ADHD review appointment

Issues: 1. ADHD 2. Anxiety Medications: 1. Methylphenidate 10mg, take 1 tablet in the morning. 2. Melatonin 3mg, take 1 tablet at night. Ceased Medications: * None Teams/Allied Health: * Psychologist I had the pleasure of reviewing Thomas, a 7-year-old boy, accompanied by his mother, Sarah. Thomas attends St. Mary's Primary School and is in Year 2. He is making good progress in most subjects, particularly enjoying Maths. Sarah reports that the methylphenidate is effective during the school day, helping him to focus and reduce impulsivity. There have been no reports of behavioural challenges or suspensions. Thomas's grades are good. Thomas has reported no side effects from his medication. Thomas has not tried any previous medications. Thomas's sleep is generally good, he goes to bed at 8:00 pm and wakes up at 7:00 am. He has been taking melatonin to help him fall asleep. Sarah reports that Thomas has been having some difficulty falling asleep recently, taking up to an hour to fall asleep. Thomas is currently seeing a psychologist for therapy. He has no other potential conditions. He is a very active and sociable child. Thomas attends football training twice a week. Thomas has been experiencing increased anxiety, particularly around school and social situations. He is also having some difficulty falling asleep. ADHD monitoring forms were completed by Sarah, and they indicate a significant improvement in attention and hyperactivity since starting medication. Physical examination revealed a weight of 25 kg (50th centile) and a height of 125 cm (75th centile). Investigations: None Impression: Thomas, aged 7 years, presents with ADHD and anxiety. Treatment optimization is ongoing. Plan: 1. Continue methylphenidate 10mg daily. 2. Continue melatonin 3mg nightly. 3. No screens 1hr prior to bed, trial meditation smiling minds/headspace or audio book. If taking >1hr to fall asleep can continue melatonin. Trial off melatonin every 2 month - every 2nd night for 1 week and then stop. Restart if taking >1hr to fall asleep despite good sleep hygiene. 4. Review in 3 months.