gcvmom

Here we go again!
difficult child 2 has been on Tegretol XR a week now and I am really wishing we could just fast forward another month because his behavior is not getting any better. Although his math/science teacher said he appears to be less impulsive this week. And he has been able to get his homework done more quickly.

That said, afternoons and evenings are becoming more and more difficult. He is gradually becoming more irritable, more impulsive, more hyperactive. I don't think it's the Tegretol because he hasn't been on it long enough, right? I just think it's the mania getting worse. He says his head is buzzing most days by the time I pick him up from school, and it shows. He is loud, he is intrusive, he is wild.

He decided to walk up the outside of our stairwell and and on our stair railing (it's a u-shaped stairway, so he was walking on the second flight and the railing of the first flight, if that makes sense) while I was out picking up difficult child 1 from school, and consequently broke part of the drywall on the outside of the steps.

I didn't find out about it until this evening when I noticed the crack in the wall. When I asked difficult child 2 about it, easy child ratted him out. Had I known that happened, I never would have left the three of them alone while husband and I went out for a quick bite for dinner. We got a call at the restaurant from easy child that difficult child 2 had been hitting a chair with a butterfly net, broke the frame of the net, then got into a can of silly string (it was easy child's) and sprayed it all over the bathtub (at least it was in the tub!), then wadded the mess into a giant ball and threw the ball at her back while she was watching TV. We could hear difficult child 2 screaming at easy child in the background as she was explaining this over the phone.

When we got home, I calmly called difficult child 2 to the kitchen to hear his version of what happened. He was very agitated, pacing around, very loud, and very close to exploding. We talked about his choices, what he should have done differently. He got more angry. I asked him to close the curtain over the kitchen doorway and he jerked it and slammed his hand into the wall which REALLY made him mad. I was going to have him do some pushups to try to calm down, but he was screaming by now. He agreed to do some situps there on the floor. Not sure if it helped. I gave him his medications two hours early, gave him a big hug and then sent him back to the livingroom, and called easy child in to hear her version. It pretty much matched what difficult child 2 said, except she was angry about his behavior.

I've already told him he's going to bed at 8:30 tonight. He's sitting nicely with easy child on the couch right now watching TV. He's still animated and loud, but the hostility has subsided (for now). I just told him he has 15 minutes of TV time left, regardless of whether the show is done or not. Hopefully he'll get ready for bed without too much drama.

This should be an interesting weekend. I'm getting flashbacks of last Spring...
 

Jena

New Member
oh man i just posted about that, the spring ahead and our torture. the transition into spring is a rough one no doubt.

You handled it so well though calling him into kitchen that way, talking about choices what he could of done better. really, great job.

i'm sorry you guys tried to get some time and couldnt'. it's so important that you do to survive

(((hugs)))

i am hoping weekend is smoother.
 

gcvmom

Here we go again!
Thanks, Jen.

I just read on the NAMI web page discussing Seroquel, that Tegretol can reduce blood levels of Seroquel. I'm wondering if that is why I'm seeing a worsening of difficult child 2's behavior?

If that's the case, no wonder psychiatrist did not want to change anything with his Seroquel dosing right now. Guess I'll be calling him Monday with an update.
 

Wiped Out

Well-Known Member
Staff member
What an evening! I'm glad you are calling the psychiatrist on Monday. I hope the rest of the weekend goes more smoothly. by the way, I think you handled the situation very well!
 
M

ML

Guest
I too am glad you're calling the doctor. Though I'm usually sorry when I do. Last time I got a lecture about being too paranoid about medications in general and to back off and give them a chance. But obviously your situation is different and I hope you get some good feedback.

I also think you handled the situation brilliantly (as usual).

Hugs, ML
 

gcvmom

Here we go again!
Thanks everyone. :) He's still sleeping. I have to take difficult child 1 for a violin lesson this morning and will see how difficult child 2 is when we get back.

Loth, to my knowledge, his dosage is not being increased. My instructions from the psychiatrist's secretary were to just start him on Tegretol XR at a certain level, period. All the more reason for me to call, huh?

ML, I am soooo lucky to have found this psychiatrist. He very much trusts parents and their assessment of their own kids. He has no problem treating issues over the phone between appointments (probably because he is SO hard to get in to see and often has to close the door to new patients).

