I would ask to try another SSRI, pref on that is approved for Obsessive Compulsive Disorder (OCD) treatment. IF your child is NOT tapering off of celexa while onto another SSRI medication, there most likely WILL be withdrawal feelings that are HORRIBLE at the worse, bad at the best. You should google celexa withdrawal to see what to expect (don't mention it to difficult child or suggest that he google it because they can talk themselves into it). There is a way to help with the withdrawal. One small dose of prozac every week or so, for about a month, will help combat the withdrawal. Prozac stays in the body longer than any other SSRI medication. So it will give the body just enough to handle the worst of the withdrawal with-o his body developing a need for the prozac. I know how strange this sounds, but I have used this four times in the last decade and it has made a HUGE difference each time. It also helped my oldest two times when we tried to take him off antidepressants totally to see where he was with-o them. WHile this helped Wiz with the withdrawal, we learned he will likely need antidepressants for life, probably more than one, to keep from becoming suicidal. it is who he is.
Obsessive Compulsive Disorder (OCD) treatment WILL require higher levels of medications than other conditions. I used to know why but cannot remember right now. It is something in how their brains work. Lower levels did very very little to help with the obsessions, but at the higher doses it was quite amazing.
What kind of evaluations/testing did your neuropsychologist do? It IS possible for a neuropsychologist to look at testing and see no autistic spectrum disorder when another neuropsychologist would see one, or for them to see different types of Autism Spectrum Disorders (ASD). It is NOT an exact science and OFTEN what shows up is partially a function of the age and mood of the child. It is incredibly common for our kids to go through many YEARS of different diagnosis's based on many different types of docs, testings, and evaluation before the one that is the best fit is found. We do NOT mean to upset you by saying that your son sounds very much like someone with asperger's. He just does, to us. Of course we don't see the entire situation, or see his test answers and results. We also do not live iwth him or have the instincts that you, his mom, have.
It is also very possible to have aspie "traits" and not have aspergers. I have quite a few of them myself. I will likely never be sure if they were there as part of who I am or if I learned them growing up, but I am quite sure that if I were a child today and got evaluated then I would be diagnosis'd with at least aspie traits if not full blown aspergers. A LOT of that would also depend on what year I was evaluated. No question that in 5th grade I would have been diagnosis'd as an aspie if for no other reason than I refused to speak to ANYONE, not even the priest and teachers. Just plain refused. It wasn't a new school, I had been there since 1st grade. The work wasn't hard, I just refused to speak. I sang in the choir, but that was IT. My parents never knew because NO ONE told them and I spoke just fine (and constantly, lol) at home.
How long was your son's neuropsychologist testing? For the most reliable results there should have been 10-12 HOURS of testing, broken up into chunks from 2-4 hours at a time. It is a real hassle, esp if you must bribe, cajole, reward, etc... to get your child to cooperate. with-o the extensive testing there are a LOT of things that can be missed, including learning disorders, auditory processing problems, memory problems, etc... About 3 years later we needed to have the testing redone because some things we hadn't known came to light. Wiz was in a psychiatric hospital at the time, and the neuropsychologist who came did 3 hours of testing, missed ALL of his learning disabilities including dysgraphia which shows in EVERYTHING he handwrites (and a substantial part of the testing had some handwritten element to it), and gave a completely wrong picture of my child. Wiz was painted as a sociopath (antisocial personality disorder) due to being "unfeeling" which somehow supposedly showed on his testing. I knew, as soon as I read the report, that it was about 2000% wrong and the doctor just did it wrong - all of it. Even the staff at the psychiatric hospital were shocked by the report and could clearly tell it was wrong. The neuropsychologist got to these very serious results in less than 3 hours of testing, so it was easy to see how he got it so terribly wrong.
Anyway, that is why many of us have mentions aspergers several times. I will say that it is rare for a doctor to completely rule out something as firmly as your doctor seems to have. They known that those are usually the times that they end up in later years to be proven wrong. Or that is what the best of our various docs have told me anyway.
The anger and rage that he feels when things do not go the way he has planned in his head (which can happen even if he gets the end goal that he wants, if the middle steps are not exactly what he has in mind, if I understand correctly) can be helped by some different things. Risperdal and other atypical antipsychotics will help with the rage and aggression. Treatment for the Obsessive Compulsive Disorder (OCD), esp the right doses of the right antidepressants, will help with the rigidity and obsessions. He also needs to have help learning to handle things that don't go exactly as he thinks they will. Change the order of things, with-o notice, and help him learn that it is NOT a bad thing, or a good thing, every time. It just is.
We had a sp ed teacher for 5th grade who taught the kids to "roll with it". It was her phrase to get the kids to not have meltdowns, or even snits, if things changed, even changed suddenly. She did this by making changes in their routines. Occasionally at first until she had their trust, then frequently. Some parents got upset, but she explained that the WORLD makes changes with-o notice and kids need to learn to deal. When they first STARTED to get upset she would help them talk out what the change meant. the best possibility, the worst possibility, some in between possible outcomes. Over time they learned that it really was NOT as big a deal as they expected, they just had to stop and take a minute or two to regroup and then move on.
We had a therapist who lead us in a group for adhd kids and parents (kids with other tdocs in one room, parents with her in another with a one way window so we could see how the kids reacted to and handled certain things. She stressed that this type of training was incredibly important for our kids. Without it, they would just get mroe and more rigid, and less and less able to cope with the real world, with school, with jobs, and with spouses and children of their own. Not to say we had to make every day devoid of routine. Routine is crucial, but changes in it need to be able to happen with-o major meltdowns.
There are very few kids with problems like ours who can become really comfortable with changes with-o several different kinds of help. they NEED to experience it and talk it out the way our teacher did, and the way we were trained. They often NEED medications to help so that they CAN process it and not make unsafe choices, and they often NEED more than just mom and dad to help them do all of this.
The therapist was about 2 yrs before the teacher. She had us start small, with running a couple of errands with our difficult child. Tell them where we are going (grocery, dry cleaners, drug store). Do the errands in a different order. Go to the dry cleaner first, for example. Or add in a stop at the drive thru for a drink or snack. When the fuss starts, ask why it is a problem. really LISTEN. Stop and sit and talk, even if you stay in the car, if possible. Or skip one errand and go home. Just a small change like this.
We were told to do this when our child was not exhausted. we also learned that he MUST have enough protein in his system and MUST not be hungry or there was NO learning that was going to happen. He just wasn't capable. At first the unexpected only happened after we had a snack with protein, even if it was getting a pre-cooked chicken or chicken tenders or string cheese at the grocery store. High levels of protein made a HUGE difference, and many of our friends/his classmates learned the same thing. The other really KEY item was to make sure that not all the unexpected things were fun. They didn't have to be hated, or horrible, but if they were all fun he didn't learn to cope with surprises that were not fun. We all know that not every surprise is fun, but it is important to help our rigid kids learn this.
i hope this helped some.
