TiredSoul

Warrior Mom since 2007
Thank you for the support gcvmom and graceupongrace. I was just looking into preschool a couple days ago, but the one we really want is full.

The nurse called back yesterday and said to continue taking the 1 mg unless I was uncomfortable with that and scheduled an appointment for today at 3:30. When I picked up difficult child from school, he was in a good mood. He said he felt better. He said he didn't want to take that medication anymore - so I didn't give it to him. I am thinking now we should have tried having him take it at night to see how that would work. I am guessing the aggression isn't from the Intuniv (although I have read others who said it did that). I am betting the aggression is from him not getting as much sleep. Don't know what the pediatrician will do or recommend when we go today. I agree she is not equipped to deal with this. I have the appointment to meet with the neuro-psychiatric on 10/13. If the pediatrician-doctor didn't consult with the psychiatrist we saw last time, then I imagine we will need to go back to him to get the medications straightened out.

I read something today that was about Fragile X syndrome (which he does not have), but it was interesting because it talked about treating aggression in those kids and to treat the underlying cause of the aggression. It mentioned 4 possible reasons for aggression and then the suggested treatment.

Cause of aggression/Treat with:
ADHD/ADHD medications-Ritalin, Adderall
Anxiety/Antidepressants-Prozac, Zoloft, Paxil, Luvox, Celexa
Hyper-arousal to stimuli/Clonidine or Tenex
Severe mood instability/Depakote, Risperdal, Zyprexa, Seroquel, Lithium

I am pretty sure we are going to have to add something else to the mix. Maybe we should try Intuniv (guanfacine) longer, or maybe we should just forget that and go right to something to treat his possible anxiety. We need a happy stable boy.
 

gcvmom

Here we go again!
As you can see, there are many different causes of a symptom, and just as many different medications you can use to treat it. This level of complexity is really best handled by someone with the training specific to mental health.

My difficult child 1 has ADHD and a lot of anxiety. He did o.k. on some of the SSRI (selective serotonin reuptake inhibitors) medications like Lexapro/Celexa for a while, but once puberty hit he changed and they disinhibited him and made him more aggressive. He's now on Remeron, which is a different type of antidepressant (tetracyclic) and works on different neurotransmitters. So far, it seems to be helping, though he still has issues. We've been dealing with this since he was 5, and he's now 16... so you can see it's an ongoing process with a lot of fine-tuning along the way. Hopefully when he's done growing things will settle down! But hang in there, you will eventually find what works for your kiddo. Just keep asking questions until you are satisfied with what you've learned or the outcome for your child.
 

TiredSoul

Warrior Mom since 2007
Thanks Shari and gcvmom. We had the appointment with his pediatrician-doctor. She told us to stop the Intuniv and stay on just the Concerta 27 mg, as he has been taking. She said she has three options she wants to run by her follow colleagues.

1. Increase from 27 to 36 mg Concerta
2. Go back to Adderrall XR
3. Reduce Concerta from 27 to 18 mg and add Intuniv back in

She confirmed what I thought about pediatric psychiatrists in the area. There are basically 4. The one who we saw one time, who is no longer taking new patients or adding to his load. Two at a mental health clinic that only take state insurance. And one at another office whom she did not recommend. I asked her what other people do in our situation, if they go to the next closest big city and she said no. They just work together with the counselors and manage it that way. So for example - we start seeing a counselor and they say difficult child's exhibiting anxiety - they would tell her that as well and she would prescribe the appropriate medication. Does this sound right?? We were her first Intuniv case.

She just says she is so glad we are going to go to counseling. I just don't think that is going to work. I don't think my son is going to participate. I don't think that is going to stop his aggression. I could be wrong - I guess we'll have to wait and see. That is at least 5 weeks out though with our initial appointment being on 10/13 and then that doctor being out until the beginning of Nov. If we have many more night like the last few, this is not going to work at all. I wish I could give him a chill pill. Something that would just relax and calm him when he melts down and rages like that. I need some too in order to deal with him.

Do you think we should find a psychiatrist in a neighboring city? Do you think the medication changes mentioned above are going to do anything to help? I just don't know.
 
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