Hospital again

[Crystal72]

doctors will say that, but we all know in real life that is not true. my son has trouble with short acting ritalin...huge rebound at end of dose so xr (concerta form) works better. why not the opposite, if a child can't handle it being in him for a long time....maybe traces of it stay in him even longer than they think so his body never gets a break...who knows. Everyone metabolizes things differently and you are the expert. Just tell them you want to know and if there is no difference then go back to short acting and compare. Easy way to see. The other issue may be just that his body can't handle THAT entire kind of medication anymore. My son can't use adderal. it doesn't work at all. Ritalin and Concerta work for him well though.

Why just on saturday? in my humble opinion, many kids on the spectrum need and are comfortable in a routine (even if they dont like what they are doing) have a hard time changing and so that first day off is a huge deal. It could be that of all the days at school, for him Monday might be a little harder too but maybe not since they are probably so consistent in their routine and he is used to it. I have seen this many times with my son. School knows Monday is a wash. He always has trouble getting into their routine and I simply dont have the things they have to keep him in their routine. NO gym, no pool, no long halls for walks, etc. He is really rigidly scheduled there so he comes home, gets to do our routine which is not stressful for him because it is mostly his high interest areas, and then he goes back to school and it is a huge shift. Very common issue with kids on the spectrum.

I actually missed this post completely.
Yes I know about routine... But how is it possible to pull him off bed by 6, get him out of the house by 7 and do what the school do?
If I could find a program for him on Saturday morning would be really helpful.you know get him out of the house and when he returned he should be just like back from school but we all know how impossible to find something on weekends except inpatient program...

 

[Liahona]

She was suggesting you make his home schedule on Saturday as much like the school's as possible.

 

[Crystal72]

I understand. Just wonder how to make it like the school

 

[buddy]

Yes I know about routine... But how is it possible to pull him off bed by 6, get him out of the house by 7 and do what the school do?
If I could find a program for him on Saturday morning would be really helpful.you know get him out of the house and when he returned he should be just like back from school but we all know how impossible to find something on weekends except inpatient program...

OH of course, it is impossible...you can't do what the school does. What i was wondering is if you could develop a really structured weekend routine so that on Friday night you can show him the cue cards of the plan for the weekend and then prep him. Then have the schedule and follow it as much as possible. When you start it may limit what you do but as he gets comfortable, you can incorporate special outings etc. by using a different color on the schedule. etc. Does that make more sense?

 

[buddy]

Here is our weekend schedule for :difficult child
8:00 wake and make bed
8:15 eat breakfast
8:45 brush teeth/get dresssed
9:15 computer
10:00 walk outside

these are all hypothetical...he may not be able to stop computer so maybe make that the last activity of the whole day?? even after shower/bath/tooth brushing pj time.????

keep same schedule for every weekend until it is very routine and he calms down.

then you can add changes in a different color to show it and prep him the day before of the changes.

IT seems elementary but it calms their brains down when things are so predictable. IT really helps my son to have a visual schedule. I even use a schedule within a schedule if we are out somewhere and certain t hings will happen....5 minutes standing in line, get tickets, get refreshments, etc.

It is only an idea based on the fact that this is such a routine and predictable issue. It is a lot of work at first but the benefits for us of preventing an outburst before it happens have been great. Now for us having friends show up and ask him to play, that has interfered with the schedule and has made lots of upsets. I have to work on that with him now while he is in the hospital i fear.

Clearly if it does not fit for you no biggie, just a thought.

 

[keista]

But if it's the adderall xr, why just Saturday? The psychiatrist insisted its no difference between adderall and adderall xr.

Because kids and medications are strange. DD1 was on something completely different, but when it started going bad, I could 'set my watch' to her "creepy" moods. They always showed up between 6 and 7 in the evening. Some days were milder, others more intense, some days not at all, but always between 6 and 7pm.

Have you given the hospital the order to discontinue the adderal xr yet? Yes, even if he's in the hospital, you get the last say. It's sometimes a fight, but as the PARENT you legally get the last say what does and does not go into your child. When DD1 was in, they wanted to add and SSRI to a medication that I thought was not working well anyway (Abilify). I told them to get the psychiatrist on the phone and CONVINCE me that this was the very best choice for her. They wouldn't. I had to play "telephone" with a nurse relaying messages between me and psychiatrist. Ultimately I refused and told them to also stop the Abilify.

 

[Steely]

Hi Crystal -

So sorry you are going through all of this. It is so tough. I have been in your shoes many, many times.

