Day 15 on Intuniv - HELP PLEASE

[TiredSoul]

Today is day 15 on 1 mg Intuniv. Tomorrow we are supposed to go to 2 mg. Tonight difficult child is so completely out of control. He is belligerent, combative, quarrelsome, antagonistic, contentious!!! He is annoying everyone! He is in all of our faces. He is acting like a crazed maniac. Looking back these past 15 days, he has been in a fight at school which resulted in him being sent home, he has been in a fight with a neighborhood kid (who he kind of always butts heads with), and today after school he was beating up his good friend. He lies so much I don't know what I can believe. Today's incident there happened to be another kid witness and he and the kid my son was beating up both told me the same story. My son tells me he didn't do that and that he was the one getting beat up.

It was supposed to be a good day. My husband was able to get off work early so we could go to difficult child's school for an assembly. difficult child was being presented an award for doing good work in class. He got to go home early. I guess that threw off the routine or something.

One thing that happens that sets my son off with his friends, is when he is playing with one of them and another comes along and wants to take that friend away. It happens all the time. You would think they are girls! I think I have figured out that whenever this happens he gets aggressive and starts in on the friend he doesn't want to leave. Does he really think beating his friend up is going to make him want to stay? Come on. It used to be that he would just corner the friend if they wanted to leave and he would tell them they can't leave. Majorly trying to control them. So here's what I think.... when he doesn't feel like he is in control or can control things, he flips out. First by trying harder to control them, then by getting aggressive.

So... do we stop the intuniv? It was not this bad before. I thought things were getting better. He has actually slept in his own bed this entire time since we started this new medication - I think. He has been in my bed for forever. He was having bad dreams and waking up in the middle of the night and early in the morning since the intuniv - but I thought that was getting better. He hasn't been waking up in the middle of the night and he has been sleep a little bit longer. He has been getting up on his own and quietly watching tv, rather than slamming doors open and demanding I get up and wait on him.

Geeez, I don't know what to do. When he is like this - I want to !@#$%^ Arrgghh I don't know. It makes me CRAZY!

I think I am ready for bed, but had to have my therapy (this board) first.

Thanks for listening.
-Jules

 

[BusynMember]

Thoughts: Stims can make kids who have mood disorders or forms of autism even worse. My son got mean and aggressive on stimulants, but it turned out t hat ADHD was not his primary diagnosis. It is usually the first diagnosis., but often not the last one. I took my son off of stimulants when I could see he was obviously worse on them than off of them, but it's your call. We tried several stims and they all did the same thing to my son, especially Adderrall. We took him to a neuropsychologist and, sure enough, ADHD was not his main problem. It is hard to diagnose kids, and all the disorders have similar behaviors...trust me, been there/done that/have the t-shirt! To me, in my opinion, his symptoms sound worse than ADHD (your son)...maybe you should take him to a neuropsychologist. Of course, you can try a few more stims first...we did. But then we did re-evaluate him.
Good luck!!!

 

[gcvmom]

You should call the psychiatrist and provide an update before stopping any medication. He or she needs to know how your difficult child is responding to this medication because it can give them a clue as to what neurotransmitters are being affected and therefore what other medication might be needed either in addition to or in place of what he's taking now. It's frustrating to have to go through this trial and error process, but it's really the only way we have of knowing for sure what works and what doesn't. Call TODAY and let them know that you need a call back with instructions for how to proceed.

Hang in there!

 

[mysrk]

Jules

I have a 10 year old difficult child that's in therapy right now. We thought he had ADD and feel it's much more than that. We know he has ODD. He does the same things with his friends, always has to have control and when he doesn't he has a meltdown. We've tried just about everything add wise for medications and he's had some major side effects. Also major side effects with singular. We've had him off ALL medications since last May so his Dr can see our "real" difficult child. During ths summer we had more bad days than good. I'm so ready for better days! I hurts my heart to see him going through things he says he can't control. We have an appointment with a psychiatrist next week and I suspect we will try the medication route again, only this time we hope to find the right combination that will help him. I wish you all the best and pray that you get the answers for your son.

Mary

 

[Shari]

We tried Intuniv and it seemed to be helpful, but Wee wasn't on it for any length of time. Wee could not use Tenex because even the smallest doses seemed to knock him out, so we don't know what the long-term would have been on that, either.

