Rough couple of days

PersonalEnigma

New Member
As you may remember we have been trying difficult child on Strattera. So far things seemed to be going quite well. He's not really complained of side effects and his behaviour has definitely improved. On Saturday I raised the dosage a final time to what was supposed to be his final dosage. At home everything has been the same. At school though he's fallen apart.

Yesterday he constantly left the classroom to go to his quiet room (he chose to do so on his own, which is a step forward, but he didn't really get any work done at school because of constantly leaving class). He was melting down there quite a bit. By the end of the day he was yelling at his aid that he wanted to die and that she should kill him. When she wouldn't do anything to hurt him he ran away into the kitchen and tried to grab a knife that someone had left out (that is a separate issue the school is sealing with). He said "If you won't kill me I'll kill myself".

Today he had the worst meltdown he's ever had at school. He went into his quiet room and trashed it. He was screaming and yelling that the teachers/aids were "murders" and were going to kill him. It took three people to subdue him :frown: Of course this was one of the very few mornings I was not available to come pick him up... I got him around noon (when I found out about the troubles) and had a long chat with everyone at the school.

I don't know why difficult child has gotten so much more volatile. Do you think it could be a reaction to the medications? Would the higher dose already be affecting him? I am returning him to the lower dose and will be seeing the doctor ASAP. He has an appointment next week, so I don't know if I will get in sooner...

I will be meeting with someone (a specialist in autism/aspergers I think) on Thursday at the school to talk about difficult child and what we can do to help him. The school is being VERY supportive - they really like difficult child as he is a very sweet boy when he's not melting down.

It hurt so bad to see difficult child struggling this way :frown: He wants to do better, but he just doesn't seem to have control over himself sometimes.

I wonder if I should get more testing done on difficult child. We've not really had anything I would consider all that thorough. They did some psychiatric testing at school (I have the report) and have done the basic Connors forms. I've not taken him to a neuro doctor yet - I don't even know how that would work up here. I don't know if it would give us any more answers... I don't really feel that his diagnoses are correct, but they give us access to the services he needs. I also really think that he would benefit from seeing a play therapist. The pediatrician doesn't agree with me, but I think that I will try to push for it.

I don't think difficult child will actually hurt himself, at least not yet, but I have always worried that he would wind up being one of those kids to try to commit suicide at an early age :frown: His emotional maturity is definitely delayed and he just doens't know how to control his anger at all.

Any suggestions/support is welcome.
 

mstang67chic

Going Green
By the end of the day he was yelling at his aid that he wanted to die and that she should kill him. When she wouldn't do anything to hurt him he ran away into the kitchen and tried to grab a knife that someone had left out (that is a separate issue the school is sealing with). He said "If you won't kill me I'll kill myself".

Today he had the worst meltdown he's ever had at school. He went into his quiet room and trashed it. He was screaming and yelling that the teachers/aids were "murders" and were going to kill him. It took three people to subdue him :frown: Of course this was one of the very few mornings I was not available to come pick him up... I got him around noon (when I found out about the troubles) and had a long chat with everyone at the school.


medication related or not, I'm concerned that the school or aide didn't do anything about him grabbing the knife and threaten to harm himself. If mine did something like that at home I would be calling for transport immediately. It sounds like there is definately something going on that need to be addressed now. Whether it is through an ER visit or a scheduled psychiatrist visit, something needs to be done. You said you had a psychiatrist appointment. next week. Do they know what has been happening this week? If not I would call back, let them know everything and demand to be worked in. JMHO but that's what I would do. Hugs to you both....that's got to be scary for him to feel like that.
 

smallworld

Moderator
Absolutely could be a reaction to Strattera, which is an antidepressant and can cause violent, aggressive and suicidal/homicidal behaviors in children. Call your doctor ASAP. You should ask about weaning him off entirely (under supervision by the doctor) instead of just going to the lower dose.

How long has he been on Strattera? What dose caused the violent reaction? How much does your difficult child weigh?
 

gcvmom

Here we go again!
I'm sorry he's having such a rough time :frown: His comments are alarming and whether he'd actually follow through on them is something you don't even want to tempt. I would take that as a serious sign that the medications are not right for him. Stattera shouldn't have that kind of effect on someone who's just ODD/ADHD. I would strongly suspect something more in the mood disorder category, based on how he's responding to this medication.

You should definitely call the prescribing doctor right away to report what's happening so changes can be made.

Let us know what happens!
 

smallworld

Moderator
Actually, just because a child has a strange reaction to an AD is not in and of itself enough to make a diagnosis of mood disorder.
 

PersonalEnigma

New Member
Wow, thanks for the quick responses!

I'm concerned that the school or aide didn't do anything about him grabbing the knife and threaten to harm himself. If mine did something like that at home I would be calling for transport immediately.

It happened at the end of the day and the aid restrained him (he never got to the knife). My dad was there minutes later picking difficult child up, so there was no time to take him anywhere. He was completely calmed down by the time he got home.