First of all, of course there is a difference between Adderral and Adderall XR! doctors. Geez. The point is that you saw the aggression increase when they switched things, so you want him to go off of it.

in my opinion - I would steer away from that medication category in general if you can. It can increase aggression. So can the medication class of Zoloft (SSRI). Perhaps he needs to do a medication wash while he is there to get him on more mood stabilizing sorts of medication?

Matt has flipped his lid every October since he was 3 - except for ONE. No lie. No reason that I could ever find - except that many kids with mood issues, find that this month is very hard. Less light, winter approaching, school ramping up - it can be a lot of things.

I am glad you made the hospital take him in. Now you will have to a be a warrior mom and demand that he get on the right medications, and get some help. These phosphs do not do well left to their own accord - (in my opinion) - you really have to push them, and hold them accountable.

<HUGS>

 

[keista]

This has been bugging me, so I looked it up. Aggression is a LISTED side effect of adderall xr. It is listed as rare, but still listed.

Common and Rare Side Effects for Adderall XR Oral

Forward that to the psychiatrist if you must.

 

[Crystal72]

Adderall and Zoloft set off aggression huh?
I miss him. Can you believe that I actually thought about military school or even Forster home..
I set of such a strong front but deep down I m so hurting. I can't even tell anyone how much I m hurting.
I don't know how to be a warrior anymore. I don't even know what's wrong anymore.
Last year when he was admitted same time. I couldn't even do Halloween. I had to get out of my house cos I couldn't bear to see how much others enjoyed Halloween when my ds is locked up there. I was just buying candies cos I thought he is able to have fun this year and he is back again.
It hurts so bad

 

[keista]

((((HUGS)))) for your hurting mommy heart. Wish I had something more to offer.

 

[Steely]

I know - I know I totally understand how hard it really is and how badly it hurts....I am so sorry. Every holiday is like that for me - like looking from the outside into a world that I am not a part of. You are not alone.

YES....the medication class of stimulants (Adderall, Rhitalin, etc.) can set off aggression in a person who is experiencing mood instability. The class of SSRIs (Zoloft, Celexa, Prozac, etc.) also can set off aggression and depression in people that have a mood disorder. In fact Prozac has a very clear warning on it stating that it may increase suicidal ideation in people under the age of 18. These 2 medications combined are bad news unless you know the kid has a documented case of severe depression with no past history of mood instability.

I know it feels like you can't be a warrior anymore - but I know you will. Because none of can stand by while our kids are in pain.

My suggestion is to get to the root of the problem here, and see what is really going on in his brain so that people know how to properly medicate him. To do so - you need to request from the phosph:

-To do psychological testing on him while he is there to help assess what may be going on.

-Discuss discontinuing the medications he is on with the dr on Monday, and discuss mood stabilizer options

Hang in there - this will get better. (And FWIW, Matt had some decent Halloweens in phosph.)

 

[buddy]

Adderall and Zoloft set off aggression huh?
I miss him. Can you believe that I actually thought about military school or even Forster home..
I set of such a strong front but deep down I m so hurting. I can't even tell anyone how much I m hurting.
I don't know how to be a warrior anymore. I don't even know what's wrong anymore.
Last year when he was admitted same time. I couldn't even do Halloween. I had to get out of my house cos I couldn't bear to see how much others enjoyed Halloween when my ds is locked up there. I was just buying candies cos I thought he is able to have fun this year and he is back again.
It hurts so bad

I really know what you are saying...really. It is just so sad. I can't even think of a better word. Not even close to fair that an innocent child should have such huge challenges. I bought candy before all of this....now I am thinking how can I hide during trick or treat time. I dont want to answer my door for the kids who said they were going to go with difficult child, his first time being invited ever in his life. Just breaks my heart. You have your other kids to keep up a front though...I hope instead of hurting it can bring you a little joy to watch your little one. You obviously know your son well and now you have scientific evidence that adderal xr can be causing this. The nurses on different shifts have said to me many times that the Autism Spectrum Disorders (ASD) kids they get in the hospital never respond to medications as predictably as kids without autism. So trust your gut. I know it is not what you really feel...I get that too. Inside mush...outside just gotta put one foot in front of the other.

 

[Crystal72]

What is phosph?
Ds was on vyvanse and depakote before switching to adderall and zoloft. The last admission, they think he cut himself due to depression so they put hIm on zoloft.
I suggested to psychiatrist to put him back on depakote but he says my ds doesn't need it.
What should I do now? Please guide me
Do they do testing there? Cos the last time they didn't do anything. I m going to tell them to stop all medications tomorrow. The medications are supposed to help him not ruin him.

