medication Wash While Inpatient at psychiatric hospital

On_Call

New Member
I couldn't decide which posting icon to use for this post.

difficult child has been through a lot in the last month or so. First, as you might remember, he was in the E.R. and lithium was at toxicity levels. He was removed from the lithium at that point.

Fast forward to a month later (2 weeks ago) and we were in the E.R. again for the same behaviors. This time, he was admitted.

Initially, psychiatrist at inpatient facility added webutrin. Then, true to form, difficult child had no problems/incidents while there - went a whole week with no issues at all. psychiatrist was considering discharge. I met with psychiatrist and social worker in charge of difficult child's case at psychiatric hospital. When we discussed difficult child being discharged and returned to collaborative day program, difficult child flipped out. It was decided to give him a few more days, although our ins co. has decided that anything beyond that day is not 'medically necessary' and therefore they will not be covering it.

I spoke with difficult child's usual psychiatrist (whom I love) and therapist and we decided that we would like to see what difficult child's baseline without medications is, so I met again last Friday with inpatient psychiatrist and had to argue, beg, cry, etc., to get him to agree to weaning difficult child off the seroquel and then off the welbutrin to see what we've really got under the surface of medications. husband and I are in agreement - we have given difficult child medications for 7 years now. We've been through about 15 medications, if my count is accurate. Nothing has ever seemed to make a marked difference. We also believe that while difficult child is inpatient, this is the safest, most ideal time to give this a shot.

So, while it has been a bit scary for us, the weaning off of the seroquel is almost complete. Tomorrow he will have none. Then, they will remove the welbutrin and we'll see what we're left with. I must say that, so far, there is no negative difference. I visited with difficult child last night for more than an hour and he was funny, at ease, appropriately talkative and expressive. He said he had a stomach ache yesterday, but has been sleeping (which we were afraid would definitely be interrupted by the removal of the seroquel) and felt pretty good. I was sad when it was time to head home.

In fact, on my way home, I cried because difficult child seems so well - if only he could be like he was last night all the time. I know it may sound weird that I cried when he's doing well, but it's like I caught a glimpse of a problem-free difficult child and just loved that for at least that moment he was comfortable in his own skin. Does that make any sense? I don't mean 'problem-free' for me - I mean 'issue free' for him. He tries so hard.

The psychiatrist is sure that difficult child will require a mood stabilizer of some sort and some dosage when everything is said and done and I have no problem with that. I am not anti-medication, but husband and I would like to know that what we are doling out to difficult child each day is doing some good, you know? Hopefully, we have made the right call here and will see something positive at the end.

You see, I still have hope - that's something, right???

Thanks for listening.
 

timer lady

Queen of Hearts
Jamie,

We've never accomplished a complete medication wash! Even in the hospital psychiatrist's backed down on finding a baseline for either of the tweedles.

Good job in advocating for your difficult child! Crossing body parts & rattling beads that, when all is said & done, difficult child is stabilized & able to come home.
 

On_Call

New Member
Linda,

Thanks. We, too, are hoping that this has a positive outcome. Scary, though, I'm not ashamed to say. Believe me, the psychiatrist on call at psychiatric hospital did not want to go this route, but I kept arguing the point - and difficult child's own psychiatrist came into the meeting and was a great help, too. We were lucky to have inherited this psychiatrist when difficult child's long-time psychiatrist skipped out. Will keep you posted.
 

lordhelpme

New Member
what i wouldn't do to see if the current medications are making a difference or if he would be the same or worse.

i hope this gives you some answers one way or the other.
 

Sara PA

New Member
medication washes should be done for longer periods than just getting the person off the medications. I believe they should last for months.

First you need to get the medication out of the system. Then the body needs time to change to whatever state the brain (in this case) is going be base. These drugs cause physical changes in the brain (increased receptors, for instance) and those changes are often reversed when the drug is stopped. That can last months and it can cause reactions which can be misidentified as "disorders". Starting medications at that point may, in reality, be medicating withdrawal symptoms.

What you are left with within a week or two of a medication wash is not likely to be related to what you are left with two months after a medication wash.
 

kris

New Member
<span style='font-size: 11pt'> <span style='font-family: Georgia'> <span style="color: #006600">jaime, i hope this gives psychiatrist & you some insights into what is going on & a clearer picture of what he need medication~wise.

you did a great job.

kris </span> </span> </span>
 

On_Call

New Member
Thanks everyone. I am not sure how long they plan to have difficult child be medication free. I will meet with yet another inpatient psychiatrist next week to talk about a plan. I do realize it can take a long period of time to really get a true baseline. We are prepared to do whatever we have to do. At this point, we don't even know how long they plan to keep difficult child inpatient. Family and friends keep asking me and I just have to say that we just simply don't know yet.

We know that we could be looking at a long, bumpy road, but so far it's not that different from the one we've been on - and at least, hopefully, we'll get a handle on what is and is not helping difficult child to reach his best potential.

I actually feel like I've been holding my breath for several weeks now - waiting, wondering & worrying and yet still hoping for the best.
 

timer lady

Queen of Hearts
Jamie,

I hesitate to suggest this but is there a Residential Treatment Center (RTC) facility that will continue the medication wash? I know that with wm, psychiatrist attempted to work on a medication wash with wm while in Residential Treatment Center (RTC) - with-o medications though, he was far too unstable. wm was in Residential Treatment Center (RTC) for 11 months at that placement & we got him down to one medication.

All involved felt that it wasn't good for wm to be with-o the medications; to be that totally out of touch.

Residential Treatment Center (RTC) also worked on skills training & behaviorial interventions - that was the plus. Some of those skills stuck.

However, it may work for your difficult child. Just a thought.
 

On_Call

New Member
Linda,

The nearest appropriate Residential Treatment Center (RTC) is more than 3 hours away. No one on staff has suggested that yet, but husband and I know another family whose son is placed there right now and who went through the same program we are currently in, so that may be an upcoming issue. We have thought of that, although we dread it. We are fortunate enough that the psychiatric hospital difficult child is in is only 45 minutes away and one of us is able to visit almost daily. 3 hours would of course limit our visits to weekends only. If that is suggested, we will have to seriously consider it. Again, as I know you well know, we have to find the safest place for difficult child while he's going through all of this.

I know that the medications withdrawal is a gradual thing, but so far, we have noticed no significant difference in difficult child's behavior or actions off the lithium and discontinuing the seroquel. I know that could change today - maybe he is in crisis at this very moment - but so far, nothing. Of course, we have to take into consideration that difficult child right now is inpatient - plentiful staff on hand to redirect and reinforce behaviors, etc. difficult child might very well be reacting differently if he were home and facing the challenges/stimulants, etc. that being 'on the outside' entails.

So many questions and unknowns. I truly appreciate your support. Many thanks going out to you, Linda. :wink:
 
Jamie,

Basset Hound had a medication wash while inpatient, best thing we ever did. It IS a long bumpy road, but well worth the wait.

Prayers and hugs.
 

On_Call

New Member
During our visit last night, difficult child requested I bring his violin. He spent almost our entire hour long visit playing tunes and practicing. Last night was his spring orchestra concert and I think he felt better in a way that he was playing his violin while the concert was going on. He asked me to email his orchestra teacher to apologize for his absence. She knows he is inpatient, but I will drop her a line and let her know how he is doing. We are fortunate to have a great many people who know and like difficult child and are very understanding of his situation.

Today will be the first day without seroquel at all. He said he has felt pretty much the same. Staff commented that he has been doing well - even taking his 'correctives' without incident.

Thanks for crossing your fingers and rattling your beads.
 
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