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13 year old in psychiatric ward for first time
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<blockquote data-quote="seriously" data-source="post: 467017" data-attributes="member: 11920"><p>None of you needed that. I am so sorry.</p><p></p><p>But I am very sensitive to the atypicals as well - 40 mg Geodon gave me the kinds of reactions most people on it don't get until they've been at the max dose for a long time.</p><p></p><p>I am wondering if he needs to be in the psychiatric hospital for medication changes at this point. But only if your new psychiatrist is sure he will get good care from the inpatient docs or if he clearly a danger to self/others. Did you call the on-call doctor if there is one?</p><p></p><p>Do you know what the dose was on the Abilify? Not that he should stay on that, but if the doctor really thinks another atypical might be good then the dose he started Abilify with could be a guide on how much NOT to give him.</p><p></p><p>If the new medication comes in liquid form, then you might ask about doing that if it would allow you to start with the smallest possible dose - probably a fraction of the typical lowest starting dose.</p><p></p><p>The atypicals have looked very good in most of the clinical trials dealing with many different mental illness presentations including early onset bipolar.</p><p></p><p>I'm not sure if you already understand this but this is going to be an extended trial-and-error process with the medications. There will be times when he will have to wash out of one medication before starting another, when different formulations of a drug will be tried, when trial of up to a month is needed to see if milder side effects like nausea go away on their own.</p><p> </p><p>My experiences have led me to have some "rules" about this process:</p><p></p><p>1. I never let a doctor start me or my kid on an extended release form of a medication. OMG horrible side effects for an extended period of time???</p><p></p><p>2. I generally insist on starting at the lowest possible dose - or even half of that if I can divide the smallest pill. And we titrate him/me up very slowly, perhaps at twice the normal schedule for increasing doses.</p><p></p><p>3. Unless it's an emergency, we don't start a new medication in the middle of the week. I usually start a new medication on Fridays so if I have big problems I won't be alone to drive and care for our kids. If your husband is at work all day then you may want to do the same with your difficult child so if he has a bad reaction there are two of you there to handle it. The drawback to this is that there is no psychiatrist on call over the weekend so I will have to use my best judgment (with or without input from the pharmacist) if I have big problems.</p><p></p><p>4. I use the same pharmacy for all our medications if possible and I will change pharmacies in a flash if I think the head pharmacist isn't a really good one. I pick up prescriptions when I am pretty sure I will be able to see the head pharmacist for a consult if I need one.</p><p></p><p>5. I make sure everyone - primary care doctor, pharmacy, psychiatrist, school, etc. - has an updated list of medications, doses, and allergies (including "sensitivities") as soon as possible. Our pharmacy has caught more than one interaction that needed to be double checked before the drugs were taken together or when it was on someone's allergy list. But they rely on you to report sensitivities to them.</p></blockquote><p></p>
[QUOTE="seriously, post: 467017, member: 11920"] None of you needed that. I am so sorry. But I am very sensitive to the atypicals as well - 40 mg Geodon gave me the kinds of reactions most people on it don't get until they've been at the max dose for a long time. I am wondering if he needs to be in the psychiatric hospital for medication changes at this point. But only if your new psychiatrist is sure he will get good care from the inpatient docs or if he clearly a danger to self/others. Did you call the on-call doctor if there is one? Do you know what the dose was on the Abilify? Not that he should stay on that, but if the doctor really thinks another atypical might be good then the dose he started Abilify with could be a guide on how much NOT to give him. If the new medication comes in liquid form, then you might ask about doing that if it would allow you to start with the smallest possible dose - probably a fraction of the typical lowest starting dose. The atypicals have looked very good in most of the clinical trials dealing with many different mental illness presentations including early onset bipolar. I'm not sure if you already understand this but this is going to be an extended trial-and-error process with the medications. There will be times when he will have to wash out of one medication before starting another, when different formulations of a drug will be tried, when trial of up to a month is needed to see if milder side effects like nausea go away on their own. My experiences have led me to have some "rules" about this process: 1. I never let a doctor start me or my kid on an extended release form of a medication. OMG horrible side effects for an extended period of time??? 2. I generally insist on starting at the lowest possible dose - or even half of that if I can divide the smallest pill. And we titrate him/me up very slowly, perhaps at twice the normal schedule for increasing doses. 3. Unless it's an emergency, we don't start a new medication in the middle of the week. I usually start a new medication on Fridays so if I have big problems I won't be alone to drive and care for our kids. If your husband is at work all day then you may want to do the same with your difficult child so if he has a bad reaction there are two of you there to handle it. The drawback to this is that there is no psychiatrist on call over the weekend so I will have to use my best judgment (with or without input from the pharmacist) if I have big problems. 4. I use the same pharmacy for all our medications if possible and I will change pharmacies in a flash if I think the head pharmacist isn't a really good one. I pick up prescriptions when I am pretty sure I will be able to see the head pharmacist for a consult if I need one. 5. I make sure everyone - primary care doctor, pharmacy, psychiatrist, school, etc. - has an updated list of medications, doses, and allergies (including "sensitivities") as soon as possible. Our pharmacy has caught more than one interaction that needed to be double checked before the drugs were taken together or when it was on someone's allergy list. But they rely on you to report sensitivities to them. [/QUOTE]
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