pysch just gave difficult child risperdal

Discussion in 'General Parenting' started by Jena, Dec 13, 2010.

  1. Jena

    Jena New Member

    hi

    went to doctor today with-difficult child. he basically leaves it up to me what to put her on, it's beyond ridiculous.

    i have to sit there and make an uneducated guess as to what medication to put her on with-o any info on the medication. he rushes me out the door. it's so hard.

    so i said we've tried ap's, ssri's, benzo's and another category but haven't tried mood stabilizer's yet. why dont we try that than he gives me risperdal.

    husband came with-me and said wow this guy doesnt like to commit and make a decision he pushes you to. i said yup that's how it goes.

    so should i go with risperdal? we're trying to combat anxiety, mania, depression and sleep issues as always.

    than i tell him about easy child well long story short we brought her with-us and he didnt' have 5 min to talk to her and wouldnt' medicate her. than i said ok i'll bring her bk tmrw? can't really wait on this with what she's saying i told him. p.s. no availability for any of their docto'rs for 2 weeks. so i gotta call her peds that wasn't in today tmrw and ask him to call in an antidepressant for her to take while i search for a pysch for her now.
     
  2. HaoZi

    HaoZi Guest

    Risperdal is an atypical ap that is used as a mood stabilizer. I know many here had success with it, but based on my experience, keep a close eye on her, my kiddo went off the deep end and into self-harming behavior on this stuff.

    http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000944
     
  3. Jena

    Jena New Member

    thanks i appreciate the input. i did look it up i just wanted some personal experiences with it. it's an ap. shes' already volatile past week and aggressive and irritable. i'm afraid of increasing that and this jerk dr doesn't give us the time we need or the right input. went bk to him because the other guy went MIA on us and right now no one else will take us on. i'm soo on the fence with this medication. my other option is to wait until tmrw she's seeing her therapist and she knows of a great pharma doctor who she said can help us.
     
  4. smallworld

    smallworld Moderator

    As HaoZi said, Risperdal is an atypical antipsychotic that has mood-stabilizing properties. It helps with anxiety, irritability, aggression and sleep. It increases hunger. It is in the same medication class as Seroquel and Zyprexa.

    Many kids do very well on Risperdal. Unfortunately, my son did not. He had a dystonic reaction that caused uncontrollable movements of his face. Needless to say, we discontinued Risperdal.
     
  5. Jena

    Jena New Member

    great, thanks. i'm sorry to hear about that. how long did it take to show the side effect? I just wanted a mood stabilizer and he handed me this. i wanted to try lithium or depakote for her. we've tried everything else adn she's driving us all totally insane.
     
  6. HaoZi

    HaoZi Guest

    Lithium and depakote are generally a bad idea for anyone under 16-18, and can cause extreme weight gain and hair loss. Those I would eyeball as last-resort medications.
    In re: effects from risperdal, in kiddo's case it was evident in a few days that this was NOT the medication for her, and absolutely apparent in two weeks (because doctor thought she needed more time to see).

    I've been told it can be a bad idea, but have you tried ativan? It worked great for my anxiety issues and insomnia, but I've been told since that it can be addictive.
     
  7. smallworld

    smallworld Moderator

    We didn't realize it was the Risperdal at first because my son has facial tics anyway. But his mouth movements grew worse the longer he was on Risperdal. When we bumped Risperdal from 0.25 mg twice a day to 0.5 mg twice a day at the two-week mark, the movements became uncontrollable, and he soon developed a staph infection around his mouth from constant lip-licking. That's when we realized it was the Risperdal and stopped it.
     
  8. smallworld

    smallworld Moderator

    According to the Treatment Guidelines on the CABF website (formulated by a consensus conference of child and adolescent psychiatrists), Lithium and Depakote are two of the five first-line mood stabilizers that are prescribed to treat pediatric bipolar disorder. The others are Trileptal, Tegretol and Lamictal.
     
  9. HaoZi

    HaoZi Guest

    I've got a friend that works in long-term adolescent and adult facilities, she works with these kids far more than the doctors do on a daily basis, so I based my response on her real-life professional experience of 20+ years as a psychiatric nurse. Lamictal is one she said they would go to before lithium in kids the age range of ours (young to pre-teen). Might have as much to do with long-term effects on health and the fact that these girls are still growing and once they go through puberty it would need a change again most of the time. Just because it's prescribed the most often doesn't mean it's the best thing for a situation (as we all know, I think we all have kids that have reacted oddly to medications here, no?) It might also depend on if you're looking for a short-term or long-term treatment drug.
     
