Why can't hte PhD do the psychological evaluation? I thought that would be his job. A neuropsychologist would run a number of tests. Similar probably to what the development center would do. We had ours done by the docs who worked with our developmental pediatrician. He had a number of other professionals (many with phd's) who did a range of testing. Then they all sat down together and talked about what they saw during the testing and what the testing showed. Then we talked with the dev pediatrician and he gave us the results and what the docs all thought was going on. The dev pediatrician was a psychiatrist who was certified as a child and adolescent psychiatrist adn had additional certification in developmental pediatrics - all that on top of first being a reg pediatrician! So he did a lot, though not hte normal cold and flu stuff.
I think the devel center will do a lot for you. It would be worth taking the time. If they are that far away, could you go the night before and stay in a hotel so that difficult child would be rested and less likely to melt down during the testing? What did the docs say about his meltdown during the testing? I would think they could get some valuable info from the melt down too.
Things are not going to get better until you have a better handle on what is causing your son's problems.
Has his behavior gotten worse since being on strattera and prozac? They are VERY similar medications, though the strattera is used for the ADHD and not the other problems. I would be incredibly leery of having a child on both strattera and an SSRI like prozac. don't get me wrong, strattera can do a lot for adhd - it is very helpful for both my son and my brother. But the two medications act very similarly. Was difficult child on the prozac before the strattera, or was it added after? Did the same doctor prescribe both medications? Did your son's behavior change after a few months on either medication? A number of people here have seen an increase in violent behavior or anger after 3-4 months on an SSRI medication or on strattera.
I was curious so I put both strattera and prozac into the drugstore.com interaction checker. It doesn't guarantee to list all possible interactions, but I have found it helpful with my medications. With ONLY those 2 medications, this is what they said:
STRATTERA (ATOMOXETINE HYDROCHLORIDE) and PROZAC (FLUOXETINE HYDROCHLORIDE)
Severity: Moderate
Description: Treatment with both fluoxetine and atomoxetine may cause too much atomoxetine to be in your blood.
Using atomoxetine together with fluoxetine may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If you are using both medicines together, your doctor may change the dose or how often you use one or both of the medicines. It is important to tell your doctor and pharmacist about all other medicines that you are using. Call your doctor if you feel that your heart beats faster than usual, feel very tired or run-down, have a headache, or don't feel like eating. Do not stop using your medicines without talking to your doctor first.
THen I added all of the medications you ahve listed for your son, so you could see if anything else was listed as an interaction. I ahve found that not all docs actually look this stuff up. (THis was with MY medications I found this, but each doctor does things differently). PLEASE do not change your sons medications with-o talking to the doctor - this is crucial for his health!
The other interaction mentioned was taking adderall with acidic food. It can increase the amount of adderall in the blood. This was rated as a minor interaction.
The strattera/prozac interaction was rated as moderate.
Here is the definition of minor and moderate interactions.
Severity rating definitions
What does "major" mean? The interaction may be life-threatening. Call your doctor immediately to discuss whether you should be taking these medicines together. Your doctor may need to change your therapy to reduce or prevent serious side effects.
What does "moderate" mean? The interaction may make your condition worse. Your doctor may need to change your therapy. Please talk to your doctor or pharmacist about using these medicines together.
What does "minor" mean? The interaction may increase the side effects of each drug. You can usually continue taking both drugs. If you experience any unusual or bothersome side effects, please report them to your doctor
Here is the link to the drugstore.com interaction checker. You can check these and any other medications/herbal supplements he is taking there for yourself.
http://www.drugstore.com/pharmacy/drugchecker/default.asp
This may or may not be the best interaction checker around, but it is handy, so I use it frequently.
I hope this helps in some way. The increase in violent/aggressive behavior that some of us have seen after being on certain medications is not scientifically proven, it is just what we have noticed here. That is to say it is anecdotal evidence, not empirically proven.
