How does medication get prescribed? First psychiatrist appointment. coming up.

[Loralyn]

I have an almost 6 year old that has been out of control/angry/defiant since birth -- I have spent almost 6 years spending every day trying to help him "be rational and calm his body down." I would love for him to be a friend someday -- and have a friend. And I would love for our youngest child not to grow up in a home filled with meltdowns, stress, screaming and tension.

I know you all have SO been here.

After years of specialists, doctors, neurologists, teachers, neighbors all saying "something is up," no one is quite sure what, exactly, is up. I am now (after years of cancelled appts) taking him to a child psychologist, would you mind sharing with me what to expect?

I don't want to talk about my son in front of him...and I am curious about the medications. I have avoided them for almost 6 years but I know they could help my boy...and my family. A cousin (with two kids helped very much by medications) visited and commented that my son would be able to "take a breath" if he had medication to teach him how to remain calm...pleasant...not so angry. I have always known at some point we would need to explore this option. Until you are a parent,you sure never think you will walk in these shoes.

I have a full write up on my son's history, so I don't have to drag my son through the stories of flights, anger, etc Does the doctor write out an rx same day or is it something that gets discussed during many visits to reach a decision? It is a huge decision for us - but one I am ready to try.

Thanks for sharing your experiences - especially about how medication gets discussed and prescribed at age 6.

 

[smallworld]

A child psychologist is not a medical doctor so he can't prescribe medications. A child psychologist typically evaluates the child for the purposes of diagnosis or does therapy with the child and/or parent.

 

[Loralyn]

Thanks -- we are going to a child psychiatrist...to talk about medications.

 

[flutterby]

You mentioned psychologist in your first post, so there was some confusion.

Probably, the psychiatrist won't read all of the information while you're there. You probably will have to rehash the history. If you don't want to do it in front of your son, ask to talk to the psychiatrist alone first, then bring your son in.

Chance are, they will prescribed medications that day. That's all they do. Very, very few psychiatrists do therapy these days (although I know Smallworld's child psychiatrists do). So, the appointment will be all about medications.

 

[BusynMember]

Have you ever gone to a neuropsychologist? They do actual testing. A psychiatrist won't.

 

[smallworld]

When we first started with our kids' psychiatrists, we had four appointments. The first was with parents alone to go over history. The second two were to get to know the child. The fourth was with parents alone to discuss a treatment plan, which included medication recommendations.

When you made the first appointment with this psychiatrist, did you ask any questions about how the first appointment or appointments would go?

 

[flutterby]

SW - I want your psychiatrist(s).

 

[smallworld]

You can have them, but first you have to move to the Difficult Child metro area, where there's a mountain of snow that no one knows how to plow. And we may get SIX MORE INCHES on Monday night.

 

[flutterby]

It's worth it for a good psychiatrist.

Sorry about your snow, though. My mom is supposed to be in Chantilly next weekend for the gem show (she works it) and she still isn't sure if they'll be going.

 

[Loralyn]

thanks all...very much for the helpful info. I am looking forward to the appointment but because medications have been something we have avoided, it makes me nervous to say it out loud (for some reason). More than anything, I think I worry that medications won't work either. And then we will have exhausted all of our options by age 6.

Anyway, hearing your stories is so helpful -- really makes me feel like I am not alone!

 

[GoingNorth]

Just remember that there's no magic pill. medications can help some children "take a breath" so they are able to learn coping methods to calm themselves, deal with anger/frustration, etc

 

[pepperidge]

One thing that was really helpful to me was to really familiarize myself with the different class of medications, some of the most common side affects, how long they typcially take to show effects, etc. Then at least when the doctor hands you a prescription you know more about what's going on.

Perhaps SW can recommend a good source of info.

Also, I think something that is very helpful is to start keeping a simple log. some medications you will know almost instantly whether they are very helpful or make things worse. Some medications will seem to have little impact. It helps to keep a record so that you can say when you go back to the doctor what you observed.

