Expert: Dr Billy Levin - 2/13/2011

Question
Dr. Billy Levin
        I am a single mom of two boys, one is 15yr old (on Concerta and Sertraline)and a 3yr old who will be 4 in April and my 3yr old "T" behavior sounds much like the others who have written in. "T" was a wonderful, low maintenance, calm baby until he reached 2yrs of age and it has been down hill ever since. ADHD does run in my family; T's biological father has (undiagnosed) Asphergers Syndrome. My son is impulsive, doesn't like to listen, has severe temper tantrums, doesn't handle being told "no", is motor driven from the second he wakes in the morning till the point he falls asleep at night, yells and screams (hearing has been checked, it is fine). Any form of stimulation and he is OUT OF CONTROL!!!! T has been reprimanded, punished in every way possible from a simple time out to a spanking, to quietly talking to raising my voice. I have sought out advice from those who deal with difficult children and so far I have been told that I am doing the right thing. I am in the process of having him evaluated with hopes of him receiving medication.
          Can you tell me what is the average amount of mg a 3/4yr toddler would be prescribed and what prescriptions are commonly given? I am trying to become as familiar as possible with what a doctor would give to my son so I can research those meds. Thank you.

Answer
A good question but rather surprising in view of the 15 year old on treatment. Obviously his doctor did not inform you fully about treatment. The dose  of a stimulant is dependent on response and has nothing to do with age, weight or severity. A small dose is gradually increased until optimal using rating scales to eliminate the guessing game. Even at this young age stimulants may be tried. Obviously if you are fully informed there would be no reason to do your own research. However some doctors would be anxious to start with stimulants at this age. Hense it would be impossible to give advice without knowing the chosen medication. Sometimes more than one medicatio may be used.