ASD & ADHD: Concerned about meds, etc

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My son was diagnosed with ADHD at 5, since then he has tried almost every ADHD drug out there (Adderall, Concerta, Daytrana, Metadate, Methylin, Focalin) and most we tried a couple different dosages, all of them just didnt work well to begin with or worked well enough but then slowly stopped being effective. He was diagnosed ASD a year ago, several Psychiatrists just didnt know what to do with him. He is now being seen by a Pediatric Neurologist who has put him on Vyvanse. So far, it seems to only be working so-so. His DR said that if Vyvanse doesnt work well enough for him we might try Intuniv which is a non-stimulant drug in addition. Has anyone heard of or tried this? The DR is also trying to get to the bottom of whether his symptoms are actually ADHD or his ASD. This Friday he is going to be getting a Quotient test, apparently it can identify ADHD reactions and movements, etc. Since we have tried most drugs out there, Im feeling nervous that there isnt much else we can do. My son has told me many times that he doesnt like feeling so scattered or that he cannot stop talking or repeating himself. I just want to help him feel more comfortable and am not sure what else we can do.

I've that you are more likely to get to the bottom of it by being drug free for a while; the medications can interfere with the testing process. Someone else can probably comment better on that than I can, however.

Intuniv (had to look that one up) is the same drug as Tenex, which is actually a blood pressure med that has been used off-label for ADHD for a few years, although it was approved for ADHD in 2007. Another non-stimulant drug for ADHD is Strattera.

Not medical advice, just my opinion -

If ADHD meds don't work, he doesn't have ADHD.

In addition, it is my understanding that a child cannot be diagnosed ADHD and ASD.

I think bjtao is right, that if the ADHD drugs aren't working, the issue most likely is not ADHD. I do think AS and ADHD can be co-morbid (different doctors may feel differently about it, but we've had children here with both), but one does have to be careful about misdiagnosis between the two, since they sometimes "look" the same, but have different causes.

There is no medication for ASD, but some families have found improvement by addressing potential co-morbid medical needs through diet, supplements, etc. It can never hurt to figure out what makes your child feel happier and healthier; every brain works better when fed properly.

Having a daughter we suspect is ADD and a son who is diagnosed AS, I tend to think of the differences as follows: My daughter cannot stay on task, period. It doesn't matter how drawn she is to the subject, how quiet it is; anything. If she heads down the hallway to brush her teeth, the odds are high she'll see something that leads her brain elsewhere and she won't make it to the bathroom. My AS son doesn't do that; he'll avoid brushing his teeth because he finds it unpleasant, or because he would rather keep reading something, but he doesn't set off with goal A only to find himself doing thing B. In school, however, he has a lot of trouble staying focused due to sensory issues, boredom, frustration, and so on - all things that I consider external. He will talk about jumpy or fuzzy brain issues, but they sound different than my daughter's; he may be tired, he may not have eaten well, it may be a subject he really, really struggles with (given that some components of his IQ are 160 and some are 90, there will be an obvious difference in brain function depending on the task, and it wouldn't surprise me if he "sees" that difference). My daughter will describe her thoughts, instead, as "I just can't stop thinking about X, and Y, and Z, and ... ! !" Anyway, don't know if that helps at all, but it's what we've noticed here.

This could be a stim, by the way. More of a self-stimulating / self-calming behavior. That is something ASD kids do a lot.

Since we got his ASD diagnosis Ive been questioning the ADHD diagnosis but havent had a DR interested/concerned enough to really get to the bottom of his symptoms. His Pediatric Neurologist is doing the Quotient test to either prove or disprove the ADHD diagnosis. Im already sure its the ASD but admittedly thats a little scary to say because I have absolutely no idea how to help him wind down. The talking is constant, he repeats himself so much and cant hold still, I dont know how to help him.

Here is the first thing to do, if you have not already: see if you can figure out what environments he is calmest in, with the least distracting behaviors, and what environments he gets most wound up in. This will help you start to get an idea of what type of sensory issues may be involved. ASD kids learn to avoid or mitigate environments that are difficult for them to handle. Over time, they develop coping skills, but the first step is to figure out what environments or activities - or even foods - tend to act as triggers. It won't always be a direct correlation, but you should start to see some sorts of patterns emerging.