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Posted by N L Holloway
My 8 year old son, recently dx with AD(not so much H)D, learning
disabilities, and expressive language disorder. He had been taking
Ritalin 2.5mg t.i.d., and the positive results were absolutely dramatic,
truly medication was the answer for this child. But he developed a motor
tic in his eyes, which, though not caused by the Ritalin, seemed
agravated by it. So Ritalin was d/c.
After 2 wks of no meds, and a neurologists oppinion that the tic may
spontaneously resolve, the Pediatric Psychiatrist started with Wellbutrin
at 75mg once in am (QAM?). (At this point the tic was seldom to rare).
But I felt uneasy starting with this dose and started my son at 37.5mg.
The tic returned that night, so I dropped the dose down to 18.75mg for
the next two days but the tic remained. The Dr suggested d/c Wellbutrin
and scheduled an EKG to get baseline before trying Pamelor.
However I started to see some effectiveness of the Wellbutrin even on
that low of a dose, and for being on it only a few days.
Well 3 days after d/c Wellbutrin I notice the tic had disappeared! And
so I tried the Wellbutrin again, 18.75mg QAM, and still no tic. After
four days of this dose I started to see some results - better
articulation & expression, improved motor skills, much less socially
withdrawn, some limited improvement in over-emotionality, but not so much
improvement seen yet with attention and impulse contol. I'm waiting a
few more days before I get input from the teacher re: academic
performance.
I increased the dose to 37.5mg this morning and still no tic. So there
may be hope of being able to continue with this med.
Now I know that these dosages are very, very low. And I've heard that
clinical effectiveness with Wellbutrin and ADD is limited. But if I'm
seeing results at low doses does this mean that there is a likelyhood of
better effect as the dose increases? Or is there only likely to be
partial effectiveness, even at incresed dosages?
My son's Dr is the only Ped.Psyc in the rural area I live in and he does
not have any hard-core treatment opinions in this case. Frankly, I think
he is "guessing" his way through.
Has anyone any additional info/experience with this med and children? I
have not found any research-based data/info through the internet and the
PsycLit database has no references for Wellbutrin and Children that I can
find.
Is only one daily dose of Wellbutrin enough for a child when most adult
dosage regimes are b.i.d. or t.i.d? Should I try to titrate up to 75mg
once a day, or go to 37.5mg b.i.d? (I know, only with the OK of the Dr.)
But at this point I'm going to dig up the data, if possible, to suggest.
Any information would be greatly appreciated. This is a kid who really
needs the assistance of medication. He really is a neat kid and deserves
to have the best chance possible to succeed in life.
Thanks.
N L Holloway.