Child struggling to maintain wieght? | ADHD Information

My daughter had been low weight for a while. Then she dropped off the wieght chart all together.  She was throwing out her lunches at school and hardly eating. If you didnt watch her closely she was good at covering it up.  Most assumed she was eating. The doctor put her on a medicine called Cyproheptadine.  She has beenusing it since July.  She put on 10 pounds and grew 2 inches!  She finally has a butt and her ribs arent sticking out anymore!  She eats like a horse and she looks great! The doctor is almost as thrilled as I am.   Hope this helps any other parent suffering from this horrible problem!

Good Luck!

Piggirl

Is this something the children can take with their ADHD meds? I too am concerned with the weight/height issue.Yes I believe so, piggirl's daughter is on the daytrana patch, I think.  (read it in another post).  I read the info on the drug, it looks like an antihistamine usually used for allergies (hayfever, etc).  But it is also prescribed for anorexia...so they know that it stimulates appetite somehow.

Sounds promising..it is an antihistamine with the off label use of sometimes stimulating appetite...here is a link, I looked it up.

http://health.yahoo.com/drug/d00790a1#d00790a1-important

I am gonna ask my doctor at the next visit if weight/appetite is still an issue.

Thank you for sharing.And yes..This can be used with ADHD meds.  My daughter is on Daytrana..a form of Ritalin.  I really hope this helps some others.  I know from previous chats my daughter was not the only one having issues maintaining weight.I PM'd piggirl and quizzed her a little more on this medicine (thank you ,piggirl).  It sounds so promising that I put in a call to my ped to request that she look into this drug for my son.  He is already on an antihistamine for allergies anyway, so why not pick one with this added benefit?  She is supposed to call me tomorrow...keep your fingers crossed.  The nurse sounded very positive, but the DR. is not in today, and we felt that it would be easier to deal with his main ped rather than try to fill in the dr on call. 

THANK YOU!!!! My son has not been on the weight chart for years, and now add meds to the mix.  He is wasting away.  We have seen the dietican I can't count how many times, we have tried Pedisure, etc.  My son also has allergies that we use an antihistamine for so if this can put weight on him and control his allergies I am all for it.  Who would you call to prescribe it??? His ped, his allergist or his psychiatrist? 

Try the ped or the allergist...I would think either one of them could do it and should be willing...even better news is that this med is fairly inexpensive.  I called my Rite Aid who gave me a price of .??  But she told me to call around and she would match it.  I called Meijer and their price was .?? and Walmart was .68!!! This was for 60 4mg tablets...my son can take pills, but this is available in a syrup form too I believe.. 

Good Luck!!!

My thoughts EXACTLY!!!!  I am still waiting for tomorrow to ask my ped that...maybe it is just not caught on yet?  I mean you read all the time about other meds prescribed for sleep issues, so it stands to reason that it should be ok to prescribe something to alleviate the appetite issue.    I think there ARE other drugs prescribed for appetite...guan..something or other springs to mind as one of the ones I have read about on this and other boards.  Maybe pediatricians are afraid of parents abusing it?  Who knows?   I mean it is easy enough to lessen or discontinue the dosage if the child begins to gain too much weight. My child has always struggled to stay on the growth charts and this has totally taken wht little appetite he had.

Good news!!  My doctor's office just called me to tell me that they are going to a) lower his dose of Concerta to 36mg (I am a little nervous about that...) and if that does not positively affect his appetite, give him the Periactin (Cyproheptadine). 

So, now I am going to call the teachers and tell them that the dosage will be changing, and that they need to alert me to any changes (good or bad).  The doctor told me that if I feel that the smaller dose is not working, we can easily switch back....

I am excited about helping my son's eating issues....finally!!

OUR DAUGHTER 13 IS IN THE 80'S IN WEIGHT AND 5FT3. Some larger babies at birth grow slower than smaller birth babies. Has been the case hear for us with our kids. Big spirts for some happen in preteen/teen years. I read in a book smaller boned people grow at a slower rate than larger built people.

GIVE THEM PROTEIN SMOOTHIES SHAKES THE HEALTH FOOD STORE SELLS COOKIE FLAVORED SHAKE MIX. PROTEIN BARS ALSO GREAT.

Thanks for the info.  My 7yo was just diagnosed & goes on Monday for the starting of medication (we don't know which one yet).  I was worried because she is such a picky eater anyways.  She can't really afford to lose any weight, she was a premie......so at 7yo she only weighs 45 pounds.  I am going to talk to the doctor on Monday!

tonyas

I have a 10 year old who is only 54 pounds!!  3 years older and only 9 pounds more...and he was well over 8 pounds at birth He has always lingered in the 5th percentile (Since about 5 months old)on a good day, and now is falling off totally on a regular basis w/o me feeling like I am constantly pushing food at him making each day so stressful.  He wants to eat to please me, and he knows he needs to to stay healthy and grow properly, but he just has no appetite.  He sits there miserably staring at his plate of food.

