Treating side effects with OTHER meds? Help!

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    • #74669

      Hello all, I’m brand new to this forum. My 10 year old son has been treated for adhd inattentive for over 2 years. We’ve tried a few different stimulants: Vyvanse made him very moody and borderline physically aggressive. Concerta was better, but began compulsively biting his nails – he is moody still but not as bad and we can usually talk him down from it. Focalin XR is what he’s taking now (15mg QD) and an as needed dose of Ritalin (10mg) for homework and afterschool priorities. The medication has helped him a ton with school and his grades and behavior are nothing to complain about. My issue lies with our psychiatrist and his psychiatric nurse practitioner, wanting to prescribe an ssri for his side effects. Again, he can be moody, obsessed with things and becomes inflexible, and the nail-biting is really bad. My concern is treating side effects of medication! Without the meds, he’s so much more loveable in terms of his goofy and happy personality coming out. He wasn’t anxious or OCD like until he started taking meds. Does anyone have any advice or input on treating symptoms AND other meds that have been less side-effect inducing? Forgot to mention, he takes generic Strattera (60mg) and I don’t think it’s helping him AT ALL.

      Thanks for your help in advance!

    • #74697

      Hello! I am an adult with ADHD and very proactive in researching alternative natural ways to treat my symptoms in order to get off of the Ritalin, which has horrible side effects. I came across a product called “NOOTROPICS.” It is basically a supplement that has an ingredient for Psychostimulatory effects ( such as the stimulant in Ritalin ) and it also includes 13 other supplements; such as L-Tyrosine which is recommended for ADHD. The brand I’m using is called NOOCOR, which I found on Amazon. I take 1 tablet in the morning, and within 30 minutes I feel focused, energetic and ready to start my day. I am 52, and have been at this a long time. This works 100 times better than the Ritalin. Please Google & research this. I became tired of constantly having prescriptions thrown at me, I want a safer way to treat this. Good luck to & God bless.

    • #74710
      Penny Williams

      Straterra was originally created as an anti-depressant but ended up better suited to treat ADHD. If you don’t think it’s making a difference, ask the doctor to take him off of it (you probably have to titrate off so make sure you get guidance from the prescribing doctor). Straterra does cause moodiness and irritability for some, so could be the problem.

      Stimulants are known to sometimes affect mood negatively. No parent wants to put their child on medication at all, much less multiple medications. I have always reminded myself that we give our son medication to help him, not to help us. If your son truly needs both to function well and successfully and with some happiness in his life, then it makes sense to have two medications. If the stimulant weren’t improving his quality of life, then you obviously wouldn’t want to add a medication to treat side effects. But, if there’s a lot of benefit then it becomes a worthwhile consideration.

      If it were me (keep in mind I’m NOT a doctor or clinician, just a mom who’s been around this block many, many times), I would ask to stop the Straterra since you don’t think it’s doing any good, and then reassess. If you still have the same issues, you can try the an SSRI and see if it’s helpful.

      Here’s some insight on multiple medications:

      Multiple Medications for Your Child: What You Need to Know

      ADDitude Community Moderator, Author & Mentor on Parenting ADHD, Mom to teen w/ ADHD, LDs, and autism

      • #74945

        I would love some comments from those who have had success with Strattera. Forgot it was originally an anti-depressant

    • #74872
      artist mother

      Hi! I’m also new to this forum – joined to respond to you. My son started medication for ADHD at age 11. When he comes off it (he’s on Vyvanse) sometimes he can be crabby and irritable. Do you find the inflexibility and obsession to be only related to the med? My son is borderline spectrum so he is naturally rigid and has a few OCD things but his anxiety makes it worse. It would be true whether or not he was on ADHD meds.
      When my son turned 15, his anxiety (always there, we’d been told about it since he was 5 but never noticed ourselves) took off and was really bad. Finally this past summer he went on an SSRI and it has helped considerably. It turns out, he just needs it.

      We have never been in a hurry to medicate him, and certainly don’t do it to make our lives easier, as I know you do not. But if your son’s quality of life will be improved, it might be worth a try.

      My other suggestion would be to get your son outside, preferably in as natural a setting as you can manage. A hike every day would be ideal: physical activity is calming, and nature helps reset our inner workings. I used to be able to do this with my son, and in fact intuitively did this even when he was a toddler. We went outside twice a day and it kept him on an even keel (now that he’s a teen it’s a lot harder to get him out of his chair!).

