5 year old about to be medicated, I think

[hayden0430]

Hi. I am new to this message board. Thank you for the forum.
I have a 5 year-old son with a lot of issues. He hits and kicks and throws things and does not follow directions. He has been kicked out of the YMCA day care, Gymboree, caught off from friends and already been sent to the Principal's office in his second week of Pre-K. I sit at work every day my stomach in knots waiting for the call from the school saying I need to pick him up because he kicked a teacher again or another student or threw blocks at people. He took Depakote about a year ago but it didn't seem to help. He has no formal diagnosis. I have been told he is bipolar and I have been told it is anxiety/depression. He did try Zoloft for a week but literally was climbing the walls (seriously, literally). He has an appointment with a psychiatrist tonight. This is the same one that tried the Zoloft. He has recommended Prozac. I'm sure everyone has heard the horror stories about young people and Prozac. It just doesn't sound right to me. There is a history of depression, ADD and bipolar in my family (I am bipolar). That seems to make the most sense to me but then again, it is hard to diagnose a 5 year-old.
I spend most of my time exhausted, frustrated and trying not to cry.
Has anyone had any experince with this age and medication? No one seems to think he's ADD because he can focus but yet he acts just like my nephew at that age who is now ADD and bipolar.
I have tried behavioral modificationa and he says a play therapist. Everyone always tried to give me advice and it's hard to explain to them (or embarrassing) that he is not a "normal" child and the Love & Locig and spirited child stuff does not work on him. In fact, they seem to make him act worse as he responds against them and me. He saves most of his real bad stuff for me. I know intellectually it's not personal but it sure feels that way. He is nowhere near this bad with my husband. His Dad is gone a lot though so I think he does his best to be good when he's around. He seems to be physically incapable of controlling himself sometimes. He has a lot of imaginary friends and likes to blame them or say they told him to do it (we don't think he hears voices). He goes from frustration to action in a second so there is no time to think about his action because he just responds. He is moody beyond belief and it is hard to tell when he'll switch moods (hence my feeling of it being bipolar). Sometimes he can be okay most of the day and then they'll will be a day or period of time when it's non-stop.
I love my son, I do, but I can't stand to be with him.

 

[Alisonlg]

Welcome to the board! I'm sorry for your reason to find us, but glad you did.

You're so right when you say it's hard to diagnose a 5 yr old. I have an 8 yr old and I'm running into the same problem. We don't know what our M has, so the Dr's are trying to treat the symptoms they think they see and we're hoping they've got it right. Unfortunately the symptoms look like so many different things and nobody wants to say a young child is bipolar (and of course you always want the answer to be something simpler too).

I'm sure the others will be along with more advice, as they're more "seasoned" than I am. I just wanted to offer you a welcome and some understanding ::::::.

 

[hayden0430]

1

 

[hayden0430]

Thanks Alison. Almost made me cry (again) and since I'm sitting at work in front of a room full of people, wouldn't be too fun.
It's so nice to know there are others out there. Not suffering too, of course, but so open and willing to help someone else.

 

[Big Bad Kitty]

Welcome to the board, Hayden. I also just wanted to pop in and offer my support.

You are certainly not alone. You have truly found a soft place to land. Stick with us, we'll get through it together.

Hugs and prayers.

 

[busywend]

Welcome!

Who are you presently working with to get a formal diagnosis? I see he works with a play therapist - what does he/she think?

Has he seen a neuropsychologist? That is where I finally got the diagnosis I was comfortabl with.

 

[Steely]

Welcome......

You will find lots of people here that are in the same boat as you are.

When my son was 5 I had to medicate him for the same reasons you described! I ran into SO many doctors trying to give him Prozac and Rhitalin - both of which made his symptoms ten times worse. I now know that stimulants and SSRIs can make kiddos like ours worse - and if you have had a bad experience on Zoloft you know what I mean. I would tell the Dr that you are not interested in trying anymore SSRIs - you have the right as a parent to do that. Although Depakote did not work, there are many more mood stabilizers out there the dr could try if he felt that was appropriate - not to mention other anti-depressants that are not SSRIs.

I am so sorry you are going through all of this - I remember how hard it was when Mat was that age - it broke my heart. I still get the knots in my stomach when I drive by his old elementary school.

