Question Title: ADHD and anxiety

My 10 year old daughter is impulsive and emotionally immature.
She has become very anxious while in fourth grade. If we try to help her by giving her advice, she misconstrues the information we give her. By Conner's she was felt to have ADHD. Could there be anything else going on here? We placed her on Ritalin which made her very depressed. We then put her on Dexedrine and saw a big improvement in her behavior. When we placed her on 30 mg. spansules, the medicine did not seem to effect her in a consistent way. We increased the spansules to 35 mg. A terrible side effect occurred in which she developed a paranoid psychotic state with possible hallucinations. Should we have decreased the dosage of the spansule instead of increasing it. Thank you.

Dear Where Do We Go From Here,

Psychosis is certainly a possible, though not probable, side effect of stimulant medications. The fact that your daughter experienced this side effect secondary to the increase in Dexedrine dose is not, by itself, indicative that the increase in dose should not have occurred. It goes without sating, of course, that the dose cannot be maintained at that level now.

Attention-Deficit/Hyperactivity Disorder is characterized by symptoms along any of three axes: inattention, hyperactivity and impulsivity. Symptoms of impulsivity tend to rerspond less favorably to stimulant medication than do symptoms of inattention or hyperactivity.

It is not at all unusual for children with ADHD to display some 'co-morbid' condition - i.e., some condition alongside the ADHD. This could well be the case with your daughter, though thre's no particular indication of this in the information you provided.

Please communicate your concern to her clinicians, and be sure that she is receiving therapy in addition to her medication. For many, probably most, children who display ADHD, therapy and parent guidance (along with collaboration with school personnel), is recommended. Generally, pediatric mental health clinicians do not recommend medication as the sole intervention.

This information is provided for purposes of general medical education. Please consult you health care providers for diagnostic and treatment options that pertain to your specific situation/condition.

*Keyword: ADHD, Impulsivity, Psychosis, Side Effect, Anxiety, Ritalin, Dexedrine, Stimulants