      Best of luck!

      • #75484

        Thank you for your reply. The NP has mentioned ASD as a possibility, and I’ve suspected that for a while. I️ know there are varying degrees as to where they fall in severity, but if he is, i think he’d be what one would consider borderline spectrum. I’m not in denial of him being on the spectrum at all, it’s just that he has so many qualities that would make anyone think otherwise, but we’ll just have to get him tested by his doctor and NP to know for sure. Until our new insurance kicks in March 1, and with the schedule from his NP, were titration him down off the Strattera. His teacher allows him to play with his fidget cube during school and he has t bitten his fingers all week!

        Anyway, thank you for your reply and thoughts!

    • #74890

      Hi Scolli 3412.
      I think Focalin frequently results in side effects such as depression and other personality changes.
      You might want to first go to simple Ritalin instead of combining focalin and ritalin. There are enough ER options that will allow you to blend the right dose and release of simple Methylphenidate. Do this before adding other meds.
      Also, is he taking Strattera IN ADDITION to the others? That would be way over the top for a 10-year-old.
      ADHD treatment is a marathon. Try to not go too far down the meds alley at this age.

    • #74901

      Hi there I cant answer for your son but for me concerta xr /amitryptlene combination did not work even with an SNRI that i was taking that brings out all those great and humorous spontaneous and otherwise happy personality traits that I had lost for 55 years. So I live with Venlafaxine and leave the apggressive assertive in a not nice way meds in the vial. My life enjoyment is profoundly improved and by the laughter so is that of those around me. Wonderful how it has dealt with the RSD and LFT and rage. Would not trade it. Memory that is working memory improvement has been outstanding (I memorize 100 pieces of music each year with very little needed in home rehearsal. The longest was Mozarts Requiem. The shortest a couple of pages. Singing gives me that added dose of Dopamine 4 or 5 times a week. Singing in Choral groups (bass) that is.
      Timeliness has not improved much but energy sure has.

    • #74907

      Sounds like me. I started taking l-theanine with my Ritalin. I heard it is the synergistic companion to caffeine and why green tea doesn’t give you the jitters like coffee. That worked to keep the benefits of the meds and sooth my mind so I didn’t feel like I was over amping. I also use a product called Brain Link Complex. Eat nuts and seeds all day. I’m a powerhouse that needs to run. Eat eat and eat to fuel this freight train. Take it easy are the worst words I can hear. I implode and get depressed. Garden of life makes a chocolate raw organic meal. I grind up oats and flax seed in a coffee grinder to add to the 2 scoops in a blender. Takes the raw knowing of not getting enough out of my day. Brings more calm power. I keep in mind that the brain does nothing but burn calories. I treated my brain like it needs to be well fed. If not, I crave sweets. Fast energy. Along with that starved energy seeking craving is heightened agitation and intolerance as well as a crash and fatigue. Never go without proteins. That’s my story. Hope it helps someone. I have to add, I lived the horror of not being properly medicated for 51 years. I finally found a Dr that understood and gave me earlier high enough dose to bump over the “almost functional” place that stole my life. Thank God.

    • #74911

      I think my reply disappeared after I hit post…Apologies in advance if this is repeated.

      From what i can tell, there’s a couple of non-stimulant ADHD medications your son hasn’t tried yet. One is called guanfacine. Russell Barkley (the ADHD guru doc) says in one of his YouTube videos that it’s often good for ADHD-Inattentive subtype and can be combined with a stimulant, as they work on different parts of the brain.

      While there’s nothing objectionable to being on an SSRI and a stimulant at the same time, it would seem reasonable to ask the doc and NP whether you could exhaust all the non-stimulant and stimulant ADHD medications FIRST before considering that option. He may do great with a different non-stimulant. Clonidine and guanfacine tend to be calming. If the remaining non-stimulants don’t work, then ask about trying all the stimulants too. My daughter, for example, was agitated and irritable on Adderall, but she’s good with Vyvanse and Dextroamphetamine, even though they’re both in the same class of stimulants. How one responds is so individual, so you won’t know until you try them.

