Still have the rx in my hand, unfilled

Discussion in 'General Parenting' started by whatamess, Jul 23, 2009.

  1. whatamess

    whatamess New Member

    Risperdal, ugh, it seems like this is the go to medication for kids on the spectrum. Always suggested by the psychiatrists the moment I give any clue that there are outbursts. Aren't outbursts just kind of one of those things that go hand in hand with autism?

    Can you guys talk with me about if you feel there is a difference in types of aggression and if medications are warranted in any case?

    For instance, my difficult child has 'temper tantrums'/rages when he is frustrated. He seriously has the mind of toddler in those moments. He will rip paper, throw things, stomp up and down, cry, talk to himself (yell to himself) about the injustice of it all. In the midst of all this a toy could hit someone, or someone might get pushed out of the way or the cat might get pushed-not that he's seeking these things out, they are just in the way as he's going up to his room (or are foolish enough to enter his room while he's tantrumming.

    Now, maybe this is denial or distorted thinking on my part, but I see the previous description of 'aggression' as really more of a result of frustration, not intentional harming.

    The psychiatrists don't ask to me to differentiate or in what situations 'aggression' occurs. I don't want to medicate him when what I really think is he needs plently of work on dealing with his emotions and finding ways to calm down instead of raging/tantrumming.

    Do you see a difference between intentional aggression ("I hate you and I'm going to hurt you") vs. incidental aggression (I'm having a fit and I'm throwing things whether you're here or not)?
     
  2. AnnieO

    AnnieO Shooting from the Hip

    Honestly? Here's my perception of medications, especially mood stabilizers.

    Kids don't learn when they are in the middle of a rage. In fact, when you are angry (and I mean really, really angry), do you want to listen to someone telling you what to do - how to handle your anger? Most people wouldn't.

    And, given that we have been given the know-how to formulate this stuff, in small doses even, that helps...

    My point of view is, if it calms the child (adult) well enough so that they can learn how to deal with their anger and other problems that might arise, then those skills are part of the person. Maybe they can stop taking the drug at some point because they've learned the skill.

    Perhaps it is different and they just need a little help over the "hump". That's why I'm on Lexapro right now.

    But that's just my $0.02.
     
  3. DazedandConfused

    DazedandConfused Active Member

    Hmmmm.

    I think the only thing I can offer is that Risperdal was the first medication that made a difference for Son. We've done Strattera, concerta, and I few others I can't remember. With Risperdal we finally had a breakthrough. Son has been on it since right before he turned nine. It's still been a very bumpy road with him, but without it, OH MY, I don't want to think about it. It was pretty awful up until then.

    I know that it doesn't help everyone and some suffer side affects like weight gain, etc.

    Son has since had mood stablizers added to the mix recently once he hit puberty. He would cry and sob for hours at the slightest frustration and I went hunting for a new psychiatrist. New psychiatrist wants to discontinue Risperdal and there was an attempt to taper off of it. That was a disaster which ended up ruining a Mother's day family get together because of his extreme irratibility (most of the family wanted to string him up!). At first I was puzzled, then the light bulb went on I realized his dose of Risperdal had been cut in half. I then gave him the rest of the usual dose with the reasoning that psychiatrist doesn't have to LIVE with him. I view medication from a "quality of life" standpoint. The medication MUST improve my child's qualty of life, or the medication is stopped.

    I see that you have been on the medication Merry-go-round. I really can't advise you one way or the other on whether you should give Risperdal a try, but I know that there was NO WAY I would have gotten Son to deal with anything without it. Though he's never fit the complete criteria for AS, I do see a lot of AS-like traits in him.

    As for different types of aggression, I don't have a answer and I'm sure others will be more knowledgeable in that area. Son was mostly aggressive towards his sister. Hitting, punching, and also calling her names. Then, recently, it turned towards me and I have even had to call the police on him.

    I sympathize with having to make these very tough decisions regarding our challenging children.
     
  4. graceupongrace

    graceupongrace New Member

    I don't think the two are mutually exclusive. Sometimes the medications give our kids a "biological pause" so that they can learn to think about their response (and, ideally, calm down) instead of just acting on impulse.

    There probably is a difference between the impulsive, acting-in-the-moment kind of aggression and the deliberate, calculated kind. But they both need to be discouraged. As he gets older, bigger, stronger and more hormone-driven, the impulsive aggression can be dangerous. Trust me, I've experienced it with my difficult child. (He's not on the spectrum, but has extremely low frustration tolerance and high impulsivity.)

