Expert: Joyce A. Anthony - 9/12/2006

Question
Hi, I have a 6 year old who has recently been diagnosed with ADHD and prescribed Focalin, and this was not alarming because I have ADHD and have had it since the age of 12, but now after being on the meds for a month, the Dr states he is concerned about bipolar, my son has a history of getting very angry, very quickly, but the Dr states because he has a very "bully" like attitude, not necessarily yelling but just forward and sometimes very impulsively rude. My sons father has a strong family history of bipolar and this was my initial concern with my son, but the Dr changed his meds to Focalin XR 10mg once a day, and his impulsive ouburst seem to have increased, but for now the Dr wants to monitor the "mood changes". Do you think that the Focalin XR could have a negative effect on his moods?    Thanks

Answer
Nicole:

Thank you for taking the time to question this.  Yes, if your son is bipolar, just giving him Focalin XR could possibly make things worse.  

It is best, when there is a possibility of both bipolar disorder and ADHD, to treat the bipolar disorder first, with a mood stabilizer.  After the bipolar is under control, then treatment for ADHD can be started.  Treating only the ADHD can worsen the bipolar by sending a person into mania, which can explain the increased impulsiveness.

As a parent, you have every right to discuss this with your doctor, and if necessary find one who is willing to work with you.  

                       Joyce A. Anthony