      I cannot imagine any doc or NP worth their salt insisting you try your relaxed and happy son (when he’s not on medication) on an SSRI when he hasn’t tried all the ADHD medication options first. (Internet search “ADHD medication guide pdf” to find a list of medications and their classes.) Health providers don’t like to be told what to do or second-guessed, even if you’re nice about it, so I would say something like, “Maybe I’m being irrational, but I’m kind of afraid of putting him on more medications right now and was wondering if maybe there’s an ADHD medication out there that might not be as agitating for him. Are there other non-stimulant options he hasn’t tried maybe?” Then, the doc or NP gets to look like the expert by listing them and prescribing them for you.

      Good luck!

      • This reply was modified 4 years ago by fatdog11.
    • #74913

      Try reducing the dose. Sometimes The lowest dose could be enough, or at least therapeutic given the Side effects of higher dosage. Perhaps even half of the lowest dose may be where you or your child do not have the anger issues. They have been likened to ‘Road Rage’ To expect your child to control such urges is not reasonable.

      The standard of care seems to be keep upping the dose until a side effect appears. The Road Rage can go un detcted by parents and teachers where they attribute the behavior to the child and not the drugs they have been given.

      My former wife, a physician, and coparent kept wanting to up he meditation. I settled her lawsuit with a three blind week trial. Meditation randomly administered by school nurse. 1 week 0, 1 week 20mg, and one week 30 mg of vyvance. This was before they had the 10mg. Dose.

      The 30 mg week was hell for my son. 20 was therapeutic with slight side effects.

      Try cutting the dose.

    • #74936

      I feel sorry for your son. Clearly the meds are screwing him up! I’ve taken psychiatric meds before and I can tell you while they helped a little they also made things worse with all sorts of side effects. I’m so glad to be off them today! Understand also that psychiatry is a hit and miss (and you are sometimes a guinea pig), simply because they DO NOT look at your brain before they prescribe you long-term mind drugs. A cardiologist and gastroenterologist would logically scan your heart and scope your gut before they give you lifelong heart and gut medication. If I were you I would look for another psychiatrist and aim at minimizing the dosages and number of drugs. Give your son therapy at the same time. The goal is always to learn strategies to manage the ADHD (requires a certain maturity, of course) so you can be off the drugs or at least have a minimal dosage and dependence on the drugs.

      • This reply was modified 4 years ago by AT.
      • #75485

        Ummm, don’t feel sorry for my son, thank you. He’s not getting screwed up because of his meds, he’s just experiencing side effects and we’re trying to help in managing it. Why do you think i thought to post my question.

    • #74942

      If the research I’m seeing is accurate, kids treated for ADHD properly have the possibility to reduce or eliminate its affects as adults. Tweens and early teens have rapidly developing brains, and their brains can still do some rewiring. BTW, any experts out there who know this to be true or false, please chime in. My only expertise is dealing with myself, and having no idea I had this condition until my 50’s.

      So doing everything we can while they are still young enough to rewire is, to me, absolutely critical. Given that we are just big bags of chemicals, everything we consume can change our biochemistry. Try everything, look for what works. It may be different for each of us.

    • #74944

      Strattera….I hated it…. diagnosed as an adult. was constipated for the entire year I was on it. hope this is not the case with your son. sorry to be blunt. most doctors HATE it. How about INTUNIV instead of the strattera….While I have heard that vyvanse can make some angry, it does the opposite for me. Really helps with impulse control…..does NOT last more than 8 hours though.

    • #74955

      SSRIs are also used to treat OCD behaviors. The Strattera is a norepinephrine reuptake inhibitor. There is a black box warning for SSRIs for the treatment of children and adolescents with Major Depressive Disorder because in some children, they can increase depression and suicidal thoughts. Discuss your concerns with your prescribers.

      • This reply was modified 4 years ago by mrm0717.
    • #74970

      “An as needed extra Ritalin dose for homework and after school priorities” sorry but this is just so sad to say about a 10 year old child.

      After school priorities for a 10 year old should be to play and if possible go out to the park. No meds required for this.

      Homework in primary school isn’t compulsory, so do it when he’s in the mood for it and leave it when he’s got a really bad day. No meds required for this.

      My 10 year old has adhd and even though the “experts” suggested meds he’s doing just fine without it. He’s learning coping strategies as he goes along which is very important for anyone with adhd.