Keep in mind , though, that some children either do not get this drastic of an appetite loss, or none at all, or the appetite issues go away after a few weeks...my son has been on the medication since last March and no let up in sight.  So maybe just watch her weight and know that this is a possible option if need be...

Good luck

OK so if weight loss is THE MAIN side effect of these drugs and they work soooo well except for the weight loss side effect.... then why isn't this drug prescribed more often to counteract the side effect. Is that considered bad medicine to treat side effects with a drug? Just wondering.

ivanhoe#1

Yes my pediatrician explained to me the same thing when my children (none under 8 pounds 10 ounces, 1 that was 10 pounds 4 ounces) were infants.  I was never concerned until he totally lost his appetite.  Even though he was small he was healthy and hungry...normal.

ivanhoe #2 ???????

Don't you think I have tried that?!!!  I have tried every flavor available, I too, know how to locate a health food store. We have 2 boxes of protein bars on the top of my fridge that he won't touch, do you want them?  We have done the protein shake/smoothie all summer with little results. I even made up my own flavors, all to no avail.  It has come to the point that his jeans fall off of his nonexsistant hips and butt. His ribs are sticking out.  All of this I could endure if he was EATING!!!  But it is a daily struggle that I fear will prompt an eating disorder if allowed to continue unabated.  I am not jumping to medicine willy nilly. This is my last resort.

Thank you for your input. 

chasesmom7939024.5778240741About the question why not used as a weight loss thing - supposedly per my pediatrician, she said this side affect is supposed to go away or "I'd be using it" she said. My son was on concerta 36mg and lost 20 pounds in less than 6 mo. He always topped the charts in height and weight, so a little weight loss didn't worry me, but 20 pounds was way too much. We basically did the Carnation Instant Breakfast with wholemilk thing, didn't work too well. He kind of wavered at that 65 pounds for a year or better and now he's slowly gaining and up to 69 pounds. The thing is - once in a while he doesn't have an appetite, but most the time he eats like a horse. Have him on Daytrana now, started 2 wks ago, and haven't noticed any better/worse eating habits.

Well this is something that I will bring up to my ped at our visit.  But really, the Concerta says that the appetite diminishing will 'go away' too and for many it does not...

maybe once his appetite gets stimulated, it will take over on its own if the med stops...if not, at least he will gain some back.  I cannot do the patch as I have no prescription coverage and Shire does not as yet have a patient assistance program.

I found one abstract on pub med using cyproheptadine for weight loss on stimulant patients:

Youths with attention deficit hyperactivity disorder often experience weight loss on stimulants, which may limit optimal dosing and compliance. Cyproheptadine has been shown in medical samples to stimulate weight gain. We conducted a retrospective chart review of 28 consecutive pediatric psychiatry outpatients prescribed cyproheptadine for weight loss or insomnia while on stimulants. Of these, 4 patients never took cyproheptadine consistently, and 3 discontinued it within the first 7 days due to intolerable side effects. Data were analyzed for 21 other patients (age range 4-15 years) who continued with 4-8 mg of cyproheptadine nightly (mean final dose = 4.9 mg/day) for at least 14 days (mean duration = 104.7 days). Most had lost weight on stimulant alone (mean weight loss was 2.1 kg, mean weight velocity was -19.3 g/day). All 21 gained weight taking concomitant cyproheptadine, with a mean gain of 2.2 kg (paired t = 6.87, p < 0.0001) and a mean weight velocity of 32.3 g/day. Eleven of 17 patients who had reported initial insomnia on stimulant alone noted significant improvements in sleep with cyproheptadine added. We conclude that concomitant cyproheptadine may be useful in youths with attention deficit hyperactivity disorder for stimulant-induced weight loss, pending future randomized controlled trials.

PMID: 15142393 [PubMed - indexed for MEDLINE]

Thanks tasmaniandevil,

This is good info, I wonder what were the sideeffects that were not tolerated.

That is very informative...the intolerable side effects would be a nice thing to know, I agree. I don't think they can be too bad or my ped would have cautioned me against doing this...I really trust her judgment and wisdom...we have been dealing with her for over 13 years.

Chase will start on this drug as soon as I get the prescription in the mail.  Piggirl told me in a PM that she noticed a difference in appetite within 3 days and that she could find nothing not to like about it at all. 

I will be telling Chase that this is just a different antihistamine for his allergies ( a partial truth) so that he will have no clue that it is supposed to make him hungry/gain weight.  This way, I will know when (if) it does, it is not his urge to make mommy happy or a placebo effect.

Hey guys, why don't WE do a random test?  Try it and see if it works...who knows?  Worth a try to see my little guy not look like an anorexic skeleton.

Wish me luck...

chasemom, please let us know how it goes...my son is still on the weight chart 15% but I will keep this inmind if he starts to lose more weight...it seems as if the weight loss has leveled off and he is even eating at school.

 

joemom

I am so happy that your son has begun to have a normal appetite again..I wish Chase would on his own as well.  He hasn't seen 15% on his weight chart for a long time! 

