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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Behavior Problem In Children With ADHD

I have a 15 year old stepdaughter who is a type 1 diabetic. She also has ADHD and Dyslexia. She is on several medications and has issues with defiance, angry outbursts with a history of striking her mother. Her hygiene is terrible, and today I discovered that she has defacated in her bathtub. Is it time for inpatient psychiartic treatment?
Mon, 14 Sep 2015
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Psychiatrist, Child,  's  Response
FROM THE INFO PROVIDED BY U , IT APPEARS THAT UR STEPDAUGHTERS CASE IS NOT A SIMPLE CASE OF ADHD AND DYSLEXIA. IT IS LIKELY THAT SHE IS HAVING OTHER DIAGNOSABLE PSYCHIATRIC CO-MORBIDITIES AS WELL. THE FOLLOWING ARE THE POSSIBILITIES WHICH WE NEED TO EXPLORE-
1.MOOD DISORDER, EVEN BIPOLAR DISORDER
2. A CERTAIN DEGREE OF MENTAL RETARDATION(SUBNORMAL INTELLIGENCE) MAY BE CO-EXISTING.

HER BEHAVIORAL DISORGANISATION AND POOR SELF CARE ARE SUGGESTIVE OF THESE POSSIBILITIES. ALSO WE NEED TO LOOK INTO PSYCHO-SOCIAL ISSUES AS WELL.HOW IS HER RELATIONSHIP WITH U? HOW IS SHE COPING WITH HER DIABETES? DOES SHE EVEN UNDERSTAND THAT SHE HAS DIABETES?



I SUGGEST 10 MG OF ATOMOXETINE TO BE GIVEN IN 2 DIVIDED DOSES. IT CAN BE INCREASED TO 20 MG AFTER A WEEK DEPENDING ON RESPONSE AND THE TOLERABILITY.
FOR ANGER ISSUES AND DISORGANIZED BEHAVIOR , A SMALL DOSE OF RESPERIDONE 2MG IN DIVIDED DOSES CAN BE STARTED. PLEASE CONSULT A PSYCHIATRIST IMMEDIATELY. IT IS BETTER TO GO FOR IN-PATIENT ACUTE PSYCHIATRIC CARE.


DR SMRITHI
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Suggest Treatment For Behavior Problem In Children With ADHD

FROM THE INFO PROVIDED BY U , IT APPEARS THAT UR STEPDAUGHTERS CASE IS NOT A SIMPLE CASE OF ADHD AND DYSLEXIA. IT IS LIKELY THAT SHE IS HAVING OTHER DIAGNOSABLE PSYCHIATRIC CO-MORBIDITIES AS WELL. THE FOLLOWING ARE THE POSSIBILITIES WHICH WE NEED TO EXPLORE- 1.MOOD DISORDER, EVEN BIPOLAR DISORDER 2. A CERTAIN DEGREE OF MENTAL RETARDATION(SUBNORMAL INTELLIGENCE) MAY BE CO-EXISTING. HER BEHAVIORAL DISORGANISATION AND POOR SELF CARE ARE SUGGESTIVE OF THESE POSSIBILITIES. ALSO WE NEED TO LOOK INTO PSYCHO-SOCIAL ISSUES AS WELL.HOW IS HER RELATIONSHIP WITH U? HOW IS SHE COPING WITH HER DIABETES? DOES SHE EVEN UNDERSTAND THAT SHE HAS DIABETES? I SUGGEST 10 MG OF ATOMOXETINE TO BE GIVEN IN 2 DIVIDED DOSES. IT CAN BE INCREASED TO 20 MG AFTER A WEEK DEPENDING ON RESPONSE AND THE TOLERABILITY. FOR ANGER ISSUES AND DISORGANIZED BEHAVIOR , A SMALL DOSE OF RESPERIDONE 2MG IN DIVIDED DOSES CAN BE STARTED. PLEASE CONSULT A PSYCHIATRIST IMMEDIATELY. IT IS BETTER TO GO FOR IN-PATIENT ACUTE PSYCHIATRIC CARE. DR SMRITHI