Daughter Had Horrible Rage Today - Abilify?

Discussion in 'General Parenting' started by FLRob, Oct 4, 2011.

  1. FLRob

    FLRob New Member

    I'm a father and am the custodial parent of my teen daughter (15). Since 6th grade I thought she had ADD and she has been on almost every medication for that over the years. She has always been defiant but it keeps getting worse. I'll try to summarize her problems over the past 2 years:

    She went through a cutting phase, drank and used drugs at 13, failed her first year of high school and skipped school repeatedly. About 6 months ago she stole a family member's car and in the process destroyed a mobility scooter that was on the back of the car. We took her to a psychiatrist and he diagnosed her with mood disorder (not calling it bipolar) and she was supposed to take a mood stabilizer and stay with her mom while she started that. She told the doctor that she would rather be dead than live with her mom and was immediately Baker Acted. She stayed in a secure facility for 3 days until they determined she wasn't a danger to herself. A month later she stole the car again, and destroyed the new scooter (it was slung off of its rack). She was sent to live with her mother but ran away from her house and it took law enforcement to find her. She ran away because she had a huge fight with her mother after her mother caught her duct taping her little sister's hands. My daughter claimed she did it to stop her sister from throwing things at her.

    In addition to all the stimulant medications and Intuniv she was given Straterra for ADD, which is an SSRI, and she became depressed and started cutting herself (at 14). At 15 she was given Zoloft. We found her walking down the road, in the freezing cold, barefoot and out of her mind in the middle of the night. She was given Celexa and became depressed. None of the psychiatrists except one thought she needed medications.

    I really don't think she has ADD. She started a private school this year and has been off of ADD medications and is making straight A's so far, but said she is only doing this so she can graduate early and get away from home, not because she has any interest in education. At least I know she can focus. Last week, because of her defiance and anger, she was placed on Abilify. She started at 2.5 mg for 2 days, then started 5 mg Monday. When I took her to school this morning she broke out into a full-on rage like I've never seen - not even close. I don't even know how to describe it. She was cursing like a sailor, just raging in the extreme, the whole time blaming me for making her lose it, because I was raging at her (I was actually very calm and tried to defuse her anger). This was triggered because I didn't have time to get her a coffee and suggested that she buy a cola at school. She was floored by the fact that I would suggest this and went from there. She was screaming "why would you suggest a coke instead of a coffee, why would you say that" and so on. It made no logical sense. She usually gets angry with small or nonexistent triggers, but this was a hundred times worse.

    Has anyone else ever had this happen with Abilify? She's refusing to take it any more and said that it made her "crazy". Her doctor said to keep her off of it for a week and if she doesn't rage any more then she will assume it was the Abilify. So what next? SSRI's are out, and the fact that she has lost her mind every time she tried one leads me to believe that she is bipolar, but all the psychiatrists except one who talked to her for 10 minutes, seem to think she just needs talk therapy. We tried that. She is extremely manipulative and conned her therapist easily. She can be likable when she wants something, but the rage today was far and above the worst behavior I've ever seen out of her and it was beyond her throwing a fit because she didn't get her way. It was like a full psychotic break. I just don't know what to do anymore and I am seriously losing any faith in the medical community. Who here has dealt with a teenager with this level of rage? Are any of the standard mood stabilizers, like depakote, worth trying or will that make her worse? The rest of my family is calm with no problems at all, but we all walk on egg shells around her and it is getting old. I feel like I have done all that I can do, and I hate to say it but I wish she would move in with her mother so I could regain my sanity.
  2. HaoZi

    HaoZi Guest

    That sounds pretty fast to be adjusting her dose upwards, but my daughter is younger and smaller and we took it a lot slower. It certainly sounds like a lot more than ADD to me, and I wouldn't rule out a reaction to Abilify, but I don't think that is her only problem. Has she ever been fully evaluated and tested? Any medication can cause a reaction because everyone is different, but I really think she needs much more thorough testing before they go tossing medications at her willy-nilly.
  3. compassion

    compassion Member

    Actually, abilify curbs those type of rages in my daughter. My experience is breakthrough mania. My daughter is on 30 mg. day of abilify and the rages do not occur.
  4. FLRob

    FLRob New Member

    I don't even know where to go again for testing. The very first psychiatrist who saw her met with her for two hours. After she was Baker Acted she was evaluated at a very well respected secure facility affiliated with one of the top teaching hospitals in the country, then I took her directly to the School of Medicine at that University where she had a lengthy evaluation by two psychiatrists, including one who was the head child psychiatrist. The problem is that she is very, very good at telling people what they want to hear. She never exhibits any unusual behavior in front of the dr.'s and it's almost as if they can't believe that she is capable of doing the things that she has done. She is very well spoken for her age and could be an actress if she put her mind to it. For example, she charmed both dr's at the University and they encouraged me to continue with therapy only - therapy that has gotten nowhere. That same night I took her to a trusted friend's house to spend the night and dropped her off. I found out the next day that she walked into the house, sat there for an hour and pretended she was going home. I got suspicious when I called her the next morning and she claimed she was going to church with the family. I activated GPS tracking on her phone and she was nowhere in the area. I tracked her to a bad section of town where she was supposedly staying with a girl she wasn't supposed to be around. While I was on the way she figured out that she was being tracked and turned the phone off. I had to send a text message threatening to get the cops to knock on every door in the neighborhood until we found her. She turned the phone on every few minutes to check her texts, saw the message and by the time I saw her she was walking down the street. I could never find the house she exited and never really found out who she was with. The point is that all of this happened after the extensive evaluation, the same day, by one of the best group of child psychiatrists in the south. The only one (besides one earlier psychiatrist) who actually thinks she needs medications is her pediatrician, and she is the one who started the Abilify. I could try to schedule another evaluation somewhere but I just feel like I am running in circles and that the only thing I'm getting from the dr's is an empty wallet.
  5. HaoZi