  10. smallworld

    smallworld Moderator

    Believe me, I'd go to Lamictal, too, because of its positive side-effect profile. In fact, two of my three kids are on it with very positive results. I just don't think a parent should rule out Depakote or Lithium because of her child's age. They are prescribed with regularity under age 16. I happen to know because I'm online with many parents through the Child and Adolescent Bipolar Foundation (CABF) and volunteer for CABF's Family Response Team.

    A few years ago, psychiatrists wouldn't touch Lamictal with a ten-foot pole because of the risk of the Stevens-Johnson rash. Times certainly have changed once psychiatrists realized if they started low and went slowly, the risk of the rash was greatly diminished.
     
  11. HaoZi

    HaoZi Guest

    I've been thinking of asking after lamictal for kiddo, but like seroquel the doctor advised against it for kiddo because she gained so much on zyprexa that he wanted to try something else with less weight effects first. Are the kids from CABF strictly bi-polar, or do they also have additional diagnosis's that make deciding on medications tricky? I've not been overly impressed with the Abilify kiddo is on now, so like Jena I'm also gathering info on other possible medications that might work better.
     
  12. smallworld

    smallworld Moderator

    Lamictal is weight neutral.
     
  13. smallworld

    smallworld Moderator

    To answer your question about CABF, many of the parents involved in the organization have children with co-morbid conditions. And yes, they can be difficult to medicate.
     
  14. HaoZi

    HaoZi Guest

    Thanks! Lacimtal in kiddo's case is more being looked at as a long-term medication after puberty, but not one they want to try on her right now. It's what do we do in the meantime when nothing else works well, just like Jena's difficult child.
    Hopefully a few more will chime in and help Jena figure this out.
     
  15. timer lady

    timer lady Queen of Hearts

    Jena, risperdal has been the only medication that helped wm with mood lability & rages. Having said that there are pro's & cons to any medication; our children all react differently to any medication. Lamictal, while a wonderful medication, also has some pretty serious side effects, i.e. Steven's Johnson.

    Don't let other children's reaction stop you from trying what might be a viable treatment option for your difficult child. I hated the idea of wm on risperdal when I researched it yet I had to take the chance ~ it was the right choice.

    Good luck with this new treatment.
     
  16. smallworld

    smallworld Moderator

    My nearly 16-year-old daughter has been on Lamictal since age 11. She just finished going through puberty (she's on the late side). Lamictal is still going strong. She's had zero side effects.

    My 12-year-old daughter has been on Lamictal since age 10. She is not through puberty yet. She also has had zero side effects.

    Is there a reason given for not trying Lamictal until after puberty? Lamictal is FDA-approved for the treatment of epilepsy in children ages 2 and up.
     
  17. HaoZi

    HaoZi Guest

    Because the doctor she saw at the hospital doesn't agree with her regular psychiatrist who thinks he knows all. Lots of conflicting things in her case, I'm still leaning heavily on his nurses to push him for the neuropsychologist referral.
     
  18. Marguerite

    Marguerite Active Member

    Jena, from what you describe, I would think risperdal would be a logical choice. We can't predict if it will be WOW! or disaster for her, but I can tell you that when my boys were on risperdal, the main problem we had with difficult child 1 was sleepiness and weight gain. The main problem we had from ti with difficult child 3 was the cost of the pills. In other words, for difficult child 3 there were no side effects (we thought) but minimal benefit for him, either. Minimal benefit, eventually, for difficult child 1 but that was because by the time we stopped the medications (in both boys) difficult child 1 was no longer in mainstream, and it was mainstream that was also a big part of the problem. Reducing the stress in their environment reduced a lot of the anxiety that the risperdal had been treating.

    We didn't think difficult child 3 had any side effects so we took him off the risperdal. Although he was already skinny, he immediately lost weight. OFF the risperdal. The doctor was worried, but the weight loss was sudden and one-off, and we think it was due to removing the appetite-stimulant effect of the risperdal. A month after coming off risperdal, difficult child 3 began to gain weight again at the normal rate for a kid his age. The weight-loss was a one-off.

    So make your choice. Your daughter has different conditions to my kids, so the medications are probably more likely to work for her.

    Marg
     
  19. Jena

    Jena New Member

    it's all so confusing cause now i've got both kids in trouble. you guys balance and juggle so well it's impressive. i guess ill get there. just feel like we've tried so many things with-difficult child and nothing ever works long term for her. no real relief to all her symptoms and there are so very many. she's such a sick girl she truly is. i have to sleep on it i didnt' fill it yet. i dont' want weight gain possibilities only because i've noticed she'll cut down on food now due to her stomach yup i know still eating issues. she seems to be reverting back to my throat hurts now. is it anxiety or just her need for constant attention? i am thinking 80 percent attention 10 anxiety.

    so much with her as always. now the idea of going back to school? you gotta be kidding me is all i'm thinking.
     
