How do you get brave enough to wean off a medication or try a new one?

Discussion in 'General Parenting' started by zba189, Dec 2, 2010.

  1. zba189

    zba189 Guest

    Please excuse the ramblings of this post. I'm hoping that this makes sense and maybe ya'll have some advice for me.

    difficult child is headed to his second appointment with psychiatrist tomorrow. I'm very impressed with psychiatrist, he believes that most decisions should be parent and patient lead and he is willing to listen to everything that we have to say.

    Last appointment., we talked about the fact that Risperdal is causing major weight gain and we are not sure if it is making a major difference in his behavior. The Risperdal was suppose to be a short term fix but has turned in a 4 month trial. He wasn't suppose to be on it long term and was suppose to be weaned while at the Residential Treatment Center (RTC). That didn't happen.

    difficult child is doing well but is anxiety ridden. psychiatrist gave us Buspirone. It made his anxiety worse. The plan was to get Buspirone on board, then wean off Risperdal and see where we are. That plan has changed due to side effects and we are at the same spot we were three weeks ago and truth be told the same spot we were three months ago.

    I know this is stupid to worry about but after this summer's events I would love to have a somewhat peaceful Christmas. I worry that messing with medications during this time of year is just being stupid. difficult child behavior is about 75% manageable. I know it will never be 100% but I worry about how much the anxiety is weighing on him. I hate to mess with medications, but the Riperdal side effects are very concerning for me.

    What would you do? Would you change things with the medications. right now? If we wean him off of the Risperdal, what should I watch out for? I know that if we find the right medication or medications for difficult child all of this will be worth it. With that in mind, I'm terrified of trying something new because so far we have had less than desirable outcomes. It's hard to know what is best when there are so many unknowns.
     
  2. confuzzled

    confuzzled Member

    i''ll ramble right back at you :-D

    i just had this exact same conversation at the psychiatrist yesterday, even though i'm the first person to admit that just because you are feeling better doesnt mean you don't need medications--in fact, that can often be a sign they are working.

    it was actually nice since the psychiatrist assistant *DID* listen to my concerns. we formulated a plan to start tapering in the spring to attempt to be medication free by the end of the school year. i'm also gunshy about rocking the boat around the holidays/harder part of the school year in the event that she does need to stay on medications, but i also need to see her weaned off in her "natural habitat" where the most stress is, so we are thinking if i start around spring break and go very slow, she'll still have some of the school year left on no medications. and in the event it fails i'll have all summer to titrate back to where she is. if the side effects (weight gain) get much worse we might have to speed it up, so its not all set in stone yet.

    so thats *our* plan.

    but the truth is, i wouldnt be so quick to do any kind of wean if we didnt have a major situational component. if i was strictly convinced that it was all her, i'd probably be leaning in the direction of what to try next with less SE's instead of no medications at all. or, i'd be asking myself if the SE's are tolerable enough in the name of stability and even though i don't like it, sometimes it is the only answer.

    it was felt that a medication free trial is warranted in our case, and we won't know if we don't try.

    but all that being said?

    yea, i'm pretty nervous about it too.
     
  3. HaoZi

    HaoZi Guest

    Having had to switch kiddo's medications several times due to bad effects ranging from self-harm to screaming foot pain combined with weight gain, I can usually tell in a week if a new medication is better or worse (Risperdal was one of those really nasty ones to her). Now would be a good time so you'll know before the holidays if it's better or worse than prior medications. Does your difficult child even have a diagnosis yet or is doctor just tossing whatever is popular at him?
     
  4. LittleDudesMom

    LittleDudesMom Well-Known Member Staff Member

    zba, i see that his bio mom had a history of depression but I don't see a diagnosis for your difficult child. I'm very sorry but I don't remember the specifics on your difficult child. Risperdal has been prescribed for other difficult children here to treat schizophrenia, bipolar mania, irritability associated with autistism, and for anxiety and Obsessive Compulsive Disorder (OCD). Is your son officially diagnosis'd with any of these?

    Is the risperdal the only medication he is on now?

    This is a tough time of the year for most difficult children, but it's also a time when they have a considerable time off from school which can be a good time to wean off or try a new medication.

    Personally, would never keep my son on a medication I was unsure really had an effect, especially given apparent negative side effects.

    Has the doctor discussed using an antidepressant for treating his anxiety (or has difficult child ever been on one)? The downside to using an anitd for anxiety would be the time it takes to "work".

    We definitely understand your fear. I think you have to take a really good look at your son and decide what it is his ultimate best interest. I know you will make the right decision.

    Sharon
     
  5. zba189

    zba189 Guest

    difficult child has been diagnosed with a nonverbal learning disorder per a neuropsychologist. The Residential Treatment Center (RTC) gave him a diagnosis of a mood disorder not otherwise specified but we were told it was for insurance purposes since they thought he was on the Pervasive Developmental Disorder (PDD) spectrum and our insurance would not cover treatment for anything Pervasive Developmental Disorder (PDD) related. He could very well have a mood disorder in addition to NonVerbal Learning Disorder (NVLD), but the doctor keeping saying time will tell. He doesn't have a diagnosis of anxiety but he's got anxiety (if that makes any sense). They have thrown ADHD at us, but his ADHD behaviors are only apparent when he is anxious. So they have taken ADHD off the table for now. Much of his less than desirable behaviors are anxiety driven, which is the reason why I would like to see if we can lessen that.
    Risperdal is the only drug he is taking. I have him on some amino acids but I'm not sure they are working either. He was put on Prozac this summer for anxiety that resulted in a mania that started this whole ball rolling with treatment and an Residential Treatment Center (RTC) stay for six weeks (ie he trashed my house).
    difficult child has had less than desirable outcomes with any of these drugs at this time. I feel great about the therapist we have on board, he is in a very supportive environment at school (his teacher is amazing and has a little girl who is a difficult child herself), I like his psychiatrist. I feel good about what we are doing, I'm just unhappy about the drug aspect. I'm not naive enough to believe that this isn't a multi-front war- I just wish I knew where to go from here.
     
