got diagnosis, drug thorazine

[Jena]

hi

so i went to dr. and he diagnosis difficult child with bipolar (not otherwise specified), adhd, and severe anxiety disorder. so there it is my ex husband is screaming and carrying on which is a nightmare for me and additional stress. i think he's going to take legal action against me at this point and try to stop me from caring for her. so ridiculous.

anyway he wants to put her on thorazine, its an old antipyschoctic drug..........and wants to add possibly klonipin to address the anxiety issues with her.

i looked up thorazine it doesn't look good.

 

[klmno]

Oh- Jen- is this thorazine, as in "the thorazine shuffle"? This doesn't sound right to me- but I'm no expert. Hopefully, some of the members with lots of medication knowledge can help you on this one.

 

[Jena]

my mom said same exact thing. she used to work in mental health. ok what is this dr. thinking here???

 

[klmno]

Did he say temporarily or what? If he thinks she's BiPolar (BP), why isn't he starting with a first line MS? I think I would ask more questions before giving her a dose, but that's just me.

 

[slsh]

Sorry you're having to deal with ex and his problems on top of trying to help difficult child.

I have to admit, thorazine caught me way off guard. thank you was on it during the worst of the bad old days but only as a prn medication. I can't tell you what dose he was on but on the 1 or 2 times I actually got him to take it, it knocked him out cold (maybe it was a higher dose?).

Do you feel confident in this psychiatrist's understanding of difficult child? Do you think psychiatrist is competent? I'm *not* questioning his/her competence at all. It's just that when you're trying to find the right medication for your kid, it really boils down to faith in the psychiatrist's ability and how much you trust him/her. In my experience, medication management has little to do with science (because how an individual child will respond to any given medication is really unpredictable) and a whole lot to do with art. There have been a couple of psychiatrists who I trusted completely and did not question the choices they made when it came to thank you's medications. There have been others who I quizzed quite thoroughly after doing extensive research on my own before I let them change medications.

I don't know. Ten plus years into medications with thank you, I'd personally wonder why a mood stabilizer (tegretol, lithium, depakote, or even Topamax) isn't being tried first, or another atypical antipsychotic like Risperdal or Zyprexa... but I'm finding it really hard to be objective. If the logic and reasoning behind this choice makes sense to you and you have faith in the psychiatrist then follow your gut.

If you're worried about the medication, definitely talk with psychiatrist about it more and/or maybe seek out a second opinion?

Sorry - finding the right combo to stabilize our kids so they can start working on self-control and self-monitoring has always seemed like pharmacologic roulette to me. It's very scary as a parent to have to make these decisions.

 

[flutterbee]

I *really* don't like the side-effect profile.

Whatever your decision, she should have an EKG prior to starting the medication. If she has a mitral insufficiency she should not take this medication.

 

[Jena]

hi,

i dont' like it either.....and he said to me you are going to go home nad read a whole bunch of really bad stuff about this medication and then you are going to call me. he started at 10mg. of it once a day at bedtime i have not filled it as of yet. i am not comfortable wtih giving her this type of medication at night no way where i cannot watch for side effects and just hope she's breathing.......i've been there before sitting bedside for first 3 or 4 nights until i know her system accepts it.

he said that to me i could try one of the newer frontline drugs......but he said i don't like them very much i go into the hospital and i see these kids on 3 and 4 medications due to side effects from first medications and i shake my head. he said people question sometimes why are you using thsi old medication, why are you doing that? he said i'm in the business to help people.

he's not a big fan of depakote or lithium (he said way too dangerous for her), or the others abilify, etc. he said i like thorezine in a very low dosage. we sat there for almost an hour tonight going over everything. she's been very hyped for a while now. he wants to address the mania and anxiety but i told him i think it's hypomania not full blown mania at all times and i also think that i'm nervous about throwing her into a depressive state because she was diagnosed with-major depressive mood disorder by columbia so if we bring mania down tooo far we'll have much worse major depression.

i can't sleep tonight and difficult child is up as usual so i figured i'd get thoughts out and type

thanks for the responses though. i'm still trying to wrap my head around the diagnosis. i've been here before doctors have said possiblity in past

 

[BusynMember]

Hi. I'm not a doctor, of course, but there is no way in hello that my kid would take Thorazine. I have bipolar and was in the hospital once for ten weeks. A lot of folks back then were on old antipsychotics, like Thorazine and Haldal and I remember the twitches and robotic behaviors. These people, however, had schizophrenia, and there were no other antipsychotics. I think the doctor is using a cannon to kill a bug. I'd tell him "Cya" and find somebody else. I wouldn't even trust his diagnosis. As for kids on 3-4 medications, I see that too, and I don't like it either, BUt everyone in the hospital who I know was taking Thorazine and Haldal was also on Cogentin to combat the side effects. And the Cogentin didn't always work that well. The patients used to talk with each other about our diagnosis. and medications so I had a pretty good picture of who took what. Anyway all this is JMO

 