He just moved from 18mg to 25mg. He weighs around 60lb (I don't remember exactly). The 25mg is supposed to be correct for his weight - actually on the bottom end from what I understood. He's only been on the medications since just before Christmas, so not long at all. He was doing very well until the higher dosage. I don't want to just drop him off the medications, but will go back to 18mg tomorrow. They are capsules, so I can't split them or anything - the doctor will have to give me a lower dose to wean him.

I couldn't call the doctor today, but will be calling first thing tomorrow morning. I told difficult child yesterday that if he tried to hurt himself I would be taking him straight to the hospital.

The wanting to be dead comments are not new :frown: He's never made any suggestion that he would do something about it though :frown: I feel so bad for the poor teachers etc - they are trying so hard with him and to have him calling them murders and stuff... It was scaring some of the other kids too.
 

smallworld

Moderator
Three weeks is when bad reactions to ADs often occur. Your son's reaction is right on schedule.

I'm glad you're calling the doctor tomorrow. Weaning is the right way to get him off. Strattera also comes in 10 mg to help you out.
 

Steely

Active Member
Definitely can be Strattera! Definitely! been there done that.

I would wean him off of Strattera. Get him tested by a neuropsychologist. And get him in therapy. If he melts down off of the Strattera with comments like wanting to die, I would admit him to a Phosph, to have a full work up done. Sometimes that is the best, and most efficient way to have urgent mental health needs addressed.

Hang in there........ :warrior:
 

timer lady

Queen of Hearts
It's possible that he's reacting to the medications - keep a close eye on him.

Otherwise, unless I missed something (which could very well be), is it possible that difficult child was having his own little version of a bad day?

I'm not downplaying what happened with your difficult child - please understand that. I'd be more concerned (& again forgive me if I missed this) if this were an ongoing symptom/reaction that you hadn't seen before.

Over the years I've had to teach myself not to panic, look for "exact" triggers, wonder about medications or diagnosis's & accept that kt or wm were just having a tweedle version of a bad day.

Before that point, I was driving myself crazy on a semi-regular basis, depending on who might be acting out when & where. I relaxed, looked at the big picture & then decided who needed to be called & why or if there needed to be a consequence happening here at home.

Something to consider.
 

PersonalEnigma

New Member
Thanks again for all the support. It means a lot to me. I am keeping a close eye on difficult child. I got a hold of the doctor's office today and difficult child is going in tomorrow afternoon. The secretary also said I should take him off the medications, so I won't be giving him any tomorrow morning. Nightaura - that's terrible about your boss's son :frown:

difficult child has made comments about wanting to die before, but only when in a really severe melt-down. Usually he is quite upbeat and positive. I am quite concerned though and am prepared to take him in if he shows signs of gtting worse on that front.

I don't think it was just a bad day. It was two days in a row, and this was far more severe than his usual bad days (which the schhol has seen lots of...). I'm not panicing over all this, but am very concerned. I do think the medications are what made things worse though. Another odd thing was that last night and this morning difficult child was SUPER hyper - way more so than usual - Strattera if anything is supposed to make kids drowsy, so that's not normal. The secertary at the doctor's sounded quite concerned. At least we are getting in tomorrow.
 

PersonalEnigma

New Member
Well, I had a meeting at the school this morning about difficult child. They are very concerned for him. His EA is going away Monday/Tuesday for a special training program for working with kids on the autistic spectrum, so hopefully that will be helpful. The school really wants us to geta psychiatric evaluation done ASAP as they are desperate for more guidance on how to work with difficult child. They all adore him (when he's not acting out) as he's normally such a sweet, bright child. They like the idea of play therapy and made some suggestions as to who to contact. One is private, which means that either my insurance or I will have to pay for it (I don't know if our insurance will cover it or not).

There is a program called "ALERT" that they suggested we try to get involved in. It is an emotional awareness program where we assess difficult child to see when he's "low" and when he's "high" and find things that help him be aware and learn to cope with his emotions at those times. They also suggested that respite care may be available if we need it (I don't think we do at this time, but if I could get a support person to go with him to camp I'd be thrilled).

For a full evaluation the school and I agree that we need someone who will see difficult child at school as well as 1 on 1. He is a totally different child in the school environment. They thought it would be best if the person could observe him at school without meeting him first so that difficult child doesn't know they are there for him. That way he won't try to adjust his behaviours for their benefit.

difficult child has a weighted vest that they want to get him to use again as it helped last year. Unfortunatley it lookslike a prison vest (really ugly stripes) and difficult child is embarrassed to wear it. My mom is making covers for it so that it looks better. The teachers thought that maybe he could wear it under his shirt. It's pretty bulky though, so I don't know if that would work. Any suggestions on how to make him more likely to accept it would be welcome.

I still have the dr appoint this afternoon. I hope to get to talk to her without difficult child so I can be more direct without letting difficult child hear everything I need to say (his self esteem is bad enough). My mom is coming along to watch difficult child in the waiting room if there is enough time for me to do this. It may only be a short appointment though as it is only a medications consult. difficult child does have an appointment next week though, so if it is too brief today I will ask to come to that appointment without difficult child to talk.

Wish me luck! The doctor hasn't been too open to further testing so far, but I really feel it is necessary. This whole situation is so frustrating and difficult. At least everyone has difficult child's best interests at heart. I will update later after seeing the doctor.
 
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