Not sure re: medications! psychiatrist appointment next Tues.

[nvts]

Hi! I see the psychiatrist at 1:00 this pm and wanted some opinions (I know most of you are shy about giving your opinions :rofl: )

difficult child 1 has Aspergers, anxiety, slightly obsessive, ADHD and ODD. I'm really cautious about medications, (he's taking 54 mg. concerta and 5 mgs of strattera). The ODD stuff kicks up big time right near the holidays, (chip on the shoulder, swearing AT SCHOOL ONLY, everyone is an idiot), and really really hyper in the morning.

Should I be looking at another type of medication? I'm a type 1 diabetic so I worry about giving him something that could cause irreversible diabetes in my kids.

Any input will be rewarded with my deepest thanks!

Beth

 

[flutterbee]

Is the holiday behavior fun because of anxiety? If so, I would consider a medication for anxiety. Does strattera help with that at all?

 

[smallworld]

I'm guessing 5 mg Strattera isn't doing much of anything, given that it's half the starting dose. Furthermore, both medications are for ADHD. I agree with Heather than an anti-anxiety medication like an SSRI might be helpful.

 

[Sara PA]

Strattera is an SNRI antidepressant. Even a small dose can cause the psychiatric side effects (anger, anxiety, aggression, etc) that antidepressants can cause.

The Concerta is maximum recommended dose for his age. People with "significant" anxiety should not be prescribed stimulants because they can cause or worsen anxiety.

Is he better now than he was when he started taking medication?

 

[LOVESDOLPHINS]

just a friendly note be careful with the concerta my difficult child was on 54 mg and started hearing voices telling him to kill everyone at school and us. he had to be hospitalized.
he began punching himself in the head telling his brian to shut up. vey scary. any way just be careful.

 

[BusynMember]

As one who has anxiety and a mood disorder, just the thought of Concerta with STraterra makes me want to jump out of my skin. Why on earth is he on a stimulant and an antidepressant? How is that supposed to help him? Do you trust the diagnosis? ODD is kind of meaningless. A child with Aspergers is going to be defiant if he is taken away from his obsessions, has to transition, is overloaded with sensory stuff/forced into crowds, or his routine is disturbed. Is he getting interventions for the Aspergers? Autism Spectrum Disorders (ASD) kids need interventions far more than medication. If he's doing well in school, why did psychiatrist even put him on a stimulant? I really hate how they hand out stimulants. They are speed.
(I'm one who is VERY shy about giving opinions :wink: )

 

[nvts]

As one who has anxiety and a mood disorder, just the thought of Concerta with STraterra makes me want to jump out of my skin. Why on earth is he on a stimulant and an antidepressant? How is that supposed to help him? Do you trust the diagnosis? ODD is kind of meaningless. A child with Aspergers is going to be defiant if he is taken away from his obsessions, has to transition, is overloaded with sensory stuff/forced into crowds, or his routine is disturbed. Is he getting interventions for the Aspergers? Autism Spectrum Disorders (ASD) kids need interventions far more than medication. If he's doing well in school, why did psychiatrist even put him on a stimulant? I really hate how they hand out stimulants. They are speed.
(I'm one who is VERY shy about giving opinions )

I know that the Aspergers is correct. Both the psychiatrist and the neuropsychologist (diff. organization) felt that this was a sure thing. The ODD isn't really "dead on" because they both feel that it's the way he defends in "adverse" situations. That's where we get lost. Do we medicate? Is there something else that we should be doing? We have him in a day treatment program, but most of the kids there are suffering primarily environmental behavioral situations (abandonment, family drug abuse,etc.) as well as some who've been placed due to behavioral issues stemming from aspies, Pervasive Developmental Disorder (PDD), bipoler etc. It's not an ideal situation, but there are councelors and attempts to try to help "our kind of kids". There's very little intervention directed at purely mental health or developmental kids. Most of the interventions are for purely environmental misbehavior (I'm sure there's a correct term for "environmental" I just don't know the best way to show the difference - I hope I'm not offending anyone - the last several months have been really really tough and I'd hate to get anyone mad!).

Bottom line: we don't have any other alternatives.

Strattera is an SNRI antidepressant. Even a small dose can cause the psychiatric side effects (anger, anxiety, aggression, etc) that antidepressants can cause.

The Concerta is maximum recommended dose for his age. People with "significant" anxiety should not be prescribed stimulants because they can cause or worsen anxiety.

Is he better now than he was when he started taking medication?

He settles down within 45-to an hour after he takes the Concerta, but he's not showing any lessening of the anxiety with the Strattera (I was mistaken - its 10 mgs of the strattera).

Is the holiday behavior fun because of anxiety? If so, I would consider a medication for anxiety. Does strattera help with that at all?

Oh Heather, we go thru he** from Nov. 1st thru 12/24 pm. He's convinced that Santa isn't coming because he's been "horrible" all year long and that Santa won't believe him if he's only good during the Christmas season!

The doctor cancelled (for which I'm thankful, she thinks she's got strep throat - nope, don't need THAT!!) so I have a little more time to check with you guys!

Thanks for all of the help!!

Beth

 

[Sara PA]

The problems with the stims come when they wear off, not when they're first taken. I doesn't surprise me that he settles down when he takes that dose. How hyper and anxious is he when it wears off? And until he takes the next dose?

Strattera isn't likely to help with anxiety.

 

[BusynMember]

Hon, for ANY child on the spectrum, my recommendation (as only a mom) is AUTISM interventions in school. These kids are not psychiatric problems nor do they respond to typical therapy. Trust me, we tried it all, plus I'm in a group of parents with kids on the spectrum. About 50% of all Autism Spectrum Disorders (ASD) kids are on medications, but my son doesn't need them, although he's tried them. If the children with Autism Spectrum Disorders (ASD) get the proper interventions so that their sensory, transition, peer issues etc. become more understandable to them, they can really improve on their own without medication. ADHD symptoms are part and parcel of the disorder--most Autism Spectrum Disorders (ASD) kids appear to have ADHD, but stims don't always work and we found that an aide to help my son not only learn to focus, but how to organize has been a godsend. He can attend well without medication as long as he has permission to ask for help if he needs it (and he has learned to ask for help in an appropriate way). He is almost 100% mainstreamed now, and I give kudos to his wonderful Special Education teachers and his aide for teaching him about the things in life that he just doesn't "get." Some kids get so frustrated that they act out, hurt others and themselves, but that can get better too with the proper school interventions. Even if the children are as smart as Bill Gates (who supposedly has Aspergers) they still need Autism Spectrum Disorders (ASD) help--don't let the school tell you they are "too smart." There are other issues here. I would NOT focus on the medications, but on the interventions. My son had Occupational Therapist (OT)/PT/social skills/life skills...and he still has social skills and life skills. He's doing great. Good luck!