Thoughts/Advice for medication

Discussion in 'General Parenting' started by farfromperfect, Apr 18, 2011.

  1. farfromperfect

    farfromperfect New Member

    It's been a while since I've been back here. We are at our wit's end with our eight year old son's behavior. He is currently on 200 mg. Seroquel, 10 mg. Lexapro, 30 mg. Metadate. His raging outbursts are far worse than ever. We have spent nine months at this psychiatric clinic, and it seems like all she does is throw another medication at him to try. Hubby spent time researching Lexapro and found that the FDA hasn't even approved its use in children. The side effects are ones he is experiencing daily. At every checkup we give a full run-down on his outbursts and his suicidal thoughts, and she just "tries" another medication. Hubby and I have decided to wean him off the Lexapro. It can't get worse, can it? My poor, sweet boy, after having these horrible rages says, "I want my life back; I hate myself, and I don't want to live like this anymore." He is losing his friends, and it's been a long time since he's been happy.

    At this time the only diagnosis my son has is ADD. We will be seeing a new therapist, and then I guess we need to decide where to go from there. Any help/suggestions are appreciated.
     
  2. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Has your son been diagnosed by a neuropsychologist? If not, what are they medicating him for?

    in my opinion he is overmedicated. Unforuntaely again in my opinion some doctors throw a pill at every problem hoping to make it go away. Often that just makes things worse. Lexapro is an antidepressant which can and often does cause activation and mania in not only children but also adults (trust me, I've tried tons of medications myself). Metadate is speed. Theoretically it is supposed to slow down children who have ADHD, but sometimes ADHD is misdiagnosed and it is really something else and also sometimes ADHD kids respond to stimulants just like everyone else...as if it is speed. So you have two activating medications in your son's system. Why is he on Seroquel?

    If you see no improvement from the medications (in fact, if he is worse) he is obviously on a mix that is not working. I have learned a lot about medications along my path of life, since I have needed them and then they were tried on two of my children. I have learned to be leery and to ask questions and to research on my own. And I would, in retrospect, give no medications to any child who has not received a neuropsychologist evaluation first. And my limit for medications would be two, but not an antidepressant and stimulant at the same time.

    Again, this is all my opinion, but I think you should probably seek out somebody else to see if that doctor agrees with this one. And if it were me and my child was raging on these medications, I would want him off of both the Lexapro and the Metadate and I'd want to wait several months to see if he is better off of those two medications. See if the Seroquel helps on it's own. If not...you can assess that later. Since I am only a mom, who has seen a lot, this is just my opinion, but it sounds l ike the diagnostician and prescribing doctor is a quack. Which type of doctor is throwing all these medications at your son?
     
  3. JJJ

    JJJ Active Member

    That is not a medication combo for "just" ADD. Weaning medications should be done under a doctor's supervision as sometimes it gets worse before it gets better. I would tell the psychiatrist that you are not seeing any improvement on the medications and that you want to try and remove the Lexapro as you feel he has gotten worse since he started on it. If psychiatrist doesn't agree, I would find a new psychiatrist. If you can get to any of the bigger cities and a children's hospital, that may be your best option.
     
  4. farfromperfect

    farfromperfect New Member

    We have been going to a psychiatric clinic for the last nine months, at our therapist's suggestion. There has been no neuropsychologist evaluation. We were set to start testing, but I don't think it was going to be as extensive as a neuropsychologist evaluation. What is involved with that? The Metadate was prescribed by our pediatrician after trying Straterra for ADD/mood stabilizer (and it didn't work). She then switched to Metadate and Lexapro (which we just found out has NOT been approved by the FDA for use in children). When we began seeing the psychiatrist, she prescribed Risperdal (which didn't work) and now Seroquel. We suspect he has a conduct disorder, obviously, but nothing has been "diagnosed."

    We are in Nebraska....we have Children's Hospital in Omaha. Is that where I should start checking for a neuropsychologist evaluation?
     
  5. TeDo

    TeDo Guest

    Yes, I would start looking there for a neuropsychologist. I would definitely tell the psychiatrist that you INSIST that your difficult child be weaned off the Lexapro, and maybe the rest also. Because 2 of the medications were started at the same time, it will be hard to tell which one is causing the increase in behaviors. It is very possible for kids to have paradoxical reactions to medications. My son "got high" when we tried him on Adderall for his ADHD and Risperdal actually made him psychotic. Giving him Benadryl to help with sleep had him bouncing off the walls for 3 hours. Tread lightly with medications. Some psychiatrists (like the one we used to have) won't change anything until it is DEMANDED of them. YOU are the parent.

    Good luck.
     
  6. cassiemoun

    cassiemoun New Member

    that sounds so frustrating. I agree that it's time for a new p-doctor. After my son had a major reaction to an antidepressant this past week (Post on Zoloft on this forum), I know how bad the side effects from medications can be.
     
  7. rlsnights

    rlsnights New Member

    If that is the closest large city to you then yes Children's Omaha may have the services you need. It's tough in the extremely rural/low population states up there to find the pediatric specialists and you may have to travel to another state for really good comprehensive assessment if he has more subtle issues. But Children's Omaha certainly should be able to do medication management and behavioral support. Here's a link to the developmental pediatric clinic. I would start there but you will probably need a referral from your pediatrician or PCP to get an appointment.