  20. Marguerite

    Marguerite Active Member

    Jena, the best way to cope, to juggle all this - you HAVE to be able to detach, at least from moment to moment. Of course you love your kids and you're deeply emotionally connected to them. But when you're trying to get all your ducks in a row, you have to detach and become an organiser. Think/act like a Girl Friday secretary, the sort of super organiser who gets things done effectively. Make lists, Keep a diary with you with all contact details, phone numbers, appointments, insurance numbers, social security numbers, anything you might remotely need. Keep other files on computer - a diary of how each child is going, a daily note of whether today was good or bad, and why/ One line only in most days, followed by a score of 1 to 10. List medications taken, list any other important happenings. But try to not have it too complex except unless something special happens. Get into the habit of doing this, and try to keep your emotions out of the reporting, however you happen to feel. If you need to record yur emotional reaction, keep your own diary for yourself. Dump your feelings into that, it's good therapy. But keep it out of the kids' appointments.

    I actually had the same doctor for all three kids (not easy child). We would book triple appointments and deal with each kid in turn. I'd have my notes, take in school reports etc. I seemed to have my own portable filing cabinet. Colour-coding manila folders (or those coloured plastic envelopes, document carriers, are really good) will really help you keep each girl's notes, reports and prescriptions organised. Although I transfer prescriptions to my diary, I take that to the pharmacy and fill the prescriptions there. We also file our insurance claims at the pharmacy (usually while I wit for the medications to be dispensed) among other places. So all receipts go into the diary too.

    When talking to the doctor about each child, you open each folder, just as if you are the doctor with the case file. If he raises his eyebrows, explain that your life is complicated enough, and this helps you keep things in order and also ensures the best possible compliance of his instructions.

    Any doctor who asks you for your opinion - it's OK for you to give it. But make sure the doctor owns any choices that are made. I went through this with a real weirdo of a pediatrician with difficult child 1. The guy was a Froot Loop, well and truly. He began to get more interested in me as his psychiatric patient (even though he was not a psychiatrist, and not even a doctor for adults) and had admitted that he found my calm demeanour "a concern" because he felt I was a cold fish. He would try to goad me into a reaction, but I recognised his type - if I had reacted in anger, he would have probably tried to say I was unstable. So I would stay outwardly calm and detached even while I seethed inside. I put it all down in writing later, including finally writing him a letter in which I pointed out his shortcomings.
    We finally parted ways when he was trying to muck around with difficult child 1's medications, purely to make me angry. I asked him what we should do about difficult child 1's medications, since it didn't seem enough. The doctor said, "Well, we could double the dose. Or halve it. Or leave it the same. What do you think?"
    I just said, "I am not the doctor, you are. I asked you because you have the medical training. I don't. I personally think the dose should be increased, to see if it can help."
    The doctor immediately chose to leave the medication dosage the same. That (plus other stuff) told me he had been playing with me (he was being a jerk) so it was the last time we saw him for difficult child 1. However, before we left I made it clear, "So you have decided to continue difficult child 1's current medication dosage?"
    Through it all, even in my letter, I stayed detached and unemotional when dealing with the doctors.

    Never underestimate the importance of your role in your child's medical treatment. You dispense the medications. You provide daily observations (the doctor can't be there) and you report back on outcomes. So keep doing this, but be as professional as you can be. You're not there to make polite conversation, you're not there to talk about the weather. You're there to talk about your child's specific needs within that doctor's modality. Tell the doctor everything relevant but don't add anything more. In other words - avoid small talk, unless it is about things that are relevant. Even the best doctor that you get on with brilliantly, can be distracted by small talk. Over the years I've had a few good friends among my doctors and we had to make a clear demarcation between our communication during appointments, and communication at other times. The subject of my health was always off limits if/when we met socially or professionally (at seminars, etc). During appointments we could briefly talk about other matters but only if it was relevant to my treatment. For example, if I was likely to be fit enough to attend an upcoming conference where the doctor was a speaker. \If we met at that conference, I would refuse to be drawn on the subject of "How are you?" but would instead reply with, "How are you?" ducking out of the answer. Then discuss the content of a speech, or some other conference-related topic.

    You need to recognise your own professional qualifications for what you do, and value yourself for it.

    Then you also have to try to give yourself time off from your professional duties. Not easy, given what you describe. Detaching helps here, too.

    Marg
     
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