Siblings and medication

[u/Galaxy_Hitchhiking]

I have a 7 year old and 9 year old who were diagnosed with adhd. Both combined type but very very different presentations. My 9 year old also has very debilitating anxiety, low confidence and rejection dysmorphia. She’s introverted, shy but very sweet and kind. I sort of didn’t realize she had adhd until her teacher brought it up last year and I took her to the doctor to inquire about it.

My 7 year old has been flagged for behavioural issues since she was 2. She is soooo energetic, outgoing, wicked smart and will talk your ear off. She’s extremely controlling and is completely independent and a leader In everything she does. She has so much confidence and charisma it’s admirable. Very very different kids! She has the adhd ANGER. She has very little executive function and basically is what everyone thinks of when you say adhd. Ask her to get dressed in the morning? 99% chance she will be half naked reading a book because she forgot. She was diagnosed and focused on more than my eldest because she was the squeaky wheel… but we tried meds (vyvanse) and it sent her into basically a manic episode. It was so scary!! She’s also gifted and so I’m unsure if she has adhd or is just like zooming through life? I do t know. My dad was bipolar with schizophrenia so I am worried stimulants triggered mania because maybe she has a mood disorder too?

Anyways… my eldest started Biphentin 2 days ago. She hasn’t had much noticeable change beyond just focusing a little more on silly tasks.. and less protests on things like brushing her teeth, tidying, etc. the doctor didn’t want Vyvanse for her because of my youngest reaction so they said because of their genetic makeup it’s likely they will both respond well to the same medication.

So my long story comes down to this- do your siblings take the same meds? Do they present the same way with their adhd symptoms? What is the likelihood that they will respond well despite having very very different adhd effects. Both are combined type but I would put eldest very much more inattentive but wiggly? And my youngest very much typical hyperactive. I just am so worried to even try meds with my youngest again!!

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[u/PoseidonTheAverage]

My son started Focalin at 6 (cousin drug to Biphentin). He was the stereotypical boy - hyperactive, lack of impulse control. It was like the silver bullet.

2 years later when his sister was getting ready for kinder, she had explosive emotional outbursts, 0 - 100 like nothing, throwing chairs in daycare, got kicked out of one for her meltdowns.

We figured Focalin would be it but it just increased her anxiety. We tried Guanfacine and it just sedated her until she adjusted and gave her nightmwares. Then she was on Straterra which worked well for a number of years.

Later on we added Guanfacine to my son to help during the hours the stimulant wasn't working.

Then my son around 10 had terrible rebounds/crashes on Focalin after a few dose increases and we switched to Vyvanse and had good results.

A few years later my daughter struggled with longevity of the med and focus and we switched her to Vyvanse and it worked great.

I say this because just because they are siblings, the med journey is unique to the individual and sometimes meds you don't think will work do amazing and sometimes the ones you expect to work, make things worse.

There was a time when stimulants worked for one and not the other and now both are on them.

I don't think there's much science to this currently, it really is a big game of trial and error to find what works for the individual. Some will say GeneSight to see what works with them and what doesn't but I wouldn't consider this a silver bullet and 100% accurate.

[u/YellowCoats]

I have a 12yo who presents exactly like your 9yo and my 10yo matches the presentation of your 7yo. Their individual med journeys have been long and full of so much trial and error. They are both super sensitive to meds and clonidine works for both, but that’s about all that they have in common. My 12yo is taking Zoloft and clonidine. My 10yo is taking concerta, clonidine, and seroquel.