I spoke with difficult children' psychiatrist about starting him on a low dose of a stimulant (5mgs Focalin XR) to see if it might help with his bedwetting (primarily) and some attentional stuff (minor) and the doctor agreed - mom picked up the prescription today. Prior to, I had talked with both difficult child and his mom about the possible risks and the fact that stims and bipolar often don't mix. Both were open to giving this option a try. I felt like now was a good time to try since we are running out of summer - school starts in two weeks.

When he was on 5mgs of Adderall (along with Depakote and Seroquel), it worked great, even addressed the bedwetting, but the Adderall caused him to get manic and very irritable. My thought (hope) is that with the addition of Tenex (which has kept him very stable since Spring Break) the stimulant might be effective without the nasty manic side effects.

I'll let you know how it goes.... :)
 

gcvmom

Here we go again!
Good luck! I hope it works for him. FWIW, my difficult child 2 could not tolerate stims even with Tenex in the mix... but everyone is different.
 
I met with difficult child and his mother for therapy today (we do family and individual therapy on Sundays because they drive a long way and Sunday is the only day that works out for both our schedules) and got the initial feedback on the Focalin. Both were positive and even though it had only been 2 days, both seemed to feel good about the medication. difficult child was very talkative and pretty much led the family therapy session which was new since he is usually pretty quiet (especially since starting the Tenex). Mom reported that difficult child was more redirectable and more involved in family activities like swimming and bowling. difficult child reported that he felt like he could organize his thoughts better and that the times that he's usually afraid (he keeps the door open to the bathroom when he's brushing his teeth for example) he said he wasn't afraid at all. difficult child was pleased that he was able to have the door closed, brush his teeth and take the time style his hair -all without being afraid or "paranoid". The larger piece for me was that last night was a dry night. While I know it's way too early to celebrate, I do like the fact that there were no negative side effects reported. I'll give things a week or so and then share how things are progressing - or not. Fingers crossed... :)

I will say that after almost three years with this child & family it's nice to see that we have moved past the sociopathic stuff - lying, stealing, intentionally hurting animals (and people), self harm, fire setting etc, etc . It's nice to watch him go over and hug the mom that he once threatened to kill in her sleep. The focus of therapy at this point has moved past safety plans and door alarms to life skills and talk independent living. Today in individual therapy we focused on how to complete a job application and his excitement about an upcoming family trip over the Labor Day weekend. Today was a good day. :)
 

gcvmom

Here we go again!
Wow, that's an impressive improvement! Glad to hear it seems to be working.

I'm curious if low dose stimulants have been shown to work for enuresis in kids who do not have psychiatric issues... I'll have to read about this further. I've got a easy child who has secondary enuresis... and she's had the problem about three years now. We tried DDAVP with no results. We tried Lexapro with no results. We're trying an alarm, but it's very hit and miss (the alarm doesn't stay put).
 

timer lady

Queen of Hearts
PW, good to see you & thanks for the update. Sounds like difficult child is making tremendous strides. It's taken a lot of time & commitment on everyone's part & it's working.

Wonderful news on the new medication beginning to work...
 
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