Treatment Team mtg today and more

[butterflydreams]

Well, today was my much awaited treatment team meeting at the outpatient program my difficult child has been in since the beginning of last week. I have been waiting impatiently for this weekly meeting since last weeks meeting I had a bombshell dropped on me. Anyway, there are still some things they want to try with him before they resort to putting him inpatient again. I expressed to them my concerns about his Prozac and the possibility of something else going on that we are not catching. They do agree with me regarding the concern for the fact that he is so obsessed with violence and death.

I then shared with them the rage he went through last night, all because his sister turned on his light. Last night the van dropped him home about 6:15pm. He didn't say anything to me except his paper - a daily report he is supposed to bring home and hasn't been - was on the table. Around 7pm all hell breaks loose upstairs with him screaming at his sister to get out of his life, go jump off a cliff and that she needs to just die. He then stormed downstairs and went to go outside. I told him he wasn't going outside, it was dark and he had no business going out there. He yelled at me to leave him alone and he then slammed the door - but didn't go outside. Thats good, I guess. Anyway, he then proceeded to kick the coffee table and ask if there was a glass that we didn't need anymore. I asked what for - he said to break, that he needed to break something or hit something. I told him to take a deep breath - he said that doesn't work he is too mad. He proceeded to pound on the couch cushions. This went on for about 30 minutes or so and then stopped and was like nothing ever happened. He just all of the sudden said I'm hungry whats for dinner. I tried to ask him what was bothering him - all he would say was he had a bad day and didn't want to talk about it. I told all of this to the counselors today.

I am just tired. I know difficult child is a good kid, and can be such a joy, but the rollercoaster ride is tiring. I am waiting to hear now because his prescriptions are done and there is no refills so they were going to discuss with the doctor (oh - I forgot to mention he wasn't there - he was out of town) and have him take care of it. I requested that I be notified after the doctor is back in tomorrow and has a chance to meet with my son.

Well, I could go on and on, but I need to get back to work.

 

[smallworld]

What specifically is the treatment team going to do before your son is put back inpatient?

What are the doses of the medications he's taking?

FWIW, I have two children who raged on Prozac. We discontinued it PDQ.

When he feels like breaking something, you might want to offer something acceptable. We have used hard-boiled eggs smashed on the driveway (less messy than raw eggs). Another poster allows her raging kids to rip up old paperback books that are no longer needed.

 

[butterflydreams]

What specifically is the treatment team going to do before your son is put back inpatient?

I believe the term they used was Psychotherapy. But basically they said that they wanted to try everything they can to not put him in. Now keep in mind, they doctor wasn't there today, it was just the lead counselor and one of the nurses. The doctor will be back in tomorrow.

What are the doses of the medications he's taking?

40mg Prozac in a.m.
25mg Seroquel in a.m.
200mg Wellbutrin in a.m. (just started last week)
50mg Seroquel in p.m.

FWIW, I have two children who raged on Prozac. We discontinued it PDQ.

I expressed my concern that Prozac could be the problem, that it possibly could be causing adverse affects now. They said that is a possibility and would speak to the doctor about it. They did however say that they would think that his rages would last longer and he wouldn't have just stopped them so quickly as he did last night.

When he feels like breaking something, you might want to offer something acceptable. We have used hard-boiled eggs smashed on the driveway (less messy than raw eggs). Another poster allows her raging kids to rip up old paperback books that are no longer needed.

I didn't think about offering alternatives. I honestly thought that if I enabled him to break something that I would be encouraging his behavior. I will have to be creative next time and find something for him to take it out on.

I am a single parent and doing this all by myself and very frustrated. I know my daughter is tired of it as well. She has expressed more than once that she can't wait to be old enough to move out. I know too, she gets tired of his problems being the focus of everything and taking over our lives. I try to spend some time just with her, but it is not always possible unless he is going through a good period - otherwise we are all basically grounded at home.

I keep telling myself that this is a process and there are no magic buttons or cures and that it will take time. I must learn more patience!

 

[smallworld]

Your son is on a whopping dose of Prozac. In fact, 80 mg is generally the maximum given to ADULTS with depression. In addition, it's usually dosed once a day. I'm wondering why the docs split the dose.

 

[butterflydreams]

The Prozac is only once a day, in the morning. I have heard that it is a whopping dose. He was on 20mg to begin with in September and then titrated in October or November to 40mg. Doctor told me then that it was the max dose.

That is my concern as well. His Seroquel is in the split dose. I don't know the exact reason why the Seroquel was split to begin with, he started it as a inpatient, but I do know that they said it would help him sleep. It did at first - now it doesn't.

I really wish the doctor had been there today. I can't wait for him to be there tomorrow. I will be calling there tomorrow and hoping that I can get through. I want to know what he has to say about the medications. It's hard when I haven't been able to talk directly to the doctor for the last few weeks.

 

[smallworld]

I'm sorry -- I could have sworn you had written 50 mg Prozac in the evening. I must have read it wrong. So I thought he was on 90 mg Prozac.

Seroquel is frequently dosed twice or three times a day (although my own son takes 800 mg at night only). Seroquel's effect can wear off over time so it does need to be increased sometimes. Is he just taking it for sleep, or for aggression, anxiety, depression or mania?

 

[susiestar]

He is on a fairly high dose for a child. My daughter started at 10 mgs. then she was high as a KITE and we stopped it. Same for either zoloft or paxil, I forget which one. No SSRI's for her.

Has your son ever been tested for seizures? The sudden stop makes me wonder. Is it possible to get him into a pediatric neurologist? If he is having seizures his medications may have an effect on them. Seizures can cause MANY behaviors, not just the grand mal behavior. My daughter just isn't there, "nobody home" type thing. Hers are very short but caused a lot of problems.

It is a hard ride for moms, and for siblings. If at all possible, get your daughter to a therapist who can help her deal with her feelings about her bro's behavior.

hugs,

Susie

 

[butterflydreams]

Thank you all. My son is taking the Seroquel anxiety, depression and the increased dose at night for sleep.

I never thought of any kind of seizure - I guess there are different kinds. I just always thought seizures were where they flail around and their eyes roll back. I will definitely talk to his doctor.

My daughter is seeing a therapist - so am I. We all started out there last spring when things started to really get out of control and I knew that something was going on more than just regular disobedience. My daughter emails her therapist as well sometimes several times a week - she has helped her alot with regards to regular teen issues too - you know school drama etc.

You know I am finding myself looking back over my son's life since he was a baby and reviewing different behaviors and actions on his part and wondering to myself if there was something going on then and that his dad's death just aggravated it. I just don't know.