medication Change & Gearing up for Discharge...

[Alisonlg]

Well, they lowered difficult child's Risperdal a few days ago from .5 mg twice a day to .25 mg twice a day to see if that would lessen/get rid of the side effects (sleepy, VERY blurred vision, and a vocal tic- clearing his throat every second).

We've noticed that after a couple days on the lowered dose, he started to return to "normal"...less sleepy...slightly more "hyper"...a little more defiant/oppositionaly & irritable, and back to pushing peoples buttons and working angles, if you Know what I mean?. And the worst part, I think, is the working angles part, because just like when he was 2 years old and would "figure out" all of the behavior mods we & the preschool would put in place (reward charts, stop light systems, etc), I think he's working an angle to get out of the hosptial.

I think the medication is helping him *just enough* that he can stay compliant there because of their VERY strict day to day structure...he can cope with having to take a shower every day if that means he's going to get out. His ONLY oppositionality with them lately is meals because they keep serving meals he won't eat...interestingly though...it's increasing to EVERY meal time it seems. So, I think he's working the angle...but I'm afraid on this lowered dose...with his now higher level of oppositionality, irritability, and manipulation, if you will, that when he gets back in the "real world" he's going to blow. Just my gut feeling.

He's already telling us that he doesn't need the medication...that they said he'd outgrow his ODD by 8 (he's heard us say it to the Social Worker when we were forced to give his background in front of her), so now he's 8 and he can "control it"....he's in control and it's not the medications...so, I think he's internally prepping himself to refuse to take his medications when he gets home. He could surprise me, but I've put up with 8 years of this kid...I really think all this talk is his mental pep talk to himself. A build up for what's to come when he gets home.

So...basically, I'm scared to death of what happens when he gets out. I'm not sure we're out of the woods yet...I'm more worried that he's figured out how to manipulate them into thinking we're out of the woods.

I got a call from the SW today and the psychiatrist decided to switch him from the Risperdal to Zyprexa to hopefully alleviate the side effects (he only mentioned the sedation, though on the lower dose, he hasn't seemed sedated...I'm more concerned about the tic and the blurred vision) and they're looking at sending him home later this week...we're going in tomorrow (Tuesday) to go over discharge plans. I hope they're going to give us a game plan for if he refuses to take his medications, refuses to go to school, refuses to go to the day school, or goes back into crisis and starts trashing the house and attacking us again.

I feel my anxiety and stress level rising by the minute. I just hope when they send him home that he's truly ready to come home and not just putting on a good show.

 

[oceans]

Well- I was told that the Zyprexa is more effective than the other AP's, and that is why psychiatrist started my difficult child on that one. She said that if it was effective that we could switch to Abilify at a later time. I know that everyone has different reactions on medications, but Risperdal only helped my difficult child for a short while and pooped out very quickly. The Zyprexa seems to be working better than the Risperdal ever did. Maybe Zyprexa will be better for your difficult child...you can only try!

 

[oceans]

My difficult child was not ready for discharge at the end of his three week stay, and the staff at the psychiatric hospital realized that. They were going to discharge him because the insurance refused to pay, but they transferred him to the state psychiatric hospital intead of home. The state psychiatric hospital had a sliding scale and also an Residential Treatment Center (RTC) if he needed one. I don't know what options you have where you live, but if he continues to be a threat to himself and/or others there might be other possibilities other than home, or the psychiatric hospital where you are at right now.

I am hoping for you that the Zyprexa works!!!

 

[Alisonlg]

Thank you! Is it normal to only try a new drug for a day or two and send him home? He won't be starting the new medication until his 8 pm dose I imagine. Last I heard they were planning on sending him home Wednesday. Guess I'll find out more at our meeting tomorrow at 4 pm.

I hate that I think of questions AFTER I hang up the phone or leave the SW's office. I swear I get dumber and less Witty every single year.

 

[oceans]

I have had someone tell me that their difficult child was sent home a couple of days after a medication change so I guess it happens. With my difficult child they did not want to continue with the medication changes unless we wanted to move forward with the Residential Treatment Center (RTC). They either wanted to do it in the Residential Treatment Center (RTC) setting or have the outpatient psychiatrist do it when he came home. The Zyprexa worked pretty quickly with my difficult child, so maybe you will see results pretty soon.