When I pack him a school lunch (about 1-2 times a week when he dislikes what is being served) it comes home virtually untouched--apparently he hasn't figured out that all he would have to do is throw it out and I would be none the wiser.  He reports to me that he finished the school lunch on days I don't pack, but I am not sure if that can be true...he is never hungry for an after school snack no matter how tempting, and dinner is like a game show with the deals being made..."just one more bite, then you can go and play.."

Chase had been lingering at the 5th percentile, but in the last few weeks he has lost another 3 pounds or so and I am concerned.

I am very hopeful especially after the study info provided by tasmanian devil...I mean SOMEONE has to be the trailblazer in combining and adding these complimentary drugs to the ADHD bag of choices!  Why could it not be piggirls doctor? 

I will definately keep you posted.

 

This is good to know just incase my DS gets too thin

Chase has never been a big drinker either.  Don't know why and I don't think that has changed since meds began...but I will pay closer attention now.    He just doesn't eat....except when off the concerta.  Well, he eats but has to be prompted and stops at the bare minimum required.

My other son though drinks all the time...since he was a toddler and insisted on "milkjuice"  which was one sippy cup of each.  He would be irate if he didn't have both and would alternate drinks from each. 

In your case it may well be a subconcious thing with him...if he was punished, it may well be a habit.  How long have you had him in your home?  Maybe when he can trust you more fully, he will relax...

I believe I'm the one who stated my pediatrician said the appetite loss diminishes eventually. Well, as I've stated before, my son weighed 85 lbs around age 6-7. He started concerta and lost 20 lbs in a fairly short amount of time. Over the past 6 months, he had started eating alot better. He still had days when food didn't even appeal to him, but usually later in the day, probably when the Concerta wore off, he would eat fairly well. He's 10, 4'9" and weighed 69 lbs as of a week ago (well, see below).

He's now on Daytrana and yesterday, he wouldn't touch breakfast or lunch, but last night we went out for supper and he ate 2 tacos, potato rounds, chips and salsa, my refried beans and my friend's enchilada!   I had him get on the scale when we got home and he was 74lbs!!

I know all children are different and I thought my child was skinny, but seeing alot of your posts, not knowing how tall they are, their weight seems awfully low. I would definitely try the above mentioned medications on this thread to help. My child had some "room" for weight loss (not 20 lbs though!), and many children don't, so I think this is a great thread for ideas for those in this situation!

Oh, also, my son doesn't drink much liquids either. I believe that's why he tends to get headaches when he's on his medication. I now buy the bottled water you can put in your frig and dispense directly from, he seems to like that and drinks a little better.

Yes,

my son is 52 inches tall and only 54 pounds!!!  He has been on this med since last March (8 months) and it is only getting worse.  I literally need to remind him to eat or he just doesn't notice...he never seems to get an appetite even in the evening...the only meal that I can get in him is breakfast, and sometimes that is a struggle.

I am glad that your son is doing so well!  I hope that I can get Chase on the same road soon.

I'll be crossing my fingers the new med will stimulate his appetite and help. I'd be happy for you of one less worry for your son. I have one question does anyone have a problem with their child drinking enough fluids. My DS even gets marbles for drink water, tea or juice. I am not sure if this is a med issues or a personal issue. I think he might have had a bed/pant wetting issues in his past foster home. I believe he might not be drinking to avoid getting in "trouble" which would not happen in our house, but old habits die hard. and you should add that it's not very expensive, either.I am going to ask the doctor about it next time.Another little tidbit of info....this drug is non prescription in Canada....

Appetite suppression: Most will note decreased appetite during the effective hours of the medication. This often means minimal lunch intake. I suggest a small protein lunch such as milk, peanut butter crackers, beef or turkey jerky to get through the day. A milk shake after school helps. Many find their appetite returns late in the evening (around 8-9pm) when their medication wears off, and they need to be allowed to eat at that time. If weight gain is a continued concern, I often add cyproheptadine (Periactin) 4mg, ½ tablet at breakfast and dinner. Periactin is an antihistamine similar to Benedryl which enhances appetite and often results in 1-2 lbs weight gain per month. Remember that good nutrition is helpful for all, and these individuals should emphasize protein intake in their diet.

I have been researching this drug almost non stop since the parent posted the info that her ped said that the appetite stimulant goes away after a time...I found this and several other doctor sites (including the American Academy of Pediactrics) that RECOMMEND adding this drug.  The effects wearing off is never mentioned on the doctor sites, though one parent account  mentioned that it did , so she simply takes a two day break when she notices and then restarts the meds again having the appetite pick up.  Makes me confused as to why it isn't prescribed more often.  Interestingly enough, a post on these boards back in February of 2005 I believe came up in the search.....this parent reported that her child had been put on the drug for weight gain.  It is also supposed to help with sleep, and some of the children that take it become sleepy, so maybe that was one of the 'intolerable' side effects?  Some parents reported that they could only give one dose at night instead of the 2 doses...but others give doses as much as 4 times a day per their child's psych. with no drowsiness reported, this was asked specifically of the parent in question. 

As piggirl reported to me in her private msg.  I really can see nothing about this drug not to like.  At least enough to give it a 1 month trial.