dose of focalin.

Pl let me know whether child had any seizures in the past. if so, we need to do an EEG

Also, we have to assess Developmental quotient down the line once these behavior is under control


start ABC charting

A is antecedent (reason for the tantrums)
B is behaviour (describe the behavior)
C is consequence (how was the behavior managed at present )

get back to me with 1 week of ABC Chart

thank you
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Psychiatrist, Child Dr. R Venkateswaran 's  Response
hello madam/sir,
focalin (dexmethylphenidate) is well known to cause dysphoric reaction especially with kids with lower IQ or other brain problems, like NF. so other agents for ADHD, like anphetamine and Atomoxetine can also cause this type of reaction, clonidine or guanafacine may be a better agent for your kid. (Expert guidelines)

regards
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Can Mood Swings Be Caused From The Medicines For NF1 And ADHD Or NF1?

hello mam, I can understand your concern. NF is a neurological condition that can present hyperactivity as one of its symptoms. it can also cause temper tantrums. focalin is dexmethylphenidate which is a stimulant drug given for ADHD. it can cause dysphoric reaction commonly. so our first step is to reduce focalin and see whether this mood swings come down. Also we have to start on behavioral management. plan: stop evening dose of focalin. Pl let me know whether child had any seizures in the past. if so, we need to do an EEG Also, we have to assess Developmental quotient down the line once these behavior is under control start ABC charting A is antecedent (reason for the tantrums) B is behaviour (describe the behavior) C is consequence (how was the behavior managed at present ) get back to me with 1 week of ABC Chart thank you