[Jena]

well that's exactly why i threw it out there because i'm not aware of the old antipyschotics, so i'm getting the necessary feedback which is helping my decision. which is always great. regarding dumping doctor i'm not that extreme, i've dumped alot of doctors when they prescribe a drug i dont' agree with or say something i don't like. he's been in practice for 25 years which is one of the things i liked about him, so he's not feeding into alot of the new diagnosis without truly believing it to be so........thus "BiPolar (BP)" a large majority of kids in her school go to him.

so i think i'll give him a get out of jail free card on this one. difficult child needs consistency so very badly, with dr.s therapists life. so i'm sticking with-him. yet i think what i'm going to suggest just to convince myself is use another anxiety type medication possibly klonipin i'm going to look that up before i go into mood stabilizers.

thanks for input though.

and yes you are on targe in regards to this drug, my mother used to work in mental health and almost got sick at thought of difficult child on this drug.

i said it once i'll say it again all some of us need is a prescription pad lol........

 

[BusynMember]

I take Klonpin. It is a benzo, like Valium, and, while I find it incredibly effective for me (as long as I only take one pill at night because even years later it still makes me very sleepy), it does cause dependence. I don't care--I'm going to take it until I die, but you should know this. Also, it's not a mood stabilizer. Although I know your doctor has been in practice a long time and has a good rep in your community, if he is diagnosing bipolar, and if she has it, Klonopin won't help that (I also have bipolar). It doesn't stabilize moods. It just kind of makes you mellow and less high strung, IF it works for you. For me, it effectively blocked my debilitating panic attacks so that I could leave the house (I was almost housebound). But it doesn't stop highs and lows. Take care

 

[smallworld]

Your daughter is only 8. She is still very young. Thorazine should never be a first-line medication prescribed to a child. There are a lot safer medications out there than Thorazine, including the newer (or atypical) antipsychotics like Risperdal, Seroquel, Zyprexa and Abilify.

Here are the guidelines for treatment of BiPolar (BP) in children:

http://www.thebalancedmind.org/sites/default/files/treatment_guidelines.pdf

These guidelines were written by a consensus group of child and adolescent psychiatrists. Treatment frequently includes one or more first-line mood stabilizers (Lithium, Depakote, Lamictal, Trileptal, Tegretol) plus an atypical antipsychotic (list above). You should take a good hard look at these guidelines because most psychiatrists treating BiPolar (BP) in children are following them.

Klonopin is an anti-anxiety medication that should only be used on a short-term basis because it can be addicting. It can also cause disinhibition in children (it happened to my younger daughter).

In your shoes, I would tell this doctor that Thorazine is not an option at this time until other medication choices have been exhausted. If he can't come up with other options, unfortunately it may be time to find another doctor.

 

[Jena]

hi,

thanks for the input both of you. ok so no to klonipin. it's hard i'm not a doctor and i'm really tired. i am not going to give her the thorazine. i decided that last night.

my gut's still telling me to try another anti anxiety medication for some reason, i don't know why and at this point i need to follow my "mom gut". if it's in her for two days and doesn't help than ok ill digest the BiPolar (BP) diagnosis and move forward. i am def. going to question what it is he was smoking last night when prescribing that drug to her. man i hate this so much. the info and feedback here is invaluable as always and it is appreciated.

she had rough one again last night uncontainable until about 1 a.m. dancing in her room high school musical songs bouncing everywhere, anxiety flying at the same time. then at 1:30 she finally crashed. woke up covered in pee up to her hair again. she didn't want to sleep in her bed last night she said she couldn't find her spot (she rubs the sheet to sooth herself when she's too hyped), so i let her sleep on recliner in living room while i sat at kitchen table watching her and chair's ruined.

so she got up at 6 a.m. with all the kids, i made breakfast with two cups of coffee in hand lol and i turned to go upstairs and wash my face and try to look like i hadn't died and come back to life and i went in living room and she had passed out. twenty minutes prior was dancing and singing again. so now sh'es out cold drool coming out of mouth and how can i drag her up and drag her out like this and bring to school?? so iput call into social worker at school to tell her. because if i bring her in late i get judged for being the bad mom.

ugh.

 

[Jena]

and difficult child is young, she's almost 10 though. weighing in at about 90 lbs. and very tall, size 6 shoe. tallest girl in her class. she's beginning to develop also and i saw what looked to be a pimple on her nose last night. time's running out till the hormone's kick in and i have no idea which end is up.

 

[smallworld]

There's no reason not to try Klonopin. Just know that it can't be a long-terrm fix for a child, and it might be disinhibiting.

Your profile says your daughter is 8. You might want to update it. However, 10 is still young. That's the age of my daughter, and I wouldn't give her certain medications because of her age.

 

[smallworld]

In terms of the school, you might need to get a doctor's note about the medical reasons she's sleeping at odd times. That should excuse her legitimately from school.