Hang in there!!!!!!!!!!!!! :warrior:

 

[JJJ]

Hi Hayden,

My youngest son was diagnosis bipolar at 5 and put on Depakote. Did your doctor make sure that the Depakote was at a high enough therapuetic level? The recommended level for bipolar is higher than for epilepsy. If it was and still didn't work, than there are many other mood stabilizers out there...

Welcome,

 

[smallworld]

Welcome! I'm glad you found us.

Before saying what medications you will or won't accept, I strongly recommend a thorough evaluation with a developmental pediatrician or a neuropsychologist, or a multidisciplinary evaluation through a children's or university teaching hospital. Honestly, it is pointless to guess what medications will or will not work without having a better idea of what you're treating. Many childhood disorders can resemble one another, and the treatment is different depending on the disorder.

I also want to make the point that just because your son had a bad reaction to Zoloft does not necessarily mean he will have a bad reaction to Prozac. I recently had an opportunity to talk with a child psychiatrist who researches childhood anxiety and bipolar disorder at NIMH in Bethesda, MD. I specifically asked him about SSRI (the class of medication both Zoloft and Prozac are in) reactions, of which he said there are 3 types: First, the child becomes impulsive within days of starting the medication. This reaction is related to medication/dose and stops when the medication is discontinued. Second, the child experiences hallucinations or delusions within days of starting the medication. This reaction is also related to medication/dose and stops when the medication is discontinued. Third, the child becomes manic within 3 weeks to 3 months of starting the medication, and the reaction does not stop when the medication is discontinued. In this last case, this psychiatrist treats the child with mood stabilizers as if he has bipolar disorder.

by the way, my 8-year-old daughter takes Prozac for anxiety, and she's doing great.

 

[TrishaBC]

Finding the right medications is always draining, but well worth it once your on the right track. I know exactly how you feel waiting at work for those phone calls. I don't have any advice just hugs and support :smile:

 

[Shari]

I'm not here as much as I was, but I also have a 5 year old. He's been on medications for 18months or so now, and it was not a decision made lightly. I was never going to medicate my child. HA.

Risperdal has been our saving grace and was recently approved for aggression with autism disorders. The first time we tried it was a disaster. The second was mediocre, and the third was an absolute miracle. He has developed a tolerance to it, but he's still on it. The results aren't as black and white as that third try 18 months ago, but its still an improvement. I'm no doctor, but its worth an ask. Be sure to understand side effects of everything, tho.

Welcome to the board. Sorry you had to find us, but welcome to the group!

 

[Wiped Out]

Welcome! I'm glad you found us. You will find much support here. I hope the appointment. went well. I think seeing a neuropsychologist is a good idea too. Again, welcome-you are not alone.

 

[nvts]

We went nuts in the same way! difficult child 1 and 2 really went through the ringer for years. Only 1 is on Concerta XR, but we are considering some changes in the medication field.

Not to sound stupid, but we didn't even know that "neurophyche" doctors existed until it was suggested a couple of weeks ago. Now we're on line for that!

Read "The Explosive Child" that ended up as a sort of bible to many. It gives you insight as to what's going through the difficult child's brain and how to work with it.

Don't move on with the medications or anything else until you're comfortable. We accepted too many people as the "professionals" and quite possibly did more harm than good!

Good Luch! :smile:

 

[hayden0430]

Hi all.

Thank you so much for your kind words, thoughts, ideas and advice. It feels amazing to know there are people out there who understand and care. This is the stuff you really don't want to discuss with certain friends or coworkers or even my husband sometimes.
I took my son to see a child psychiatric Tuesday night. He is considered one of the best child psychs in our city. Our play therapist works with him a lot and has full trust in him (nice to know). We decided to go with Focalin. It's a new ADD drug. Supposedly it is Ritalin without the side effects. I actually suggested an ADD drug. Prozac still had me frightened. [ I appreciate your thoughts on that smallworld.] My psychiatric told me all the side effects of the mood stabilizers and anti-psychotics, many of which are long term, not just usual ones like dizziness and nausea. We decided to start conservatively. Maybe his impulsivity is part ADD. If this drug works, great. If not, then we try again. He did mention Lamictal which I also take and love. It has few side effects and no long term ones. My son has taken the Focalin 3 days now. It has seemed to help. He has had some trouble but more typical for his age than his usual outbursts, tantrums, and hittings. He did however start to talk to me tonight around 4 and didn't shut up until after 7 (he's always been a big talker but this was motoring). From 5-7 he worked on a very tedious craft project I had bought him. Very impressive. But he sounded like me when I am manic, talking non-stop. He sounded "high" so I don't know if the stimulant is giving him a rush. He has taken much longer to go to sleep and he takes Clonidine at night (has for over a year. Doesn't seem to curb the agression but it's the only way he'll sleep). The doctor said I could double his dose so from 5mg to 10mg. I may try that and see if he calms a little more or flies more. It's so hard now to tell if it's the drug helping or if he's been having good days. Those are the things that made us think bipolar from the start. And family history.