    The whole trial-and-error thing is so difficult. I can empathize with you there -- been there done that!

    (((Hugs.)))
     
  5. Shari

    Shari IsItFridayYet?

    My son uses Risperdal, also, and it is the only medication that has made a difference for him. Like your son, his outbursts and aggression were generally frsutration-related, altho he would occassionally be aggressive seemingly for the purpose of being aggressive.

    My other thought on aggression, particularly when related to anger/frustration...what starts out as a kid's only known way to cope quickly becomes a habit, and then you are fighting two battles instead of one; instead of teaching a coping skill, you also have to break a bad habit on top of that. If the medication can help break the cycle and teach a new skill, in my humble opinion, its worth it.

    I had a lot of reservations about Risperdal, but my sister in law, who is a nurse, said to me one day while she and I were restraining my violently angry and frustrated difficult child on the floor, "what other option do you have? really? This is no way for him to live." It hit home and we started the medication.
     
    Last edited: Jul 23, 2009
  6. JJJ

    JJJ Active Member


    I'm not sure Risperdal would help a child who has enough control to intentionally hurt someone. I think it is for children exactly like yours -- to help give them enough of an "assist" to control their anger as they learn anger management skills through therapy.

    I have 3 difficult children. ALL has been on Risperdal and the other APs. Both boys learned enough anger management skills that they have been successfully weaned off of all APs. They needed it so that we (parents and therapists) could get through to them and teach them how to manage their frustration and anger. My daughter will be on APs for life as she needs them both for anger and psychosis (actually I hope they develop a better class of medications for her as the APs just take the edge off and she needs something much more).

    Putting him on it doesn't mean you are stuck forever. If it doesn't help, you can take him off of it.
     
  7. flutterby

    flutterby Fly away!

    Given your exact description, I personally wouldn't give risperdal. (I will note that you didn't say how many times a day this happens.)

    I don't like the side effect profile of AP's to give them unless psychologically warranted, i.e., hallucinations, mania, impulse control (hurting self/others).

    What interventions is your son receiving?
     
  8. Shari

    Shari IsItFridayYet?

    I don't know what has caused it, medication or otherwise, but we have seen fewer and fewer acts of intentional aggression by difficult child as time has passed. Its very, very rare now.

    We also keep M-tabs on hand, which melt in the mouth, to use in "immediate" situations. The school used them a couple of times and they could visibly see hm calm in response.

    That said, do research it on your own. It can be a very good medication for some, and tho I think serious side effects are rare, they are out there.
     
  9. whatamess

    whatamess New Member

    Outbursts where he is throwing toys around his room, yelling, crying- 2 or 3 times a week. His outbursts have actually decreased since I've read The Explosive Child and changed the way I deal with him when he is misbehaving. However, when we tried sending him back to school 1/2 days in spring he was having terrible meltdowns daily at school. I do know this is due to the way the teacher handled him. He is now in summer program with an awesome teacher and he has had 2 meltdowns in 5 weeks there.
     
  10. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I actually agree with you about why he acts out. It's not the same as a bipolar child. However, Risperdal *is* given to spectrum kids who rage. My son had a terrible reaction to it. I like him better doing interventions and being medication free. And he's older now and he no longer rages. He hates the way medications make him feel. Why did his doctor put him on Risperdal? Do you agree with the reason? My son learned without medications to control his aggression, but every child is different. This is definitely one of those "your call" things. I took my son off medications at age 11 and he's been doing great. There are pros and cons to medications, but if a child really loses it a lot and can't control himself, I think it may enrich his life as long as he can tolerate the medication.
     
  11. mstang67chic

    mstang67chic Going Green

    I think you've gotten some good opinions here and mine are pretty much in line with the majority. So....as I just yesterday had my son's Risperdal refilled, let me share part of the prescription information that came with it.

    Risperdal/Risperidone

    Risperidone is used to treat certain mental/mood disorders (schizophrenia, manic phase of bipolar disorder, irritability associated with autistic disorder). This medication can help you to think clearly and function in daily life. This is a psychiatric medication (antipsychotic-type) that works by helping to restore the balance of certain natural substances in the brain (neurotransmitters).



    **I typed this in instead of doing a copy/paste but I typed it straight off the info sheet.
     
  12. Fran

    Fran Former Site Owner

    You certainly don't have to medicate your child. Outbursts of frustration are normal for just about everyone. It's only when it interferes with his life or poses a danger that it's a problem.
    If you feel he is fine the way he is, then don't medicate and work on teaching him to regain control.
    Most of us try to work with our kids without medications for years. Eventually, we realize our guys need all the tools they can get and still they struggle.
    I agree with JJJ that if your child was intentionally trying to hurt someone or himself, the risperidol wouldn't work.