It's funny, the compliments about how I handled this... why is it so much easier for me to deal with difficult child 2's drama than difficult child 1's? Wonder if it's because difficult child 2 often seem tormented by his own emotions, whereas difficult child 1 is the one tormenting MY emotions! Hmmmm....
 

gcvmom

Here we go again!
difficult child 2 did okay today until just before it was time for his afternoon dose of Seroquel. I could just see that the evening dose was done because he was becoming more "busy" and starting to get wound up. About a half hour after the lunchtime dose, he was calmed down and looking forward to a friend coming over. The two rode outside on their skate boards for about an hour or so. Then came in to play a video game for about another hour. Then went outside to poke around the back yard and visit the chickens. By 4:00, that lunchtime dose was fizzling out. He was just zooming around the yard, talking to himself practically and trying to get his friend to help him dig. Just wanted to dig a hole. No reason. Just wanted to dig. Couldn't understand why his friend wasn't interested in a digging race. I went inside to check on something. Glanced out the window, and he's got a chicken in his hands and throws it up in the air as high as he can, laughing. The poor bird was frantically trying to get back down to earth without crashing. Meanwhile, he's encouraging his friend to do the same! And being an 11 or 12yo boy like he is, he does it. Ugh. I rush outside as the second bird is airborn and scold them both :biting:, ordering them both out to the front of the house to wait for the boy's dad who's supposed to be there any minute to collect him.

They go out, and about 10 minutes later, difficult child 1 comes running in to say difficult child 2 fell off his skateboard and knocked a big scab off his knee and now it's gushing. Great. easy child and I are supposed to be leaving now for a birthday party. So I usher difficult child 2 into the bathroom to assess the damage, patch him up, and head out the door. Yup. It's bleeding quite a bit and through his jeans. I give him a cold compress and have him lay on the couch, turn on the TV and holler to husband that it's his turn now and I'm leaving! :salute:

easy child and I get home at 11pm (it was a slumber party that she opted not to stay over night) and both difficult child's are up, but at least they'd taken their medications. husband is asleep. difficult child 2 is in the bathroom with a wet tissue on his knee again because he decided to remove the bandaid from earlier and it started to bleed again. Then he has to have a specific type of bandaid and is adamant about it. I can hear the anxiety in his voice. Fine, we fix the bandaid issue. I tell him to get to bed. But first he has to plug in a light in his room. Then he has to get a new lightbulb for the light. Then he has to put some old batteries in the battery jar (we recycle them). Then he has to... ENOUGH! Mom, can I please sleep on the couch tonight? FINE! LAY DOWN! :crazy2:

difficult child 2: Mom, why in a cave does it echo?
Me: (Offering a quick and simple explanation) Now go to sleep.
difficult child 2: So if you... (more questions)
Me: SHHH! Go to SLEEP.
difficult child 2: Whispering to himself and then making soft whistling noises... then coughing.
Me: (Thinking to myself: I'm calling the psychiatrist TOMORROW).
difficult child 2: Mom, does coughing necessarily mean you're sick?
Me: No.
difficult child 2: What, I didn't hear you.
Me: NO.
difficult child 2: (More noises, babbling, soft whistling). Mom, so when you whisper, you're not vibrating anything so how can you still hear noise?
Me: (Whispering and trying not to scream) Your vocal chords are still vibrating when you whisper!
difficult child 2: (More whistling whispering noises)... Mom, I'm buzzing for talking (means his thoughts are racing... duh! Really?)
Me: Yeah, I can tell. Shhhh, go to sleep.

:talkhand:
And husband wonders why I never go to bed when he does... just think of all the fun stuff I'd miss!

Okay, it's midnight now, and he's finally snoring on the couch. Tomorrow oughtta be loads of fun!
 
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tiredmommy

Well-Known Member
I just thought of something that helped us with Duckie that may help calm difficult child 2 when he just can't settle himself: a good strong massage. It really seems to calm her a lot when she's downright wired.
 

gcvmom

Here we go again!
Thanks TM. I'll try that tonight if he's still spinning like last night.

It's becoming more obvious that his afternoon dose of Seroquel XR is only lasting about four hours before the impulsivity is back, the restlessness, boredom, zooming around, talking more and more, intrusive behavior, etc.