Also, I'm so used to problems that when he's being a "normal" kid, I still get frustrated so quickly because I'm so used to constant problems that I can no longer recognize what might just be typical kid stuff. Anyone else do this?

I have to go put the ragamuffin back to bed. I'll keep everyone posted on any medication changes and again, thank you.
You are all cherry lifesavers.

 

[Sara PA]

I suspect his dose of Clondine is .1mg, not 10 mg. Tenex, the other antihypertensive given to children for ADHD, was shown in a study to cause aggression in children with bipolar family history. Some here have reported the same reaction to Clonodine.

That motor mouth around 4 PM might be stimulant rebound. They noticed back in the 60's and 70's when these drugs were used as diet pills that a lot of people got ravenously hungry when the drug wore off. And many parents see increased hunger and/or energy/aggressiveness when stims wear off. You might be hearing stimulant rebound.

 

[pepperidge]

You have been given some great advice.

I would strongly suggest you read the book the Bipolar Child particularly the chapter about medications. It has a lot of great information.

Given your family history, I would hope that you ahve a psychiatrist who is sympathethic to the notion that your child may have bipolar. And while I think neuropsychologist testing is great--particularly if you have any issues with school and learning--given what you have described re family history and such I would be looking more to the psychiatrist angle at this point. Given family history I would definitely want a board certified child psychiatrist. neuropsychologist testing might well come later.

While my very moody child has been helped by stimulants, he realled has responded well to mood stablizers + Risperdal. Not to say at all that is what your chid should have, but I again would push your psychiatrist on the mood stabilizer question. I think what many of us have found here is we have needed to trial a number of medications before getting a combination that helps so don't give up. Make sure you get up to a therapeutic level before you give up unless there are bad side effects.

If you don't like what Focalin does, tell your psychiatrist immediately. My second son did a bit better on it than on Ritalin, but in about five days it was obvious that it was only exacerbating his whininess and tendency to fall apart over everything.

 

[guest3]

Welcome

Have you considered going through neurologist as well? MRI/EEG? My difficult child II's MRI came back normal, We're still fighting for the EEG.

You've found a great "safe' place, welcome again.

 

[smallworld]

EKG is a test that measures heart function. EEG is a test that measures brain waves.

 

[1905]

No medicine!!!!! I work with 5 yr old autistic kids, and this sound like a student of ours. Does he have a pecs book? Does he work for things? after each activity? Does he have breaks when needed, having full access to the braek card? Doe his teacher give tons of praise and free time between activities? Is he working on things that are/ or will be meaningful to him? Is he conctantly earning tokens for his rewards? He needs to be in aspecial class where this happens. Please be an advocate, things can go wrong so badly.-Alyssa

 

[hayden0430]

I am trying so hard to be an advocate. As everyone knows, raising a difficult (or any) child is exhausting so it is so hard to try to keep up with reading, new therapies, etc. I tend to feel so bad for the people that have to "put up" with my son that I am probably not as demanding as I should be.
I certainly do not think he's autistic. I have found very little in his behavior that would suggest that and neither have any professionals. His language skills developed very early on and his social skills are fine. He is very well liked and his main problems with friends is that he hurts them. This seems to come entirely from his impulsivity and not from a driving need to hurt or because he doesn't know better. He will tell you himself that he doesn't know why he does what he does. He gets angry and responds immediately. Think of the worst day you've head and you want to go home and throw something. Well, he does that after the first worst incident.
We haven't given him the Focalin this weekend. He was a little spastic yesterday but bearable. I think the body needs a break from these types of drugs since I read they can curb growth.
The doctor did say he could still take his Clonidine (actually .05 dosing) along with the Focalin but I have read many things that warn against it. Anyone know anything about this?
I may still end up going with a mood stabilizer. Focalin has helped some but we'll see. Maybe I will double the dose. The doctor said I could try that if there were still some problems. Compared to bipolar, ADD seems so much simpler. I'm sure ADD parents would disagree!