BUT - we also tried clonodine for Wee, and it just plain made him MEAN. It helped him sleep, and it calmed him down, but the longer and longer he was on it, the meaner he got. So we stopped it. We use it now as an emergency PRN if we have to knock him out. And we notice, also, that the day after he is more emotional and tired...so I'm guessing its possible with the Intuniv/Tenex, too, but I don't know.

 

[smallworld]

MWM, Intuniv is not a stimulant. It's long-acting Tenex, which is a blood-pressure medication used to help with the imulsivity and hyperactivity of ADHD. Sometimes it can be helpful for kids with mood disorders as well.

I agree with gcvmom that a call to the psychiatrist is in order to see what he/she might say before deciding to discontinue the medication or increase the dose.

 

[TiredSoul]

Thanks everyone. I have a call into his pediatrician (she is the one managing his medications).

If I don't get a call back before he has to go to school, should I still give him 1 mg today? I was hoping this would be the miracle we needed to control his behavior.

I will also call and schedule the appointment with the new neuropsychologist. Uggh.

 

[Shari]

I would be tempted not to. If doctor says to give it to him, you can always run it in to school to him....you can't pull it back out...

Wee's docs have also given me a lot of wiggle room to adjust Wee's medications. Not sure you're doctor would feel the same way.

 

[TiredSoul]

I would be tempted not to. If doctor says to give it to him, you can always run it in to school to him....you can't pull it back out...

Wee's docs have also given me a lot of wiggle room to adjust Wee's medications. Not sure you're doctor would feel the same way.

Ok, that is what I am going to do. I will take him to school and when she calls back if she says to give it to him, I will run up there. Thanks!

 

[BusynMember]

Ah ok. Thought that was another stimulant. Personally, it sounds like he's responding badly to it.
I still think another evaluation would be helpful.
Good luck!!!!

 

[TiredSoul]

Ah ok. Thought that was another stimulant. Personally, it sounds like he's responding badly to it.
I still think another evaluation would be helpful.
Good luck!!!!

Thanks. I do also feel like the stims he has taken also contribute to this - but looking back at his first diagnosis in 2007 - it indicates aggression, and he was not medicated then. It also says 97 on the Affective Problems Scale and a 96th percentile rank on the anxiety problems scale. He mentions Affective instability. What does that mean exactly?

 

[smallworld]

Affect = mood

I'd say you're looking at mood instability. When that is in the mix, you medicate that first, not last. We've been told by our psychiatrists that you medicate mood first, anxiety second, and if necessary, ADHD last. I think your psychiatrist may be doing things backwards, which may be why your difficult child keeps getting worse on the medications.

 

[gcvmom]

Affective instability is essentially an unstable mood, mood swings, etc., which suggests a mood disorder of some type. At one end of the mood disorder spectrum you have depression, and at the other end you have anxiety. Some people suffer from one or the other, or a degree of both. It sounds like he tends to be prone to anxiety, which could easily explain the reason for his aggression in the past. Stimulant medications can exacerbate or worsen anxiety even while they are helping with focus and attention. It doesn't mean you should necessarily stop the stimulant, especially if it's helping his ADHD symptoms. However, it could mean that he needs an additional medication support to address the anxiety part.

Unfortunately, there is no black and white solution and this really is going to be a trial and error process. Don't be too hard on yourself or him or even the doctor because this all takes time and a lot of patience and careful observation. The good news is that there are so very many drug options out there that your chances of eventually hitting the right combo or cocktail of medications are pretty good. I highly recommend seeking out the help of a trained pediatric psychiatrist to help you manage these medications. A difficult child whose situation is more complex than a cut and dry diagnosis is usually beyond the training and experience that a typical pediatrician has and you will likely drag out the process longer than you would with a qualified psychiatrist.

 

[TiredSoul]

It's kind of dumb that the psychologist who diagnosis'd him (and also mentioned he may have a mood disorder) is the one who recommended the stimulants - I think. Now we have an appointment for the other psychologist who may or may not be a neuropsychologist on 10/13 - but who will manage his medications? So we need to find a psychiatrist too? Or do offices with many psychologists usually have someone who can also write prescriptions/manage medications? I feel like we have wasted 3 years with all of this. First and Second grades were so good (at school). Now all of these problems at school and more aggressiveness/moodiness/unhappiness. Argghh.

