What would you do?

Discussion in 'General Parenting' started by Alisonlg, Jul 22, 2007.

  1. Alisonlg

    Alisonlg New Member

    Well, we're still seeing a steady increase in anger, irritability, outbursts, etc. (in fact, his outbursts have gone from a rare occurance to several times a day now), so thank goodness our psychiatrist appointment is tomorrow.

    I'm guessing the psychiatrist is going to do a medication change- I can't imagine he'll see this increase in behaviors as a "let's leave things as they are and wait and see" kind of thing given M's history. But, here's my dilema...

    We leave for a family vacation out of state next Saturday...less than 1 week away.

    Would you do a medication change and risk any potential ill side effects/reactions happening during vacation...and out of state nonetheless? Would it depend on *what* changes were being made?
  2. Hound dog

    Hound dog Nana's are Beautiful

    I'd go with the medication change. It's pretty clear that M is needing it. The psychiatrist might not even change his medications, but just adjust them some by increasing doses.

    I understand your worry. But wherever you go there will be ER's. if M has a reaction, you can run him into the ER to be seen if necessary. Odds are their ER doctor would contact psychiatrist and the situation would be handled.

    You can let psychiatrist know you're going on vac soon, too. It might change how he decides to handle the medication issue. And he could offer advice on what you could do if M has a reaction or such while you're away.
  3. Sara PA

    Sara PA New Member

    Sounds like a typical reaction to Celexa. I'd begin gradually decreasing it and go on vacation. I would hope that the psychiatrist would only make one change at a time and that would be to decrease or eliminate the antidepressant. Adding another medication to control the psychiatric side effects of Celexa is worthless. It just doesn't work.

    Side effects to these drugs rarely require emergency room visits. A lot more things are likely to happen on vacation that would require a trip to the emergency room.
  4. Alisonlg

    Alisonlg New Member

    Ah...see just decreasing and eliminating the Celexa and going on vacation itself is enough cause for worry...because prior to adding the Celexa, we were experiencing daily rages that lasted several hours that landed us in the psychiatric hospital for the 3rd time.

    I'm not sure we'll survive vacation on just Seroquel and Tenex.

    Ok...I'm going to pack my Rx for Ativan! LOL I've never opened the bottle, but I just may need to!
  5. Steely

    Steely Active Member

    My guess would be that psychiatrist would add another medication.........just guessing, but it seems like he might try a mood stabilizer.......in any scenario I would do what the psychiatrist suggests, but also ask him for a PRN in case M gets out of control.

    I know M has a lot of anxiety, and recently my son's anxiety has been through the roof as well. Our psychiatrist XR'd him Klonipin as a PRN in addition to the Paxil we just started - and the rages are almost obsolete as of late. It is like night and day. He is old enough, and so is your M probably, to feel the anxiety coming on, and ask for the Klonipin, thus eliminating the meltdowns.

    Try and have fun on your vacation, and definitely take the Ativan for you!!!!! :crazy2: You might need it!

    I will be thinking of ya.
  6. oceans

    oceans New Member

    I would ask him for a plan, so that if any change makes things worse, you know what to do next. If things are getting worse now,I would not want to go on vacation that way...
  7. smallworld

    smallworld Moderator

    First, I don't think you can make the assumption that it's the Celexa causing the problems, particularly if some of the medications were started at the same time. Tenex, for example, can cause irritability. The psychiatrist should be in the best position to judge what about the medication mix is not working.

    Second, I personally would not recommend a major medication change during a vacation. When we weaned A from an antidepressant, she suffered from withdrawal illness that was so severe she was lying on the couch for two weeks. It would have been terrible to have been on vacation with her at that time. We typically make medication changes only at home when we have access to our psychiatrist if necessary. You should definitely let the psychiatrist know of your vacation plans and let him weigh in on when any medication changes should take place.

    Not an easy situation to be in. Good luck.
  8. Alisonlg

    Alisonlg New Member

    Thanks EVERYONE!

    Ugh...this is just such terrible timing. On one hand I'm scared to death of what a medication change would mean for our vacation and on the other hand, I'm scared to death of how M will act if we leave things be!

