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Q
My eight-year-old daughter was diagnosed with ADHD when she was two and a half. She can't sit still and is very jittery, but her attention is affected only when she gets very hyper. Most of the time she will concentrate for long periods of time. She's a perfectionist and has an IQ in the superior range.

The doctors have tried Ritilin, Adderall, Dexadrine, Prozac, and Ibuteral, but none of these helped her. Stimulants just keep her up all night. Depressants make her cry and sick to her stomach. The only things that have worked were Clonidine, until kindergarten, and Tenex, until now. She also tests authority figures to the limit -- one minute she's hateful and yelling, and the next she's so loving she's hugging and kissing us. Every school year after Christmas break, we either have to increase her medications or they want to try something new. It's that time again -- any suggestions?

A
It's not clear to me who is doing the evaluation to decide what course of treatment you should follow to address your child's needs. Has a comprehensive evaluation been done? I see that you have an IQ score, but has she had a full psychoeducational evaluation in addition to an assessment for medication? There appear to be many behavioral issues in addition to attentional problems that are not being addressed here.

There are many other conditions, ranging from learning disabilities to psychological disorders, that often co-exist with ADD/ADHD. It's important to get a full picture of your child's needs, so that a comprehensive treatment plan can be drawn up for her that goes beyond multiple trials of different medications. I would call the toll-free number for CHADD (Children and Adults with Attention Deficit Disorders) at 1-800-233-4050 and see if there is a branch in your area where you can get a referral.

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