    • #74972
      Exhausted Mum

      My 13 yo has been on Concerta and high doses of fish oil for seven years to keep her Concerta doses as low as possible. We do notice when she doesn’t take her meds, her teachers complain every term about her focus and concentration. We added melatonin to the mix to help her sleep at night, and my concern was more pills to treat symptoms as well. Her diet is regulated to assist the Concerta as well.
      Everything makes a difference, and with the onset of puberty we are constantly slightly altering the total treatment to find what works best this week.

      Your concern is real, but sometimes treating symptoms helps. Good luck. 😀

    • #74975

      My first piece of advice, breathe. Second, don’t doubt yourself or your parenting. The medication game SUCKS and is a long hard road. We are just now at a good place with meds after almost 3 years. I’m a single mother with adhd raising my 8 1/2 year old with adhd. Balancing taking care of his adhd and mine is a struggle..but not half as hard as the advocating and fighting at med checks. My son and I went through this EXACT situation almost a year ago. His psychiatric nurse wanted to put him on Prozac because of his uncharacteristic anger and outbursts and his anxiety. (Which was decided to be the reason behind his aggressive behavior.) I literally cried in the meeting. After fighting tooth and nail for my kiddo to have the right medications for him and taking on the school department for two years you’re telling me my 7 year old is depressed? Why is everything I do not good enough to make an innocent child happy? I was very broken up about it to say the least. But I put my foot down and refused it. Yes, you ARE mom and CAN tell them no. We did well on Focalin for a while. But Strattera MADE HIM WAY MORE ANGRY AND AGGRESIVE. We are having luck with vyvanse. And I 100% know what you mean about the loving and relaxed version of your kid, the one you know, existing off meds. But I promise you you can have that loving kid all the time with the RIGHT medications. You are not alone. Remind yourself that there are so many parents out there that get it and will cheer for you rather than drag you down and make you question your parenting. The biggest help I can offer you is to get your kiddo into a neuropsych exam. They take a whole day and require a lot of paperwork from mom..but it’s the only thing that put a stop to the useless mountain of pills they were trying to put my kid through. And it also shut the school up trying to call my son autistic in my IEP fight. Currently my son takes 30mg Vyvanse with breakfast, has .05 clonidine to take in the afternoon as he feels he needs, and 10mg hydroxyzine and 9mg melatonin for bed. The neuropsych was a blessing. I wish you the best of luck!

    • #74979

      I understand that stimulant meds can dehydrate kids which can be very dangerous and also cause adhd like symtoms. Please make sure your son drinks enough water,

      Also, you might like to research a condition called PANDAS

    • #74903

      According to this guide (below), there’s two other non-stimulants you haven’t tried yet. I’ve read that many people with inattentive subtype (ADHD-I) respond to guanfacine plus a stimulant. One of Russell Barkley’s YouTube videos says they affect different parts of the brain in a complementary way particularly effective sometimes for ADHD-I.

      I don’t think there’s anything unreasonable about adding an SSRI for your son, but it seems reasonable to also ask whether he could try all the non-stimulant options first before considering adding an SSRI on top of what he’s taking now. In fact, why not exhaust all the ADHD medication options (stimulant and non-stimulant) before adding an SSRI if the child is happy and not anxious when not on medication? For example, Adderall made my daughter irritable, but Vyvanse and Dextroamphematine (in the same medication class) do not. What medications work best is such an individual thing, and you don’t know until you try them all. I can’t imagine the doctor and NP insisting you start him on an SSRI without allowing you to try all the non-stimulant and stimulant ADHD medications first. I’ll bet they would be open to that if you ask them if that would be okay with them.

    • #75123

      I’m a psychologist who has diagnosed and treated children and adults with AD/HD for over 20 years. One thing that is so very important in the treatment is to combine the medication with COUNSELING. Counseling is highly recommended because there will be a need for information in order to adjust to the changes.

      Nearly anyone with AD/HD has had their self esteem threatened because the symptoms of AD/HD bother other people who are then critical of, sometimes mean to, the person with this neurological disorder. So there is much to learn in counseling about how to manage strong negative emotions as well as how to cope with stressful relationships.

      When first given a stimulant, the child (or adult) is likely to notice that they can no longer “space out” so easily. If they have been in the habit of “spacing out” when someone is mistreating them, suddenly they are focused more than they want to be and can feel the full brunt of whatever negative thing is going on around them. Hence anxiety develops and a symptom of anxiety is irritability and sometimes anger.

      In other words, his irritability and anger may not be a physical side effect, but rather an emotional one and so he needs help in coping.