    You may prefer some of dietary changes that some members have had some success with. It's an alternative to medication.
     
  13. TerryJ2

    TerryJ2 Well-Known Member

    No, I don't see a difference. When they're raging, they're raging. I understand why the dr wants to try it.

    What the Risperdal can do (or any medication that will take the edge off) is 1) calm him down so that he has more calm moments than raging moments. Then, when he does rage, he'll truly understand the difference and understand how uncomfortable it is.
    It will also 2) allow him to think more clearly and escalate more slowly, so you can talk him through a potential rage and stop it b4 it gets out of hand, or at least see it coming so you can stop the situation/conversation.
    Again, the fewer raging moments he has, the more time you have in between to do behavior modification and therapy.

    Taking off on what Fran said, have you tried an elimination diet for your son? Wheat and milk products, for example? When my son went off wheat he was like a different person.
     
  14. fiendish

    fiendish New Member

    my difficult child takes prozac and seroquel. His diagnosis is High-Functioning Autism (HFA) but with severe anxiety/OCDish stuff. And ADHD. The prozac is for the anxiety and the seroquel is for anxiety plus aggression (mostly toward himself, but also of the unintentional variety--not in control of himself). I too held a risperdal rx in my hand for a few weeks and never filled it. He was 4 and it didn't feel right. He started the seroquel at 5.5 and added prozac at 6 and they have been miraculous. He is a different kid. We didn't tell anyone he went on medications and we had all kinds of people from his school, friends' parents, etc. coming to us to tell us how much he had "matured" or what have you within about a month of starting the prozac. I think that they are working together well. I do think they give him that added pause & capability to think about why he feels the way he does. He just doesn't fly into a blind panic/rage very often anymore.
     
  15. mamabear01

    mamabear01 New Member

    I have experience with two boys on Risperadol. They are not on it now.

    First Risperadol is the BOMB. I loved it. It was a night and day difference with my boys regarding the rages. All of a sudden the rages stopped and I could deal with the other stuff.

    So I put my boys on it with the advice of their Pys.

    Okay so child no 1 went on it, it was GREAT but gained 50 pounds. I would talk to this doctor about something else and he refused to change it.

    I finally left him and went to a neuro who put him on Topamax (Topamax has a mood stabilizer, but you don't gain weight. He also went on this due to his migraines.) So far so good for the mood and no more weight gain. It's been wonderful.

    Other son did the Risperadol and again, it was GREAT for his mood. He didn't gain any weight but I also noticed it fizzled out after 6 months. I had talked to other parents that said this can happen at times. This doctor (pys) wouldn't listen to me and wanted to add a 4th medication (Prozac, clonodine, Risperadol and Orap). I am not anti medication, but I won't do a cocktail when I don't think it's necessary.

    So I took him all all medications and went to his pediatrician about clonodine only. He won't sleep without it. So far all I see his problems are with anxiety only so I am thinking about going back to my other son's neuro for something else.

    I had a bad doctor, but if I had a good one I would try again for my younger son who didn't gain any weight.

    The thing is.... if you don't like it, or your child has horrible side affects with it you can take your child off. You will never know until you try. I might try again with my youngest, but have a doctor now that I trust to not put him on too much.

    Plus I was angry at the pys cuz he changed his prozac to zoloft to go on the Orap and after googling the food and drug administration I found out this was a deathly combo! Stupid doctor !!!!
     
  16. timer lady

    timer lady Queen of Hearts

    Lots of very wise responses here....as Fran said, you don't need to get that rx filled.

    I didn't get the chance to decide to medicate my difficult children or not; they were placed with me on medications & it hasn't ended.

    Saying that it took a lot of insight from a very experienced child psychiatrist to find the right medications for kt & wm. AND risperdal has given wm his one best chance to function at his highest level.

    One more thing ~ it's not healthy for you nor your child to be in the center of a rage for a long period of time. Our psychiatrist put it at 30 minutes & was stunned to hear that kt could/would keep it going for 6 or 7 hours. She was no longer with us at that point ~ the rage was in control.

    Just something to consider.
     
  17. Josie

    Josie Active Member

    I think it is easy to say someone needs to work on calming themselves down if we haven't experienced strong feelings ourselves. I really believe some of these kids have biochemical issues that make it difficult, if not impossible, for them to control themselves.