    Depending on where you are in NE, Minneapolis/St. Paul or Denver or even Kansas City will be places you can get a comprehensive and high quality neuropsychologist assessment.

    Patricia
     
  8. smallworld

    smallworld Moderator

    Both Lexapro and Metadate can make kids more wound up and aggressive, particularly if there is an underlying mood disorder. That's why it's important that your son be evaluated by a neuropsychologist or at least get in with a competent child psychiatrist, not one who is just going to layer medication upon medication. I agree with asking the current doctor to carefully wean your son from his current medication cocktail so you can get a read on his baseline symptoms. It certainly can't be worse than what's going on now.

    For what it's worth, Conduct Disorder is not a helpful diagnosis (and very likely NOT what your son has). It is a description of behaviors for which there is an underlying cause. When the underlying cause is identified and treated, the behaviors typically improve. In your son's case, the medications could be contributing to a worsening of the conduct disorder.

    And in terms of FDA approval of medications for children, unfortunately many of our children take medications that are not FDA approved for them. That is because clinical trials are not typically conducted on children (it doesn't feel ethical to run clinical trial on kids). My own daughter has been taking Lexapro since age 11 with no ill effects, and it was not FDA approved for her at that time (in 2009 it was approved for children 12 and over). What you need to focus on is what effect the medication is having on your child. If it's a bad side effect, you need to convince the doctor to stop the medication and try something else -- not add something else to counteract the bad side effect.

    Hang in there and keep posting your questions. We're here for you.
     
  9. confuzzled

    confuzzled Member

    is the clinic aware that the pediatrician rx metadate and lexapro?

    and was your child on that combo during the risperadol trial? (if so, i wouldnt assume risperadol didnt work).

    if a child is mood disordered i'd be looking to either/or/both metadate or lexapro before i'd load up on more.

    if it were me, i'd march into the clinic with all medications, demand to wean off all of them, regardless of which dr rx'd them, and start fresh...and leave the psychiatric medications to the psychiatric clinic.

    its a very bad idea to have two prescribing doctors, no matter how well meaning one is.
     
  10. DazedandConfused

    DazedandConfused Active Member

    First off, I'm not a fan of Pediatricians prescribing medications for anything beyond routine childhood illness; it is beyond their scope of expertise. However, I do know that is how so many of us begin this road to help our children.

    I agree with the neuropsychologist testing. I had it done with Son when he was 10 and it was a grueling three days (done over several weeks). For him, and for me though, it left as many questions as it did answer. It's interpreting the results and how they are used to further gain insight into your difficult child that is key. Our current psychiatrist wants me to have another one done but I just can't afford the cost and insurance won't cover it. She is being careful and thorough before giving a diagnoses. We did luck out with finding her because she did a lot of research regarding the Autism Spectrum during her residency and she suspects that son is Pervasive Developmental Disorder (PDD) and I tend to agree with her.

    For me, getting a knowledgeable psychiatrist is key. Unfortunately, I don't have any worthwhile advice on how to get one. So much of it is trial and error. After our former psychiatrist of about a year passed away from Cancer, we were left adrift because all the other recommended psychiatrists were not taking any new patients. And, we had had two psychiatrists before where one required a 90 minute drive and the other mostly specialized in geriatrics, but helped out at a clinic (A nice guy who admitted that Son was more complicated than he had expertise. I appreciated his honesty.). Then, I just happened to call his former psychiatrist's clinic to see if they had gotten a new psychiatrist and they had and we were in!

    Anyway, I've blathered on. Medication. For me, if a medication does not provide a noticeable improvement in quality of Son's life, he doesn't take it.

    He has taken some where I saw no difference, some where he got meaner (oh boy, and I didn't need that!), and some that helped temporarily but then didn't. But, they did get him through quite a rough patch. He's now on two medications Risperdal (helped him for years), and a new one to help with his ADHD/Impulsiveness, Intuniv which has to be slowly titillated. With the Intuniv I saw the positive impact almost immediately. So, so far so good and as long as it continues without affecting his physical health, he stays on it.

    With your boy, I would be very concerned about what he is saying and the suicidal thoughts. Red flag that what he is taking is making things much worse! But weaning off medications is best supervised by a professional. This may not be the case with you, but diagnoses with some kids can be very elusive. It certainly is with my son. He's just never fit neatly into any diagnostic box.

    I would definitely begin with Omaha children's hospital and then go from there. Also, a teaching university with a children's hospital is another good source. That is how I found a neuropsychologist when I took son to a pediatric neurologist for a MRI to rule out any brain anomalies.

    It can be a long and bumpy road to help our kids, as you most certainly know. Keep pushing and seeking.
     
    Last edited: Apr 19, 2011
  11. farfromperfect

    farfromperfect New Member

    Thank you all for your advice and help. I made an appointment with the pediatric/behavioral specialist at Children's in Omaha. Unfortunately, her first opening is August 29. I've canceled all appointments at the psychiatric clinic we were seeing. Tomorrow, I will make an appointment with the first pediatrician we saw, so that we can start weaning him off his medications. I'm so glad this site is here; I've felt so alone and wondered what on earth I've done wrong to create this in my son. It's so nice to have people who understand to check in with. Thank you!
     
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