    I'm going to need to make notes for the psychiatrist appointment tomorrow...that man makes me so frazzled I'm bound to forget to ask questions about whatever decisions he makes and to ask for a clear cut plan of action. And, for the first time, I have to drag the 3 1/2 yr old along to boot! Ack! (I might need the Ativan tomorrow! LOL)
  9. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    From my experience with antidepressants, this is pretty normal behavior for younger kids taking them--My layperson's guess is that the Celexa is causing the escalating behavior. Both my daughter and son have taken antidepressants with similiar results. My daughter was a teenager and flat out refused her Celexa after about a month saying it made her "jittery" and she's NOT a nervous kid. Prozac made her flip out and it's related to Celexa. Prozac also made my son flip out. I've taken almost all the SSRIs and they are hit or miss, period. They are as apt to cause worse agitation as they are to help. My advice from my own experience is that the more the medications build up in the system, the more agitated a person will get by adding fuel to the fire. If it were my child, I'd start withdrawing (and do it slowly. SSRI withdrawal is often worse than the side effects). If you're going on vacation, the last thing you need is an escalating child. in my opinion I'd slowly withdraw from the Celexa before I'd let a doctor add a medication (yes, YOU have the choice). I'd want to see if the Celexa was causing the child to act out that way before throwing in another heavy medication. I've learned from experience that the psychiatrists make suggestions, but I have the right to make the final decisions. I didn't always make good ones, but neither did the doctors. I've learned to trust my gut. I don't know if this was helpful or not, but I'm just passing along both my layman's opinion and my real life experiences. The medications Game is very tricky and a lot of times I get the feeling the doctors are picking a medication out of a hat and saying, "Ummmmmmm, we'll try THIS." It doesn't make me feel very comfortable. I've had to do my own research on medications so that I could have halfway coherant discussions about them with psychiatrists both for my kids and myself. For me, a combination of Paxil/Klonopin has worked for years and I don't know why. Paxil causes a lot of people to "lose it" but it calms me down. I wouldn't give Paxil to either of my kids. Klonopin was added because I had such bad panic attacks that I couldn't leave the house. It really helps, but it sedates me (even after all these years) so I only take it at night (1 mg.) Also, it is habit forming, and a cousin to Valium and that would be my last choice for a child. It's another tough withdrawal unless you are certain your child will need it for life. Adults who have withdrawn from both SSRIs and benzos have told me it ain't pretty. I never plan on quitting my medications--they made my life normal. Anyways, enough rambling. Good luck.
  10. Alisonlg

    Alisonlg New Member

    Thanks, MWM, for your input!

    I totally understand the idea of weaning off of the Celexa (yes, smallworld, I hear you out there saying "don't assume it's the Celexa...it could be the Tenex!" LOL I'm just responding to the thread that MWM assumes it might be the Celexa ) Anyway...I get and agree with slowly weaning of the Celexa to see the difference...my fear/problem/worry is that M was WORSE off of the Celexa. We actually saw improvement with the addition of the Celexa and in the begining we had our "honeymoon" phase of elimination of rages, an increased threshold for irritations, and increased compliance. With Celexa out of his system, I'm afraid we'll return to 2-6 hour long rages, school refusal, constant irritability (well, we're practically there now), etc...basically, I'm afraid we'll end up back in the psychiatric hospital.

    Ok...I'm rambling...psychiatrist appointment is coming up at 4 pm. Wish me luck!
  11. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    It's normal for kids who will be sensitive to antidepressants (and adults too--myself being one) for the antidepressant to kick in unusually early, but then, as the medication builds up, it can put the person over-the-top. I don't know what to tell you about withdrawal, as it isn't much fun (that's an understatement). in my opinion there are better medications for rages than antidepressants in many cases, such as mood stabilizers. My son's psychiatrist wasn't a big Tenex fan and didn't prescribe it, but did not say it causes agitation--just said it is not that effective (his words, not mine, I know nothing about Tenex). I do know first hand what antidepressants can do, and, with what I've experienced, I'd never want to put an angry kid of an ad--at least not before trying a mood stabilizer. Heck, as an ADULT I couldn't control antidepressant hyperness. It can get pretty extreme. That doesn't mean it WILL, but it seems your child is already experiencing some of that. Was your child on something else before that could have triggered 2-6 hour rages? Them's LONG rages!
  12. Alisonlg

    Alisonlg New Member

    Nope...the 2-6 hr rages were unmedicated. They started as 45 minute average rages as a toddler and gradually escallated in length as he got older. But, really peaked this year (thus the 3 psychiatric hospital stays) in length and frequency, again, all unmedicated. So, the rages are part of whatever he has going on, they're not medication triggered.

    Celexa has kept the "rages" at bay, but I imagine with the rate we're going, full blown rages are not far off at all. We've had long, drawn-out outbursts, rants, etc. and instances of him screaming, throwing things, smashing things, flipping out, but with the degree his rages hit, I wouldn't throw these episodes into the "rage" category. But, obviously this behavior is not acceptable and not livable.
  13. busywend

    busywend Well-Known Member Staff Member

    How long has he been on the Celexa?
  14. Alisonlg

    Alisonlg New Member

    He's been on the Celexa approx. 7 1/2-8 1/2 weeks.
  15. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Has he ever tried a mood stabilizer? The mood stabilizers are Depakote, Lithium, Tegretal, Tripletal and Lamictal. They need eight weeks to kick in and need to be at a therapeutic level, but they can do wonders with raging and out-of-control behavior. Does psychiatrist say why he doesn't want to try this?
  16. Alisonlg

    Alisonlg New Member

    psychiatrist wanted to try a mood stabalizer 2 visits ago, but to avoid blood draws he picked Topamax starting at 25 mg and at the time M was raging so intensely in his office that I really was not in a place to dispute his decision or ask about his personal success rates with Topamax as an effective mood stabalizer. This was the visit that by the time we reached the parking lot, I had to call 911 for a medication transport to the hospital and M was admitted for the 3rd time, so we never ended up starting it and the psychiatric hospital psychiatrist started the Celexa.

    My guess (purely a guess) is that psychiatrist my want to try a mood stabalizer now since that's what he wanted to do before the psychiatric hospital psychiatrist changed direction to the SSRI. We'll see.

    AGH. Will 4 pm just hurry up and come already?