Tips to Reduce the Side Effects of ADHD Medications

Medications for Attention Deficit Hyperactivity Disorder (ADHD) can be very helpful for children who struggle with hyperactivity, impulsivity, and inattention so that they can be more successful in the home and school environments. Often these medications can lead to problematic side effects such as decreased appetite, stomach pain, sleep problems, and moodiness, that can make […]

“My child can’t focus. What does that mean?”

Many children and adolescents present to their primary care provider’s office with concerns about inattention, poor focus or poor concentration. Since the primary care provider’s office is typically the first stop, it is important to be comfortable further evaluating the presenting problem, identifying associated symptoms, determining the diagnosis and implementing the best treatment plan. Many […]


It used to be thought that obsessive-compulsive disorder (OCD) was rare, but it is more common than originally thought. The prevalence is between 2-3% worldwide and it affects males and females equally. Symptoms usually present between childhood and early adulthood, with 75% of patients having symptoms before the age of 18. OCD can be a […]

Signs of a Sensory Processing Disorder

Case Presentation 7 year old boy with chief complaint of “frequent meltdowns”. Additional history: daily meltdowns (crying, hitting) with loud sounds or when asked to wear certain clothing; wants to make friends but poor boundaries and accidentally hurts peers at school when he is playing with them; hard time sitting during seat work at school […]

Depression in Adolescents

Major depression affects 6% of adolescents with an additional 5-10% presenting with sub-syndromal symptoms of depression. There is a 2:1 female:male ratio of major depression in adolescents. Teens frequently don’t present with the typical DSM criteria for Major Depressive Disorder (MDD). Common depressive symptoms in adolescents include: irritability (as opposed to reporting a sad mood), […]

4 Traits That Put Kids at Risk for Addiction

The New York Times had an article in September 2016 ( that discussed the risk factors for addiction. Traditional anti-drug education in schools focuses on scare tactics and the message “Just Say No”, which has been found to be largely ineffective in children and adolescents who at the highest risk for drug abuse. Recent anti-drug […]

Non-stimulant Approaches to ADHD

There are situations that come up in a primary care setting when a pediatric patient presents with symptoms that are concerning for Attention Deficit Hyperactivity Disorder (ADHD) but where there are concerns about prescribing a stimulant medication. These are some of the situations when this can occur: The patient’s presentation meets the symptom checklist for […]

Choosing a Medication Treatment for ADHD

Once a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) has been made, a decision has to be made about treatment. Most children do well with a combination approach of medication and behavioral therapy. The most likely medication to start with is a stimulant medication. And then the provider has to make a decision from many, […]

Link Between Lead Toxicity and ADHD

When a child first presents with symptoms of Attention Deficit Hyperactivity Disorder (ADHD), it is important to assess if there is an underlying medical cause for the symptoms. Lead is a neurotoxin that has been well studied to affect children’s cognition and behavior, and the behavioral profile seen with lead toxicity can mimic ADHD. Children […]

ADHD And Co-Morbid Tic Disorder

A call recently came into the SmartCare PC2 line that highlights an important clinical situation. Case Presentation: 10 yo boy with history of motor tic disorder (eye blinking, shoulder shrugging) who was then diagnosed with ADHD combined type. He was started on Concerta and titrated to 36 mg qAM, which has been helpful for his […]