      In addition, an SSRI that is Okayed for kids, i.e. Prozac, is commonly used along with a stimulant because anxiety as a secondary disorder to AD/HD is very, very common. Again, if you are heavily criticized for things that you cannot help, you are going to feel anxious (and/or depressed). Prozac for a few months can help a great deal along with counseling.

      • #75143

        Thank you for posting this information. I certainly wish I had this EXPLAINED to me by the clinician who diagosed me with ADHD as an the charts combined…then while I am still wound up asks me if I want to do THERAPY with her. I declined based on what I felt was an unethical approach at certainly a vulnerable time. COUNSELING however since you have it in capital letters sends a different message. I kept a diary of when I first began taking Vyvanse last March and have another “ADHD twin”….we have similar life stories….that I call once a week….every week at the same time….now for 14 consecutive months. I value our friendship and the support we have given one another. When the psychiatrist who eventually prescribed Vyvance was asking me questions about my life..symptoms ect…. I told him very candidly that my ADHD was an altered state of consciousness and about every 4 days I felt “focused”…an overused word imo..He eventually said ,”You are not depressed.” I agreed and said thank God I had a father with a sense of humor that rubbed off on me. LOL…

      • #75497

        On a different note….Would anyone be interested in getting a few boys together and work as a group of sorts? Like a teen gathering to build friendship skills? I could find someone to run it…

    • #75149

      I can only speak from my experience, in having been medicated for symptoms caused by other meds. I do not think it is appropriate. I am on nothing now and copying very well, with taking Omega 3 fish oil, and talk therapy. I structure my life, and keep distractions to a minimum. I go to bed at around the same time, get exercise, and eat healthy and balanced.
      I suggest, you try and record, the data of one strategy that is best practice (research based) and track the behavior you are trying to improve. For a period of 5-7 days, after the strategy is implemented. Track it at the same time of day, at several points in the day.
      One defined behavior, you chose.
      If the behavior gets better. Great!
      You found a strategy, that has been effective.
      I’d like to be positive and say there is a one size fits all. But as an individual with a disability, we all struggle with something a little different. And working out of your child strength, is much more of a positive solution.
      Find his strengths, support him positively, reinforce good behavior, and remember he is not broken but in need of support to get through this.
      You are capable, and ask the school to help with best practices known to be effective.

    • #75150

      I’ve noticed a lot of people are mentioning Guanfacine as a non stimulant med. My grandson was placed on this medication (2mg) at age 10. Prior to treatment, he had always been thin. Within a few days of being on this medication, he looked like he was gaining weight. It was most noticeable in his face, tummy, and rear. He gained 20 pounds in 3 months. The doctor said this was not caused by the medication, but there was no change in diet, or amount of exercise. By the time he was 11 and a half, he started to develop gynecomastia. That was enough for me! I discontinued it. Weight gain is definitely a side effect of Guanfacine. Initially, it seemed to calm him down, but as time went on, it was less effective. I would never try this medication again. Should you decide to try it, just be aware of this possible side effect, so you can intervene early on.

    • #75326

      My son started with Focalin, which helped drastically reduce his impulsivity, but it made him incredibly irritable. So then we added Intuniv and it helped his irritable behavior and he seemed happier. Then he started developing extreme anxiety, no one is exactly sure why. So after trying talk therapy, we decided to add Prozac and it has made such a difference in his anxiety, happiness and impulsivity that we may be getting rid of the Focalin and just keep him on the Intuniv and Prozac for awhile. We think his significant problems may have been caused by anxiety and not adhd. My point here, is, we do not always know what we think we know and since the child brain is such a mystery trying things could lead you down a more successful path. Maybe all along our sons problem was dopamine production and not the brain chemical focalin works on. More drugs sucks, but with the goal of a happy, well adjusted child, it could be the best solution.

