Double Edged Sword?

[4sumrzn]

I'm feeling like dam*ed if I do, dam*ed if I don't....

Neuro has been telling me for months to give Vyvanse a try with difficult child. I took her off of stims because I felt they were causing her to be more aggressive & mean......even though she was on them for quite a long time with other positive results. She was not on any this past school year & things did not go well at all (including the new placement in the medically handicapped unit starting next year).

This past school year has been rough all around for everyone.....feels like one big spinning carnival ride, ya know!? Every day from the time she wakes up until she finally goes to sleep.......non-stop "issues" along with non-stop motion & mouth running. School had hard time with her, but much easier because of it being that "controlled" environment, following her peers. I will mention...the honeymoon period didn't last as long as they had hoped for though.

So, school was over Thursday. The 3 days 24/7 with her was unbelievable! I mentioned in another post that husband has been working 7 days a week....so no relief there along with no other authoritive figure around most of the hours but me. I lost it! Couldn't take it anymore & ended up hiding in the garage in the middle of the night crying in my beer & a bag of Frito's!

Well, I decided last night after talking with husband about it too......let's give the Vyvanse a try & see what happens. She is home all this week & hopefully will start special needs camp next week. I am still babysitting, but just part time now. Babysitting was something I wanted to get away from because things just run a little smoother when no other kids are around difficult child. But, after finding out difficult child has a chance at this camp (meaning she's got a spot....I'm not getting my hopes up they will KEEP her)....I took on my part timers for the summer.

Anyway, to this morning. I started the Vyvanse & chose to skip the Clonidine. The kids showed up, difficult child was calm & nice. She even SAT DOWN & watched a movie! What???? Well, I consider it her watching it....she was up & down some, but actually SAT & watched for longer than 30 seconds! She never watches TV unless she's has one eye closed & about ready to go to sleep. She was actually somewhat quiet. All of a sudden (exactly 5 hours after medication) she slapped one of the kids, ran the bike into her & slapped her again! I was not standing there to see or hear what might have set difficult child off. It could have been a simple word or possibly just that the girl didn't want to do exactly what difficult child wanted. I don't know. But, I did see the end & watched difficult child run into her & slap her. I won't go into details about the time out, she got one though. After the time out.....she ended up playing something with a different kid & played nicely. Kids are gone now, easy child is with friends & difficult child is playing babies quietly.

OMG.....what do I do???? I know that the violence she experienced in the past was the reason for me stopping the stims & she wasn't as violent. BUT, my gosh....it sure works to calm her butt down & stay focused on something for longer than a second. Do I continue this for a week & see what happens? She will be around kids for 2 more days here at home. I ended up giving her Clonidine shortly after the incident too. Neuro suggested not disc it.....but, use as needed. Just want the child to be able to function around other children & not be evil! I can't help but to think maybe she needed a stimulant during school & possibly would not have gone backwards.

Just don't know what to do!?!?

Oh, I forgot (she just walked by doing this)...she started making this noise like she's thirsty or has peanut butter stuck on the roof of her mouth. It's non-stop. Weird.

Thanks for any advice & thanks for listening!

 

[BusynMember]

Hi there. First off, has she ever seen a neuropsychologist? Not a Neurologist, but a NeuroPsychologist? If not, I recommend having one do another evaluationi. Ok...
I'm looking at your diagnosis. and medications and have to wonder if the stims aren't making her worse in the long run. She has a lot of diagnosis, not just ADD/ADHD and ADD/ADHD BEHAVIOR is almost always present with kids on the autism spectrum, which she is (Pervasive Developmental Disorder (PDD)-not otherwise specified). Is she getting specific interventions for the Pervasive Developmental Disorder (PDD)-not otherwise specified? Are you sure she is MR? My son, who is Pervasive Developmental Disorder (PDD)-not otherwise specified, used to test around 75 for IQ, but that was due to his autistic spectrum disorder. He just didn't understand tests well. He is almost fifteen now and clearly NOT MR. He is almost mainstreamed completely and is holding his own. Last year they discontinued his aide and he did quite well with only cirriculum modifications. Socially he has grown by leaps and bounds. However, he has had interventions since before he was two. It's never too late to start them. And the interventions should be for the autism, not "behavioral therapy." That doesn't work for kids on the spectrum.
I have no idea how epilepsy can play into this picture. Has it shown up on an EEG? Is he on medications for seizures?
I am taking a wild guess that most of his trouble is due to the Pervasive Developmental Disorder (PDD)-not otherwise specified and that stimulants are making him worse in the long run (and I believe Vyenese is either a stimulant or an antidepressant). My autistic son did horribly on medications. He got mean and aggressive on stimulants and weird on antidepressants. He is medication free now and doing well. Sometimes food changes help kids on the spectrum. We never tried them with my son because he has always advanced so well without them, as long as he kept up his interventions. Food doesn't seem to affect him at all. But it does some kids.
Others will come along with other advice. Mine is to focus on the autism as in my opinion that's probably causing most of the problems. Good luck, whatever you decide to do.