 

[klmno]

I looked up thorazine on rxlist.com because I had only heard of it being used in-patient on people going through withdrawal or uncontrollable people. It actually does say that it can be used on kids from 6 mos to 12 yo who are severe behavioral problems and manic. Apparently, it has been used for this due to the risks of other MS's in young kids. But, the way it mentioned "major" or "severe" behavior problems gave me the impression that it would be for kids that made our difficult child's look typical. Maybe this dr is really old-school or something, I don't know. Maybe he had a young patient have a bad reaction to a typical MS in the past. All I know is that if they had told me my son needed thorazine, I would have fallen out of my chair. I would definitely want to explore other options first, or at least have someone explain to me why that shouldn't be done (as in- a second opinion), like SW mentioned.

And really, what exactly would one see in a 6 mo old baby to be defined as "uncontrollable and severe behavior problem"? And if it was a difficult-to-handle baby, there are a lot of other options out there besides thorazine.

 

[Jena]

i really dont' knwo to be honest with-you what a dr. would see in a 6 mos old baby to consider it out of control.

yup i've fallen out of my chair alot the past 4 years. difficult child is just very unstable right now and i'm a basket case. i take as much as i can and then it gets to the point where i unravel for a bit due to exhaustion and pressure and then i come back again. i've been sitting here in pain all a.m. body aching crying and confused lol.

boyfriend told me just put her on newer mood stabilizer, just accept BiPolar (BP) diagnosis and le'Tourette's Syndrome move forward. i spoke to school their just nasty and yes i will have dr note very good idea i didn't even think of that how pathetic am i today? love the school sw but people don't get it unless you live it they truly don't. she was like pull her up and bring her in. i siad she's been flying high for almost a mos straight now, it's never been more than 5 or 6 days she is done now. exhausted i would be too and i am and i didnt even stay up all those nights with-her my body cna't hack it every night.

 

[BusynMember]

jennifer, has she ever seen a neuropsychologist for possible high functioning autism? My son got that bipolar diagnosis. and was on heavy duty medications for three years...and it was not the right diagnosis. My gut told me "no" and he's been weaned off medications now since age 11 (he's 15). He used to get very silly. That is also a symptom of Autism Spectrum Disorders (ASD). He had no social skills. He is much better now on every front due to interventions. Anxiety is just "another day in the life of somebody on the autism spectrum." It's a way of life with them. It is very easy to mistake bipolar for Autism Spectrum Disorders (ASD) and vice versa. You need very good diagnosing and testing. There are huge differences in both cause and treatment and Autism Spectrum Disorders (ASD) kids tend to get better and better as they get older. Bipolar is more iffy--I have it.
Like you, I am very touchy about medication and I actually think you are smart to go slow. In retrospect, I wish we had questioned the diagnosis and medications more...could kick myself because my kid was on so many medications.
Anyway, use your "mom gut." It's good. We live with our kids and we know when something is wrong. I think we also know when the diagnosis is also wrong. I did, but I didn't trust myself.

 

[smallworld]

When a child is manic -- if that's what's going on here -- it is not uncommon at all to start with an antipsychotic to calm the mania down quickly. As we all know, antipsychotics work much faster than the 6 to 8 weeks it can take for a mood stabilizer to kick in. After the antipsychotic is in place, a MS is introduced for long-term treatment.

However, I personally would never start with Thorazine. I would opt for the newer atypical antipsychotics like Seroquel, Zyprexa, Risperdal and Abilify (in that order, based on my kids' responses).

 

[Jena]

hi,

i'm sorry to hear that, yet you can't beat yourself up you were a strong advocate for your child we all are and we are far from perfect, dr.s put too much pressure on us and our opinions and thoughts to lessen the actual time that they have to observe the child, it's all *ss backwards in my eyes.

i'm glad to hear that he is weened off medications. it's a horror show for most.

in regard to neuropysch, yes you guys told me to do it when i first came here a while ago now..........and i was good and i listened lol so it showed nothing even remotely close to that. no learning disabilities.....at all. yet deficiencies can't spell i'm tired in executive functioning skills, short term memory is challenged, and something else. yet they were all indicative of BiPolar (BP). yet she diagnosed with major depressive disorder the ding bag because difficult child was on a low at time. it was her birthday last year and we spent 3 to 4 days in a 2X4 room in testing 7 hours a day. what kid wouldnt' be depressed or on a down if they were BiPolar (BP)?? dopes in my opinion most of them. i know that's terrible, bite my tongue yet yuck.

boyfriend who is less emotionally attached than i obviously he's only known difficult child for year and a half, said to me today i love you we will get thru this together you have to start taking care of you to do so, but i believe that she is bi polar now after watching her night after night.

he sees the swings.

i'm going to go with-mom gut. i'm going to say i want to try one more anti anxiety medication, before i swallow this diagnosis. if she flies south again on it then i know i tried my best. yet if it madea difference and i took the chance and tried then wow. i'm probably kidding myself i know but i have to give it another shot.

our families are very much filled with-depression, anxiety, panic attack, suicides, nervous breakdowns, my ex's mom had one when he was kid was hospitalized for a mos. or so. there's probalby BiPolar (BP) in there, his dad has never been able to hold a job, has never gone to dr to get medicated or get some assistance, he was on drugs years ago, still plays in a band seems to think he's going to be the next hit wonder, he's almost 60 now.

oh wow, huh..? lol