    HaoZi Guest

    I'm going to guess you need to find a neuropsychologist that's very familiar with kids that "honeymoon" well. I'm pretty certain there are several parents here that can explain that far better than I can. I'd almost say that instead of a teaching hospital, maybe call a juvenile justice facility and see if they'll recommend someone who will understand better.
  6. FLRob

    FLRob New Member

    How often did breakthrough mania occur? I was reading some about hypomania, which can involve rage. Maybe it triggered this, but if her past episodes have been examples of mania I'm confused as to why this episode was so extreme, easily twice as bad as anything I've witnessed before.
  7. HaoZi

    HaoZi Guest

    That does remind me, depression can show up as rage, too.
  8. FLRob

    FLRob New Member

    Thanks. I'll look into that tomorrow. The university town near me has every sort of dr. known to man so I should be able to find someone. I would be interested to hear from anyone on the board who has had experience with one.
  9. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I had a daughter who took drugs. You said she went through a "phase..." are you positively sure she isn't still drinking and using drugs because her behavior sounds like it. Have you ever given her a surprise drug test? Have you checked her room? Do you feel her friends are probably using drugs/drinking?
  10. keista

    keista New Member

    YES!!!!!!!!!!!! Well, not exactly, but close. I Baker Acted DD1 while she was on Abilify. She's 10. She had always had her moods and tantrums, and also strange episodes which were due to an SSRI, but she had never been seriously defiant, aggressive or made a serious suicide threat. (mild forms of these yes). Anyway she became all 3 after being on Abilify for about 2 1/2 months. Before that day, the Abilify seemed to agitate her. She was constantly in her "extreme boredom" state (a mixed state of agitation and depression).

    Considering how manipulative your daughter is, it's difficult to accept the fact that she may refuse medications, but in this case, I wouldn't argue with her at all. 1. You don't think this is good for her either, 2. If you force her to continue an obviously poor choice of medication, it will make it that much harder to get he to take something different that might really help.

    Is she still on ADD medications? If she doesn't have ADD those medications could cause some of this behavior (overall, not the recent episode). Haozi is correct that depression can manifest in rages, but she sounds WAY to manipulative to be depressed. I'm sure she has such episode, but it's certainly not the whole picture.

    Is there a specific reason why she hates staying with her Mom? How long have you been apart? 6th grade is puberty time. Is that when the behaviors started. or did you notice things earlier? The family dynamic is probably not the cause of all of this, but can certainly be a contributing factor. Puberty on the other hand, can be the trigger for some serious disorders.

    by the way Welcome to the board!:notalone:
  11. FLRob

    FLRob New Member

    Thanks for the welcome. We divorced when she was 3. She is off the ADD medications. Her mother was the custodial parent until she was 8, and then she decided she was going to move across the country with her boyfriend (now husband) and my daughter's half-sister. I took it to court and won to stop her from taking her. She chose not to stay and relinquished custody to me, which caused some fairly severe abandonment issues. Her mother returned a few years later and we split custody but her mother and her are oil and water, and at the same time their personalities are very similar. Most days she simply hates her mother. I tried to encourage their relationship, but since her mother's idea of child rearing involved spanking and yelling it didn't get far. She has chosen to see her once in 3 months. I'm sure that this had a lot to do with my daughter's problems, but the lying and manipulative traits have always been around.

    Anyway, my daughter came home from a friend's house tonight in a good mood. It was like this morning never happened. In response to the possibility of drugs posted above, I will test her again. The last time I tested her a few weeks ago I was convinced she was using but the test was clean. I have also gone through her room and found nothing. I think that if she has another freak out I will take her directly to a lab and get her tested for everything under the sun, just to rule that out. The irony is that I have a LOT of experience drug testing people in my profession and I work with drug addicts daily. I just don't see the typical signs of use. Generally, it is easy to hide drug use in the short term, but there are dozens of "tells" that give it away. I haven't seen any of that with her - no missing money or valuables, no changes in appetite or hygiene, weight fluctuation, excessive sleep, etc.
  12. keista

    keista New Member

    I wouldn't be surprised if she came up clean. First, bipolar all by it's lonesome has some very similar symptoms to drug use. And if this is the case, yay for both of you that she is not self medicating. Second, the kids are into so many things these days that won't show up on traditional drug screens. Inhalants including compressed air and whipped cream. Mega doses of cough syrup. And now you can get synthetic marijuana in virtually every privately owned convenience store (I have not seen it yet in the big chain stores). So many ways to "legally" get high.