 

[Christy]

Sorry! I know how it can be to get your hopes up that a medicine will and then have the opposite effect It's especially bad with stimulents because like you said, it was helping in one area but is could be causing worse problems.

There is a slim chance that this was an isolated incident but most likely it was the Vyvanse. To be sure, you can try it a few more days but, as you know, you things could get worse.

in my humble opinion, regulating mood is much more important than controlling ADHD. This is a lesson we learned the hard way with our difficult child.

Good luck witht he camp!
Christy

 

[4sumrzn]

Hi there. First off, has she ever seen a neuropsychologist? Not a Neurologist, but a NeuroPsychologist? We are in the process of getting all new evaluations through Cincinnati Children's Hospital. It was suggested to move outside of the Dayton area for additional testing. Many different things scheduled through October.If not, I recommend having one do another evaluationi. Ok...
I'm looking at your diagnosis. and medications and have to wonder if the stims aren't making her worse in the long run. She has a lot of diagnosis, not just ADD/ADHD and ADD/ADHD BEHAVIOR is almost always present with kids on the autism spectrum, which she is (Pervasive Developmental Disorder (PDD)-not otherwise specified). Yes, many different diagnosis. I get overwhelmed with diagnosis thrown at me. Is she getting specific interventions for the Pervasive Developmental Disorder (PDD)-not otherwise specified? She has been receiving services through school & home therapy through MR/daughter. Are you sure she is MR? No, I can't say I am sure. But, she is unable to perform tests. She still can not write her name & is unable to verbalize enough to even perform verbal testing. She is being moved to the MH unit next year because she still can't perform daily life skills, let alone academic skilss of any type. She has been in Special Education Kindergarten & First Grade. Aide full time. My son, who is Pervasive Developmental Disorder (PDD)-not otherwise specified, used to test around 75 for IQ, but that was due to his autistic spectrum disorder. He just didn't understand tests well. He is almost fifteen now and clearly NOT MR. He is almost mainstreamed completely and is holding his own. Last year they discontinued his aide and he did quite well with only cirriculum modifications. Socially he has grown by leaps and bounds. However, he has had interventions since before he was two. It's never too late to start them. And the interventions should be for the autism, not "behavioral therapy." That doesn't work for kids on the spectrum.
I have no idea how epilepsy can play into this picture. Has it shown up on an EEG? No, they did not show up. BUT, I don't believe a little short EEG test was what she needed, I think she need the longer one. Is he on medications for seizures? She takes Lamictal.
I am taking a wild guess that most of his trouble is due to the Pervasive Developmental Disorder (PDD)-not otherwise specified and that stimulants are making him worse in the long run (and I believe Vyenese is either a stimulant or an antidepressant). I know. That is why I didn't want to try another stimulant. But, she is NOT bouncing off the walls today, NOT babbling non-stop, IS actually playing AND watched a few minutes of TV. Just wasn't great with other children for that short time today. My autistic son did horribly on medications. He got mean and aggressive on stimulants and weird on antidepressants. He is medication free now and doing well. Sometimes food changes help kids on the spectrum. We never tried them with my son because he has always advanced so well without them, as long as he kept up his interventions. Food doesn't seem to affect him at all. But it does some kids.
Others will come along with other advice. Mine is to focus on the autism as in my opinion that's probably causing most of the problems. Good luck, whatever you decide to do.

Thank you MidwestMom!

 

[smallworld]

Is it possible she would have hit this child if she hadn't taken Vyvanse this morning? Or is this totally out of character?

Vyvanse can cause a dry mouth, which is why she may be making that sucking noise. Give her a drink of water and see if it improves.

 

[TerryJ2]

Gosh, you've gotten some good ideas here. Wish I could help but I don't have any experience with-those medications. Just wanted to wish you luck.

 

[Sara PA]

Consider too that the abrupt discontinuation of the clonodine could cause some problems. Sometimes it's not what you add but what you take away. From the Catapres prescribing information:

Withdrawal

Patients should be instructed not to discontinue therapy without consulting their physician. Sudden cessation of clonidine treatment has, in some cases, resulted in symptoms such as nervousness, agitation, headache, and tremor accompanied or followed by a rapid rise in blood pressure and elevated catecholamine concentrations in the plasma. The likelihood of such reactions to discontinuation of clonidine therapy appears to be greater after administration of higher doses or continuation of concomitant beta-blocker treatment and special caution is therefore advised in these situations. Rare instances of hypertensive encephalopathy, cerebrovascular accidents and death have been reported after clonidine withdrawal. When discontinuing therapy with Catapres® (clonidine hydrochloride, USP) tablets, the physician should reduce the dose gradually over 2 to 4 days to avoid withdrawal symptomatology.