    Lasted edited by : Dec 2, 2010
  6. timer lady

    timer lady Queen of Hearts

    If you want a somewhat peaceful holiday I would wait until after the festivities to mess with medications. During winter break would be a good time.

    Saying that, medications are always a cr@p shoot & one of the most difficult decisions a parent has to make for their child. And as our difficult children grow there are many times you have to changes medications due to the growth & bio chemical changes in your difficult children brain. I could never bring myself to remove a medication due to weight gain if it worked in the area it needed to, i.e. anxiety, rages, attention span, etc. , it was prescribed for. So many medications have the weight gain side effect ~ particularly psychiatric medications.

    I wanted my kt & wm to be able to function; I dealt with the weight issues after they were stable (or as stable/functional as they can be).

    Good luck with whatever you decide.
     
  7. shellyd67

    shellyd67 Active Member

    The majority of our difficult child's have been down that road of medication changes. It takes time and patience to find the right fit. It is a heck of scary rollercoaster ride, but eventually you will find the right fit. Just hang in there .... I would also wait (if possible) until Christmas break when school is out and maybe difficult child can have closer monitoring. ((( HUGS)))
     
  8. Bunny

    Bunny Guest

    This is something that we are going through right now. difficult child was prescribed Celexa for anxiety, with the idea that if we could get the anxiety under control the tantrums and screaming rages that he has would cease. That has not happened. I talked to the psychiatrist the other day and told him that I thought it was time to try something else because this is just not working. So, even though it's a few weeks before Christmas, we are weaning him off the Celexa and will start the Risperdal. Am I worried about starting something new? You bet I am! But we need to find a medication that works for difficult child because we have very little peace in out house and it's not fair to anyone, including difficult child, and if we need to do it over a school vacation, then that is when we will have to do it.

    Good luck with the medications. Let us know how it is going.

    Pam
     
  9. slsh

    slsh member since 1999

    This was one of the most frustrating parts of raising my difficult child. I called it pharmacologic roulette because you just never knew what you were going to get with- a medication change. Seems like each medication can have a different effect for each kid - there's no 1 size fits all. *Extremely* frustrating. I finally realized that medication management is more art than science and the very best prescribing psychiatrists were the ones who truly listened to not only husband and I, but also thank you, and who were willing to think a bit outside the box (just our experience).

    I went into this totally anti-medication, but then we had several hospitalizations due to homicidal/suicidal behaviors within a few short months and... something had to give. Starting out, I trusted his outpatient psychiatrist and was willing to follow her recommendations. We had a really horrendous reaction to Ritalin resulting in yet another hospitalization and after that I got a bit more diligent about reading up on medications myself and picking the brains of the good folks on the board.

    As far as when we stopped a medication, if it had no effect (would wait until next psychiatrist appointment to discuss) or if it had a negative effect (immediate call to psychiatrist for instructions on discontinuing medication).

    When to switch or add a new medication? The majority of the time, that was the result of another hospitalization (averaged an admit every 3 months for over 3 years). I knew medications weren't going to "fix" things. They were a tool. But when thank you got so dangerous that we couldn't manage him at home, it was time for at least a try at either another combo or a higher dose of what he was already on.

    I understand your concerns about Risperdal, but I think something else to consider before you decide to discontinue it right now is that the holiday season for most of our kids is extremely rough. The anticipation and disruption in schedules can just play havoc. on the other hand - if you're not sure it is having an effect.... I think Shelly's suggestion to wait until Christmas break to make a change is a good one. You're going to be able to keep a much closer eye on him.

    It's really hard to know what to do, when to do it, and if you're making the right choice. Unfortunately, in our experience with- thank you, it was trial and error at best.

    Hang in there!
     
  10. Kjs

    Kjs Guest

    You will know when it is time to switch medications. When it gets to a point that difficult child is not doing well, not feeling well you know it is time. We just went through a medication switch. Two weeks and it was awful. psychiatrist then took him off. Things were really, really difficult for two weeks. However, difficult child suffers from depersonization and extreme anxiety. sweating, shaking, dizzy, afraid every ache and pain he is dying. After trying xanax for a while psychiatrist put him on klonipin. Anxiety is gone. Just dealing with all the other issues.
     
  11. pepperidge

    pepperidge New Member

    Don't know if this is helpful, but we used Risperdal on an as needed (PRN) basis. They even make a melt on your tongue version. You could wean him off (what dose is he on?) and then get a prescription for using it as needed if there are only certain days that he seems to need it.

    If you are really not sure he needs then then it might be good to wean him off of it. You can always put him back on. Just maybe wait until after the holidays to make a definitive judgement about whether or not it had a positive effect.
     
  12. zba189

    zba189 Guest

    Thank you all for your kind advice and words of wisdom. I know it's been said many times, but it's nice to come somewhere and get sound advice from people who understand.
    We met with the psychiatrist today and in the end we had no choice about weaning off the Risperdal. difficult child's prolactin levels came back high. We are now weaning off Risperdal with a mood stabilizer on board. psychiatrist said there was no reason to do a wash, due to the fact that difficult child anxiety is so high that he needs something. I'm being brave, hoping for the best, and keeping a close eye of difficult child.
     
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