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More medication tweaking... what's your take on this?
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<blockquote data-quote="gcvmom" data-source="post: 157805" data-attributes="member: 3444"><p>Sara, here's the history:</p><p> </p><p>He was diagnosis'd this past March with SC. SC is believed to be caused by an autoimmune inflammatory response to strep infection and can result in damage to the basal ganglia.</p><p> </p><p>He's had ongoing shakiness at various times at least since he was 4 (it's documented in an old 2000 report by a speech pathologist). He would be a bit shaky and jerky when he woke up. He wouldn't want to play with anything that required fine motor skills (Legos, drawing, etc.) He did have two positive strep cultures at age 2-3, but they were treated.</p><p> </p><p>He was diagnosis'd with-ADHD at age 5 and started on short-acting Adderall. He was eventually put on Concerta upon starting kindergarten. The next year, Zoloft was added because he was having increasing difficulty controling impulses on the playground (by October, he had 4 behavior citations, several detentions and was put on a behavior contract in school). Zoloft made things worse and in retrospect he was sort of hyopmanic. So it was d/c and we added Risperdal, which seemed to help for the next two years. by the way, he always seemed to need more stimulant than his brother in order to acheive the same effect.</p><p> </p><p>In 2005 he had a suspected strep infection while we were on vacation that was only partially treated with antibiotics (our pediatrician had called in a scrip for what was initially a persistent cough that would not respond to the usual treatments, and then developed a fever. After a day or two on the rx he broke out in a fine red rash -- I thought it was allergic reaction, but we now believe it was scarlet fever -- so I stopped giving him the antibiotic). </p><p> </p><p>16 months later, his handwriting suddenly became horrible (writing samples are like night and day) and he started having more mood problems and issues on the playground. And the stimulant became like water no matter how much he took. At the time, he was on Concerta and Risperdal.</p><p> </p><p>psychiatrist switched him to Abilify, and that was o.k. for a couple of months, but then he started to deteriorate again. More of the same with playground issues, impulse control, etc. psychiatrist added Tenex. difficult child became MMMMMAAAAANNNNNIIICCC. EXTREMELY pressured speech, flight of ideas, paranoid and almost delusional (he thought he could tell what strangers were thinking), hypervigilant, hyper-hyper-hyperactive.</p><p> </p><p>At that point, we stopped everything for two weeks and then started from scratch, this time adding Depakote ER first. That seemed to help a lot. After two months, we added a low dose of stimulant to see how he'd tolerate it and he seemed fine. (He now is on Daytrana and takes 1/2 the amount his older brother does.)</p><p> </p><p>Five months into this treatment, he still seemed to get emotional and depressed, and he got in trouble for bringing a knife to school and was still having problems on the playground. psychiatrist added Lamictal. Things looked good. In the process of establishing an IEP for him, I saw a neuropsychologist and mentioned the hand shaking and the handwriting issue having coincided with his mood getting worse, and she suggested a neurology consult. </p><p> </p><p>Neuro put him on Zyprexa to address the tremor/chorea but two days into it he had a dystonic reaction (and in hindsight, this also happened to a milder extent on Abilify). So now he's back on Risperdal. The first 1.5mg did some good, handwriting got a little better (not as good as it was two years ago, though) and his cognition and self-awareness even got better. psychiatrist felt we could try to drop the Lamictal to see if he didn't need it anymore with the Risperdal in place.</p><p> </p><p>But I was still hoping to get his handwriting back to where it was, so I asked on Monday to increase the Risperdal a bit to see if it would help. He only went up to 2mg. In the past, he was as high as 3mg. Apparently, that was not a good idea!</p><p> </p><p>So that's how we got here today -- and you deserve a medal if you've read this far!!!</p></blockquote><p></p>
[QUOTE="gcvmom, post: 157805, member: 3444"] Sara, here's the history: He was diagnosis'd this past March with SC. SC is believed to be caused by an autoimmune inflammatory response to strep infection and can result in damage to the basal ganglia. He's had ongoing shakiness at various times at least since he was 4 (it's documented in an old 2000 report by a speech pathologist). He would be a bit shaky and jerky when he woke up. He wouldn't want to play with anything that required fine motor skills (Legos, drawing, etc.) He did have two positive strep cultures at age 2-3, but they were treated. He was diagnosis'd with-ADHD at age 5 and started on short-acting Adderall. He was eventually put on Concerta upon starting kindergarten. The next year, Zoloft was added because he was having increasing difficulty controling impulses on the playground (by October, he had 4 behavior citations, several detentions and was put on a behavior contract in school). Zoloft made things worse and in retrospect he was sort of hyopmanic. So it was d/c and we added Risperdal, which seemed to help for the next two years. by the way, he always seemed to need more stimulant than his brother in order to acheive the same effect. In 2005 he had a suspected strep infection while we were on vacation that was only partially treated with antibiotics (our pediatrician had called in a scrip for what was initially a persistent cough that would not respond to the usual treatments, and then developed a fever. After a day or two on the rx he broke out in a fine red rash -- I thought it was allergic reaction, but we now believe it was scarlet fever -- so I stopped giving him the antibiotic). 16 months later, his handwriting suddenly became horrible (writing samples are like night and day) and he started having more mood problems and issues on the playground. And the stimulant became like water no matter how much he took. At the time, he was on Concerta and Risperdal. psychiatrist switched him to Abilify, and that was o.k. for a couple of months, but then he started to deteriorate again. More of the same with playground issues, impulse control, etc. psychiatrist added Tenex. difficult child became MMMMMAAAAANNNNNIIICCC. EXTREMELY pressured speech, flight of ideas, paranoid and almost delusional (he thought he could tell what strangers were thinking), hypervigilant, hyper-hyper-hyperactive. At that point, we stopped everything for two weeks and then started from scratch, this time adding Depakote ER first. That seemed to help a lot. After two months, we added a low dose of stimulant to see how he'd tolerate it and he seemed fine. (He now is on Daytrana and takes 1/2 the amount his older brother does.) Five months into this treatment, he still seemed to get emotional and depressed, and he got in trouble for bringing a knife to school and was still having problems on the playground. psychiatrist added Lamictal. Things looked good. In the process of establishing an IEP for him, I saw a neuropsychologist and mentioned the hand shaking and the handwriting issue having coincided with his mood getting worse, and she suggested a neurology consult. Neuro put him on Zyprexa to address the tremor/chorea but two days into it he had a dystonic reaction (and in hindsight, this also happened to a milder extent on Abilify). So now he's back on Risperdal. The first 1.5mg did some good, handwriting got a little better (not as good as it was two years ago, though) and his cognition and self-awareness even got better. psychiatrist felt we could try to drop the Lamictal to see if he didn't need it anymore with the Risperdal in place. But I was still hoping to get his handwriting back to where it was, so I asked on Monday to increase the Risperdal a bit to see if it would help. He only went up to 2mg. In the past, he was as high as 3mg. Apparently, that was not a good idea! So that's how we got here today -- and you deserve a medal if you've read this far!!! [/QUOTE]
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