 

[buddy]

psychiatric hospital is the psychiatric hospital

Yeah, how does he do off medications period? What was he like before you started medications? I am not saying do nothing just wondering what his normal state was. The thing that helps my son with aggression (and he was on it even when I adopted him at age 2...a very very small dose--then off till about three years ago and we started it again and it really made a huge difference) is Clonidine. another option in that category is Tenex...They are actually blood pressure medications but work to help with aggression/agitation. Not suggesting it just sharing the one that makes the most difference for us in regard to that symptom.

 

[Crystal72]

I was actually looking at tenex too cos my 6 years old Pervasive Developmental Disorder (PDD) not otherwise specified is very disruptive.
I can tell the different before and after my aspie takes his medication. he would be moving everywhere, not a seconds of quiet. Talking and laughing uncontrollably. Everytime he does that, I would know he hasnt take his medication
One time he missed his medication, he almost drowned his best friend in the pool for constantly pulling his legs in the water.

 

[Crystal72]

Clonidine and guanfacine (tenex) are an alternative to stimulant so it's not stimulant??
Are these for mood stabilizer or for his ADHD?
I noted them down so I can talk to psychiatric hospital tomorrow.
I m now taking amitryine and lorezepram to calm my nerves cos I couldn't focus to think. All I do all day is to fool the world I m fine, how fine I am if I don't even want to cuddle my dog???

 

[buddy]

I'm glad you got help to start to work on the extreme stress you are under and your feelings. It can feel forever to be depressed and anxious. I went thru a time in my twenties for several years. I always said I would go for help in a second if feelings like that lasted more than a week. Even with my horrible days now, I have tons of hope, love most of the services we have etc. Just lots of unknowns hanging over me, but I have not lost hope for sure. I spent time today laughing my head off with my typical neices and nephews. They love me and difficult child so much and all offered to carry a bag to get candy for him! They are so sweet (naughty but sweet).

You dont have to be fake here. It is ok to say you are feeling like you need to turn the world off. it literally does come down to one step at a time...one ACTUAL step at a time during these phases of life.

True, Tenex and Clonidine are not stimulants. They are used for adhd and agression to address symptoms. Does not mean it is the answer for you, I am sure there are as many stories where these did not work for some kids too. But so far you are not seeing what you use as working. Like I said, adderal didn't work for my difficult child at all...ritalin did though. In a dramatic way. I can tell too right away when medications time has been missed. this summer at the pool was hard. time woudl fly and I did't have a watch on so all of a sudden he was too wild or impulsive and getting in trouble and duh....I missed the time by half of an hour! I really have to be on my toes when it comes to medications. Well, you have some options. One thing at a time... you can do this and you are not alone.

 

[Steely]

What is phosph?
Ds was on vyvanse and depakote before switching to adderall and zoloft. The last admission, they think he cut himself due to depression so they put hIm on zoloft.
I suggested to psychiatrist to put him back on depakote but he says my ds doesn't need it.
What should I do now? Please guide me
Do they do testing there? Cos the last time they didn't do anything. I m going to tell them to stop all medications tomorrow. The medications are supposed to help him not ruin him.

Phosph is - Psychiatric Hopsital

Vyvanese is another stimulant. Again this class of medications *may* be making things worse.

Depakote is what Matt is on, and it is a mood stabilizer. It addresses his mood cycling, his anxiety, and hostility.

They should do testing if requested at phosph. The thing about the hospital is that they tend to be a holding tank, unless the parent demands *things* be done. So just like you demanded that he stay there because of his violence, you can demand that he have a medication wash, and you can demand he gets testing (although insurance companies can balk at this), and you can demand that they start trialing mood stabilizing medicines.

A psychiatric test would help identify if he has Bi-Polar, or Depression, or a myriad of other things.

Within the mood stabls there are so many, I can't list them all, but Depakote is one, Lamictal, Lithium, Tegertol, etc. You could also suggest they trial an Anti-Pyschotic, which is a very common medication for our kids to be on. Matt did the VERY best on this class of medications. These are medications like Abilify, Zyprexa, Seroquel, etc.

 

[buddy]

Hey guys who have had kids do the medication wash... does that mean they stop medications suddenly? should she ask for a medication wash or just ask to stop all of the medications altogether? Seems like the adderal xr needs to be the first to go. Cant remember all of the medications you listed crystal, are there any that are dangerous to stop suddenly? Just making sure...

 

[Liahona]

When difficult child 1 did a medication wash in Residential Treatment Center (RTC) it was under a psychiatrists care. They just stopped the ones they could but they went slowly down on the ones they needed to. They also just stopped one at a time.