      • #75550

        Thank you Kevin for your response. It is overwhelming with the different options (to medicate or not to medicate). It’s just so frustrating to see kids struggle! One thing that i swear is helping my 10 year old son is his “xbox bank” – I’m 100% sure electronics have played some type of roll in his moodiness and anxiety – so we implemented the Xbox bank. He earns minutes throughout the week based on responsibilities being met, polite attitude, and reading when he’s supposed to. We give him the following:
        For every page read = 1 min (he’s kind of a slow reader so he usually accumulates about 10-15 minutes in a half hour of reading.
        Starting homework and completing before hockey = 10 min
        Helping his younger siblings (with various things) = 5 min
        Practicing his hockey shots = 10 min for every 30 shots
        By the end of the week, he usually only accumulates 60-70 minutes of time BUT he is 100% responsible for earning it. Some weeks are better than others, and we even take minutes away if needed. My point being, for some reason, this has helped with his anxiety. I️ don’t know if it’s less screen time (thus more tuned in and not off in another world), or he feels like he has a hand in something. His moods have improved a ton too.

    • #75495

      Hello fellow parents! I have a 15 year old who just started HS he had OCH,ODD and ADHD…we have been to social groups, counselors, and much more…He is on Adderall 5 mg by day and 3mg Intuniv by night… I saw he hid his Intuniv and I was wondering why I was getting emails from teachers etc. I know it’s extremely dangerous to miss because it messes with you blood pressure. He hates the side effects!!

      Does anyone have any suggestions on teen support groups to develop social relationship skills? Also, any med. that helped your child with attention and impulse control?

      Thank you!!

    • #75544

      Does anyone have any experience with Buspirone for social and “life” anxiety. I had to pull my 13 year old son from middle school due to social anxiety and ADHD, inattentive type, issues. I was also given Quillivant for his ADHD problems. I have not started either one yet. Although apparently nobody can get quillivant right now. Not sure whats going on??

      • #75552

        My dad (who has since retired) was a pharma rep and actually sold the branded drug BuSpar. I asked him and he said doctors like it because of its safety profile – it’s non habit forming, however it can take a month to really see a difference. Supposedly it is used as add on for depression and other anxiety disorders.

        I asked our physician yesterday about Quill, and ironically, he confirmed what you said…there’s some type of hold on producing it due to pfizer selling it to another company (generic company probably since it’s an old molecule in a new form). Check with a specialty pharmacy. Sometimes they can get access to things other pharmacists don’t because they’re more focused.

        I read Q was a great form of methylphenidate and worked particularly well for kids with inattentive sub-type and those possibly on spectrum…which my son may be.

      • #75630
        Penny Williams

        Yes, Quillivant and Quillichew are pretty much unavailable and wreaking havoc for a lot of people:

        Quillivant and QuilliChew Shortage Disrupts ADHD Treatment

        We used Buspar in combination with a stimulant medication for a while with some positive effects on anxiety. Unfortunately, my son needed to bump up the dose and then it affected his mood (But he’s extra super sensitive to these meds).

        ADDitude Community Moderator, Author & Mentor on Parenting ADHD, Mom to teen w/ ADHD, LDs, and autism

      • #75631
        Penny Williams

        See this discussion on the Qulli med shortage. Apparently, it was just announced that Quillichew is back in stock and pharmacies can order it.

        Quillivant Shortage – Anyone else?

        ADDitude Community Moderator, Author & Mentor on Parenting ADHD, Mom to teen w/ ADHD, LDs, and autism

    • #75555

      Thank you to the psychologist who pointed out the importance of counseling. I agree 100% – were waiting to find out if it can be provided by our school OR since he’s not struggling academically right now, if we have to utilize outside counseling.

      Your point about hyperfocusing on criticism and/or change, even challenges faced in everyday interactions (otherwise seen as normal to everyone else) really hits home. You articulated what I was trying to really say when I created this post. I feel like the Med has brought out so many other things, and I just don’t want them to define him.

    • #80564

      My DD has high anxiety esp when taking stimulants. The only one that doesn’t cause terrible anxiety is short acting Ritalin at a VERY low dose (half the lowest dose!). We tried an SSRI but it made the ADHD worse and didn’t help the anxiety much. After a LONG journey, she is currently taking THREE ADHD meds: Strattera, guanfacine, and Ritalin, AND two supplements (PS-100 and l-theanine). This combo is the best we have tried so far. The Ritalin helps focus and impulsivity, the guanfacine helps hyperactivity and impulsivity, and the Strattera helps anxiety and impulsivity; the two supplements also seem to help overall moodiness and emotional lability. She can actually handle a “punishment” (actual punishments are rare but I’m talking about even a conversation about behavior) without excuses and lying (“It wasn’t me”, “I didn’t do it”, etc), lashing out, or extreme meltdowns, so this is super good.

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