    I did not rage but I used to be irritable and stressed all of the time. Then, I tried Lexapro and the things I thought anyone would be irritated about, didn't bother me any more. When I was irritated, I would have an ugly tone in my voice about the slightest thing. I knew I needed to work on that, but things would just come out of my mouth before I could even process that I needed to think about my tone. With Lexapro, I didn't have to worry about my tone, because I wasn't irritated. Being on that for a while made me then realize when it was me that was easily irritated and not the situation being irritating. Before that, I was unable to see that the problem was within me.

    So I believe in adjusting biochemistry to help our kids.

    After I was on Lexapro for a little over a year, I discovered that I had gluten intolerance. Going on a gluten free diet meant I didn't need the Lexapro any more.

    My oldest daughter was diagnosis'ed with ODD and depression. She needs to be on the girlfriend/CF diet. Before we started her on that diet, she was taking Lexapro and we were going to add Seroquel. She would lash out when she was angry and sometimes hit or throw things. I was scared she would hurt her sister so we were going to have to add something else to the Lexapro. It was at that time that we discovered she had gluten/casein intolerance and I saw how well it worked for me, so we held off on adding the Seroquel while we tried the diet for her. She has been able to get off the Lexapro also and is fine, unless she doesn't stay on her diet.

    She is a teenager so she cheats on her diet some. I still don't think medications are the answer for her because I am not convinced her mood problem would be controlled by medications if she was continuing to eat gluten. I also think the gluten is probably doing other damage to her body and her mood is the only symptom that I can see. When I went on the girlfriend diet, many symptoms of mine went away that I would never have thought were related to gluten. So she is pretty compliant with her diet and is doing well enough.

    My other daughter is also on the girlfriend/CF diet. Her problem with gluten is that it causes stomach problems. Her mood does get much worse, I think, if she makes a diet mistake but she is having some other issues that we haven't been able to solve with diet or other natural means so far. We are giving her medicine for those issues.

    My older daughter and I have to stay very strictly on our diet for it to work. Eating at restaurants is risking accidentally eating gluten. I have found some restaurants that I trust but this diet requires a serious committment of being extremely careful about what we eat. My last mistake happened when I ate a supposedly gluten free meal at a chain restaurant. I felt like I had been drinking when I left (I had not had any alcohol) and for at least 3 weeks I was extremely depressed and crying over trivial things (like Hannah Montana!). I was aware that this wasn't right but I couldn't control it.
     
  18. 'Chelle

    'Chelle Active Member

    Speaking only from our situation, my difficult child couldn't learn how to control his frustrations etc. while he was in the midst of his frustrations and anxieties. The Zoloft helped our difficult child be able to calm and see what he needed to do to get through. He was on for a couple years, then gradually took him off and he did fairly well for a couple years. Late winter/ early spring this year he went through a VERY scary bad patch (we're talking probably SAD as well for him) and he's back on the medications and it's helped him tremendously. I'm thinking we'll probably have him on them for the rest of high school, and then see where he wants to go with it. When off the medications going through the bad periods, his frame of mind and situation is such that he just can't see the right choices to make to deal with situations. As our difficult child's psychiatrist always says, going on a medication doesn't mean it's a forever thing. If it's helped to the point you may be able to now deal without, then you make a change.
     
  19. Marguerite

    Marguerite Active Member

    I certainly do see a huge difference. However, you can get equally badly injured by either kind of rage. How you handle the child needs to be different. With the first kind, it is a huge worry because you have a kid who is actively trying to cause harm to others. With the second, it is impulse control and frustration driving it. You need to help them learn better ways to handle the frustration. It can take time, they often take longer than age-equivalent peers. So in the meantime, offer support and help in reducing frustrations.

    We've tried risperdal for both boys and stopped it. There did seem to be a "smoothing off" of mood which helped at school, but over time it just wasn't enough to justify the cost (for difficult child 3) and for difficult child 1, it sedated him too much plud made him gain weight. No other problems from risperdal, though.

    When both boys eventually were at home (no more mainstream school) a lot of the raging stopped (not having to deal with idiot school staff or school bullies who set the boys off). So given the expense and lack of WOW factor, we stopped the risperdal. difficult child 1 lost the extra weight; even difficult child 3, who hadn't seemed to gain much weight, lost some (which scared the psychiatrist a bit).

    I hope this helps.

    Marg
     
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