 

[gcvmom]

Psychiatrists are specialized MD's. Psychologists are not licensed to write prescriptions as they do not have the necessary medical training. You haven't wasted any time, and you are doing the best you possibly can. This is as much a learning process for you -- we all go through it, and honestly, the learning never ends. Your child is going to change with time, too. Once puberty begins, the situation can become even more complicated, so what worked when he was 8 may no longer work when he's 16. Hang in there and be confident that you will find a solution for him. Keep pressing for answers, keep asking questions.

http://en.wikipedia.org/wiki/Psychiatrist

 

[TiredSoul]

Psychiatrists are specialized MD's. Psychologists are not licensed to write prescriptions as they do not have the necessary medical training. You haven't wasted any time, and you are doing the best you possibly can. This is as much a learning process for you -- we all go through it, and honestly, the learning never ends. Your child is going to change with time, too. Once puberty begins, the situation can become even more complicated, so what worked when he was 8 may no longer work when he's 16. Hang in there and be confident that you will find a solution for him. Keep pressing for answers, keep asking questions.

http://en.wikipedia.org/wiki/Psychiatrist

Thanks, I just want to

 

[gcvmom]

This IS very stressful for parents to go through. Be gentle with yourself. It's okay to cry about this. It's okay to grieve the loss of the "normal" child you thought you had. Eventually you will come to a place where you feel like you've got a handle on things, you'll have created your warrior parent armor, and you will start to appreciate your child's differences, even celebrate them. This allegory describes what many of us have gone through:

http://www.our-kids.org/Archives/Holland.html

Something to keep in mind is that you really have to take care of yourself throughout this process of raising a difficult child. Carve out time to do things that recharge your emotional, physical and spiritual batteries, so to speak. Even if it's just 15 minutes at a time, it will help you be a better parent, a better spouse, a better human.

(((Hugs)))

 

[TiredSoul]

This IS very stressful for parents to go through. Be gentle with yourself. It's okay to cry about this. It's okay to grieve the loss of the "normal" child you thought you had. Eventually you will come to a place where you feel like you've got a handle on things, you'll have created your warrior parent armor, and you will start to appreciate your child's differences, even celebrate them. This allegory describes what many of us have gone through:

http://www.our-kids.org/Archives/Holland.html

Something to keep in mind is that you really have to take care of yourself throughout this process of raising a difficult child. Carve out time to do things that recharge your emotional, physical and spiritual batteries, so to speak. Even if it's just 15 minutes at a time, it will help you be a better parent, a better spouse, a better human.

(((Hugs)))

Thanks gcvmom. I never get a chance to do anything for me. I can't even go to the store by myself once my husband gets home without feeling the guilt that I just left my 3 year old being restrained by husband and screaming and crying to come with me. I am worn down. I am no good to my 3 year old, I am no good to my husband, I am for sure no good to myself - because I keep fighting this fight for my difficult child who in turn tells me he hates me. I know he doesn't but.... geee, can I please just have some peace?!! Thanks again for your support.

 

[gcvmom]

Can you drop off the 3yo for a playdate with a peer for an hour once a week? Even better, can you afford something like a moring preschool a couple days a week for the 3yo? That could buy you some much needed down time.

Check out your local churches for mother's groups, too. Where I live they have an organization called MOPS (Mothers Of Preschoolers) that meets weekly at churches for an hour or so once a week. The little ones get to play together supervised by moms who rotate volunteering, while the moms have time to hear a speaker, do a craft, or have some fellowship time. There is also an organization called MOMS Club that may have a chapter near you. They are geared towards stay at home mom's and usually have informal monthly meetings, weekly park days, playgroups, monthly Mom's Night Out, etc. I found that invaluable for preserving my sanity when my kids were young and undiagnosed yet!

As for the guilt of leaving the house -- fuggeddaboutit! It does not help you, it does not help your family. If you DON'T take care of yourself, you CAN'T take care of your family. If you don't have a therapist, consider finding one you can check in with, if only once a month. They can be worth their weight in gold when you are going through a rough patch -- I know it's helped me because my friends don't always have the bandwidth to talk about the issues I have in my life with difficult child's. And a therapist will. And of course, come here, come often! Because you KNOW we all get it.

 

[graceupongrace]

I never get a chance to do anything for me.... I am worn down. I am no good to my 3 year old, I am no good to my husband, I am for sure no good to myself .... geee, can I please just have some peace?!!

Jules, it's OK to feel that way. We've all been there.

One thing that really helped me get rid of the guilt is to think of time to myself not as self-indulgence, but as self-care.