QUESTION:

Dear Dr. Heller,

My son is 8. He is ADHD. His pediatrician put him on Ritalin, and he was a good boy.   Now he’s hitting and biting and his friends hate him.  The doctor told me it was the Ritalin, and gave him Adderall and that made him worse!  He bit me at dinner one night when I made him eat his spinach. He’s so mean.  His teacher said he’s better, but he’s mean at night.  He’s better on the weekends when I don’t give him his pills. The doctor said I was just a bad mom. Please help me!

ANSWER:

The most likely explanation is that your son is depressed.  Irritability and hostility are definite signs.  I doubt that the Ritalin stopped working, but that depression also occurred.  This is like having an ear infection and saying Ritalin stopped working because he got an ear infection.  Ritalin can unmask depressions and the main sign here is irritability and hostility.  Adderall (because it raises serotonin levels while it’s in his system) makes him better while it’s in his system, but when it wears off he is likely getting depressed again.

Depression is not uncommon in children.  I strongly recommend you get him checked and likely treated for his depression AND his ADHD.  Risperdal is sometimes necessary for a while to get the behavior under control.  I’m a strong believer in keeping violence under control!