Also I think most people's experience is that it often takes considerable time to get things right on the medication front.

Trust your gut. You know something is wrong. No one likes to put young kids on medications. We all do what we can to not go there. But really they can have such positive impacts if (big if) that's what your child really needs.

My experience has been that psychiatrists (child psychiatrists) don't typically prescribe on first visit.

P.

 

[totoro]

Our psychiatrist is much like Smallworld's.
A good psychiatrist will listen and talk to you, maybe give opinions, give suggestions for possible medications. They may talk to your child after talking to you or you can go solo and set up another apt.
I have done both. If their is anyway possible and if your husband is on board he should go also. This shows a united front. We don't have child care so when we go and we want to talk about our kids in front of our Doctors we bring our Leapsters and head phones.
Do not be afraid to ask questions. Do not be afraid to question the psychiatrist.
Ask questions about medications if they suggest them. If they give you a RX for a medication I would say you would like to think about it and maybe you can take a couple of days to think about it and maybe e-mail the psychiatrist to let them know when you start?
I told her I would rather not bother you with phone calls can I send you a quick e-mail? I have done just this also, hardly ever send them and I keep them short.

I am a huge fan of keeping in touch by e-mail with our psychiatrist. We have actually become "friends" because of this. So to speak. I send her info and updates... (Like the release of the new Temple Grandin movie)

Good luck this is a scary step, just going to the apt. It gets confusing, bring notes.
Stay strong and remember you are trying to help your child. Go with your mommy gut.

 

[smallworld]

Two helpful websites to check factual info about medications are:

www.drugs.com
www.rxlist.com

 

[TerryJ2]

Loralyn,

it may ease your mind a bit to know that, since your son cried since birth and had other issues, that he probably has something physiologically/neurologically wrong with-him that medications can soothe. If you have a cold, do you take a decongestant? Same kind of thing. It simply helps you cope with-the world around you and the world inside of your body.

You are not taking his mind away. You are giving it back to him.

 

[sosotired]

One other comment I wanted to make along with all of the other wonderful advice you've received.

If at first you don't succeed, try try again.

We are on our 4th psychiatrist. I had more then one talk to my son for less then 15 minutes and then diagnosed him with a plethora of different things.

The one he's seeing now spent an hour with me alone and an hour with my son alone. We came back for a second appointment and spoke for another hour and a half. He is very thorough and always spends more time then he probably should with us when we go for a medication check.

If you're not comfortable with this psychiatrist, look for a different one.

We fought medications for 8 years; tried everything from diet to therapy to vitamins. Now that we've been there done that for a few years, I wish I had done it earlier.

After he's medicated, I'd suggest you look for a psychologist that will see him on a regular basis to start therapy. Once they can take in information due to the medications, therapy is critical to give them the skills they'll need for the rest of their lives.

Good luck!

 

[Loralyn]

Just wanted to say thank you so much for the great info. Our appointment is March 8 and I feel much more prepared.

 

[maxeygirls]

Loralyn,

it may ease your mind a bit to know that, since your son cried since birth and had other issues, that he probably has something physiologically/neurologically wrong with-him that medications can soothe. If you have a cold, do you take a decongestant? Same kind of thing. It simply helps you cope with-the world around you and the world inside of your body.

You are not taking his mind away. You are giving it back to him.

I totally agree with this. My difficult child is only 3.5 years old and medicated with much improvement. She doesn't act drugged and it isn't simply hiding the problem. Until she was medicated I only saw two emotions; anger and excitement. Now she cries, laughs, talks to me and thinks things through. She likes taking her medications and reminds me if I give them to her late because they "feel good" and "head no ow hurt." I have never said the medications will do either of those things, that all comes from her little 3 year old mouth.
Best of luck to you and remember, this is your child and if you aren't comfortable with something the psychiatrist wants to do, say it!