We went for a hike this afternoon and he was very wound up. Marched at a quick pace ahead of the rest of us. Just wanted to keep going and going. Couldn't keep quiet when we were trying to observe some wild life and he scared everything away. Insisted on whacking plants and rocks with his hiking stick he'd brought along. When I took his stick away after he kept ignoring my requests for him to stop swinging the stick (he almost hit some bikers who rode by us on the trail), he stomped his feet and had a little tantrum. Really annoyed difficult child 1 and easy child who kept shushing him. ;) Complained about being bored on the way back, even though it was a different route (not the one he wanted) than we took on the way out, and even though this hike was his idea. It was like having a toddler with us. I'm tired just from redirecting him the whole time.

When we got back home, he helped himself to the TOPS off some muffins I'd bought at Costco, and left the mess all over the counter. I had him clean it up and now he's in the tub getting himself cleaned up.

Everywhere he goes he leaves a trail of mess and/or destruction. No wonder I never feel caught up on stuff around here...
 

smallworld

Moderator
I've heard some other parents complain about the delivery system of Seroquel XR. I know this is highly inconvenient, but I'm wondering if difficult child 2 would do better if you took the total amount of Seroquel he's taking now and divide it into 4 equal doses of regular Seroquel spread throughout the day. At least until Tegretol is fully on board, it might be worth a shot.

My own son does great on 600 mg regular Seroquel all at night, but he's also taking Lamictal and Wellbutrin.
 

gcvmom

Here we go again!
SW, it's worth asking about. Last summer he took the regular Seroquel and it lasted about 4 hours for him. Anyway, I'll add this question to my list for the psychiatrist when I call tonight.

What does your difficult child 1 take the propranolol for? I'm just curious. difficult child 2 is now taking it in the morning to help with anxiety.
 

smallworld

Moderator
J has been taking Propranolol (60 mg LA) for migraines since age 10. We call it his miracle medication. He has such severe anxiety that we never noticed Propranolol having any effect on it. But Seroquel does a nice job on his anxiety.
 

totoro

Mom? What's a difficult child?
We spaced out K's Seroquel in 4 doses a day. It worked better for her this way.
We would have kept with it if she wasn't gaining way too much weight.
If the Abilify doesn't slow it down over time we may go back to it because Seroquel seems to be the best AP overall so far! Besides the weight gain.
 

gcvmom

Here we go again!
Thanks Totoro, I did ask this morning about perhaps going back to regular Seroquel and just dosing it more often.

psychiatrist's office called and said yes, the Tegretol is diluting the Seroquel (so to speak) and that the psychiatrist needs to rethink this and get back to me. So I guess we're stopping it today. He's already on a very high dose of Seroquel XR, so it's not like we can just increase that to compensate.

I asked about revisiting Depakote, because he was on it a year ago, but because we were trying to treat his movement disorder (which is now in remission) with other dopamine-regulating medications, we took him off it. I know it did have some cognitive dulling, but maybe he wouldn't need as much since he's on Seroquel XR now?

I feel a teeny bit frustrated that we've yet to find acceptable stability for this poor kid... seems like such a long time since he first started medications (seven years ago for gosh sakes!). I realize his symptoms have changed over time and what we thought we were dealing with at first is actually something different. AND he developed the neurological/movement disorder in the middle of all this which further complicated things.

Of course, he's on the edge of puberty, which will probably knock things for a loop soon, too!

Never a dull moment, huh?
 

smallworld

Moderator
Didn't he do well on Lamictal? There seems to be less cognitve dulling with Lamictal than with Depakote, and Lamictal is weight-neutral.
 

gcvmom

Here we go again!
He's more manic than depressive, and I think Depakote is better for mania than Lamictal, isn't it? The way I understand difficult child 2's issues, they are more related to dopamine being off than anything else.

He did trial Lamictal with Depakote last year, but that was when he was starting to pick at himself and was becoming more emotional during extended rainy periods here. From what I remember, Lamictal made him shak(ier) and gave him insomnia (just like his dad).

psychiatrist's office just called back and said he wants him to try Stavzor. It's a new delayed release gelcap of valproic acid (Depakote). Of course, I still have a mega bottle of Depakote ER on hand... so if I could use that first, I'd rather do that than spend more money on this other stuff... Then again, they also have free samples I can go pick up tomorrow.

Here we go...
 
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