Need input before psychiatrist tomorrow

[pepperidge]

Hi

difficult child 2 has been on Abilify (very low dose) for a few years for impulsivity, getting in other kids' space etc. He has major focus issues. executive function etc.

Stimulants made him miserable, have tried just about everything else. (Abilify is only AP though). We finally decided to d/c it for a while to see if was actually do anything since he kind of seemed to be irritable all the time. His mood has improved, much less irritable, less aggressive, though that hasn't bee a big problem. (He doesn't rage at all). But the impulsivity has gotten worse. Teachers are complaining etc. He has Fetal Alcohol Syndrome (FAS) ( not too bad), ADHD, not at all clear there is actually a mood disorder, definitely not on spectrum. He has been neuropsyched and psychiatristed and tdoced to death.

We go to see the psychiatrist tomorrow. I'm not sure what to suggest or where to draw a line in the sand. This kid has tried about 12 medications or so (Ritalin Adderall, Focalin, Tenex (disaster), Strattera (gave him tics), Prozac, Wellbutrin, Abilify, Lamictal, Trileptal that I can remember for now. psychiatrist had suggested we try Risperdal back when we were concerned about irritability and anger, but I'm thinking that the Abilify was partially responsible. I really don't want to go to Risperdal with the weight gain issues unless there is an overwhelming benefit.

Maybe there is nothing left to try. I think that drugs that kind of make him sleeply also tend to make him irritable. But stimulants made him really irritable and perseverate even worse on ideas (like going shopping at midnight).

Anyway, all you wannabe mom psychiatrists out there, anything I might think about suggesting? Anything that helped your kids with impulsivity, focus?

Thanks. Desperate here for something to help this poor kid, who really does want to do good, but can't seem to.

P.

 

[RWHangel]

Just want to add my input here as I am very picky myself about my kids medications. My difficult child is currently taking Concerta, Resperidal, and Clondine. Here is my 2 cents worth my difficult child is very large and only 6 so weight was a big issue for me too but I had to wiegh out what really causes the wieght gain is an increase in appatite. difficult child is currently 4'2 and wieghs in at 87lbs so already big. While in the hospital her doctor recommended Geoden for her aggression I declined due to sever side effects including liver failure and death. I will not allow that so I said we would deal with the possibility of wieght gain. There are times I have to remind her after she just ate and starts asking for more that her medicine makes her think she is still hungry and to give a few minutes if she is still hungry she can have more veggies or a piece of fruit that seems to work. She has a wieght complex as it is so this way of explaining it works. As to its effects she is a totally differant kid. I am actually impressed with the medications she is on. I actually took her off Trazadone (another one started at the hospital) after she came home and I noticed an increase in irritability and aggitation. So my recommendation is give it a try I have a totally differant kid and I am thrilled. Honestly you are the mother you know when things are just not for your kid take the chance if you don't like the reaction take your difficult child off it. Do your research too some medications have horrible side effects that unless I really really had no other choice I would not allow mine to take. Praying for you and your family.

 

[BusynMember]

Fetal Alcohol Syndrome (FAS) is a neurological disorder (it is actually organic brain damage). Does he have the entire spectrum or just effects? Either way they cause lots of trouble and the brain damage can't be healed. Have you thought of taking him to a center that understands Fetal Alcohol Syndrome (FAS)? Frankly, most psychiatrists don't. There is a clinic in Chicago just for kids who were exposed to substances in utero and it's nothing like a psychiatrist appointment. I took my son when we first adopted him to see if they felt he had Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE).

There may be something like that near you. I'd certainly try it. Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE) is bad. All the kids have trouble remembering day-to-day and tend not to "get" right from wrong. It is a lifelong problem that is different from a mood disorder or ADHD, but can look like both. Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE) kids and adults both need high level supervision and that doesn't change. medications can take the edge off sometimes, but not cure the problem.

I suggest reading "Fantastic Antone Succeeds" about Fetal Alcohol Syndrome (FAS). I don't know the author anymore, you can find it in your search engine. Good luck!

 

[timer lady]

I agree with MWM ~ there is a lot more to Fetal Alcohol Syndrome (FAS); a lot less that is untreatable medication wise. You end up treating the symptoms but the syndrome is life long & life skills need to be implemented.

Social, emotional, community, etc ~ double duty on help in those areas.

Good luck, maybe psychiatrist has some new ideas.

 

[crazymama30]

My difficult child had did not respond well to stims, could not tolerate them at all. He does well on a mood stablizer with daytrana. I think the daytrana is easier to tolerate for him as it releases a smaller amount into his system at a more reliable rate, not just half the dose now half the dose later. I know for my difficult child that all of his medications play a part, but the stimulant and the ap do the most for his impulsivity/hyperactivity.

That being said, my difficult child has definate cyclic mood disorder. It can be traced back 3 generations, and once you get to know him there is no doubt. I do not know anything about Fetal Alcohol Syndrome (FAS).

Hugs. I hope that something can be done. It is so hard when they want to do well, but they just can't. They can have such good hearts.

 

[smallworld]

I agree with consulting an Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE) specialist. Perhaps you will get some ideas on how best to medicate your son.

My son's Residential Treatment Center (RTC) specializes in "processing" kids -- kids who have large discrepancies between their verbal IQs (high) and processing IQs (low). Does your son have this profile?

If so, Seroquel is often used by the Residential Treatment Center (RTC) psychiatrist. My own son does very well on Seroquel. I know it causes weight gain, but in this case benefit has outweighed risk. In addition, my son lost 22 pounds while in wilderness over the summer. He has continued to keep the weight off this fall while working out at his Residential Treatment Center (RTC).

Good luck. Let us know what the psychiatrist recommends.

 

[pepperidge]

Thanks for the input. Yes, both of kids have a large gap between verbal IQ and processing. I'll find it for you. What did the seroquel do on that score? I am really interested in what you found...

More later to those people who asked about Fetal Alcohol Syndrome (FAS).

It is complex and I haven't found a clinic that treats it. It was diagnosed by child developments experts when he was young and he fits the profile quite well, though his intellectual functioning is pretty much on traget. I keep wondering if a therapist who is really trained in Fetal Alcohol Syndrome (FAS) would take a different approach. We've got a pretty good one now, but I wonder. I haven't had any luck identifying the best place for treatment. Lots of places identify Fetal Alcohol Syndrome (FAS) but don't really treat it throughout the lifecycle. Are the treatment issues really different? I don't know, and havent' found any reliable info.

Thanks for the reponsese...I'll read them again when I am not so tired.
P.

 

[BusynMember]

Well, yes. The entire approach to the child is different. If he has Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE), it can't be cured and the kids tend to forget what you teach them day-to-day so teaching them social skills, for example, isn't very helpful. They are "swiss cheese" thinkers. They may know something one day and totally forget they were even told it the next day. They tend to break the law then not comprehend why they are in jail. They require HIGH LEVEL SUPERVISION and it never changes.

Maybe this isn't your child's problem. Have any genetics test been run? I *think* Fetal Alcohol Syndrome (FAS) can be found in blood tests, BUT Fetal Alcohol Effects (FAE) can't. And Fetal Alcohol Effects (FAE) is pretty much the same as Fetal Alcohol Syndrome (FAS) minus the physical differences. If you find out your child is on the alcohol spectrum your expectations can change, you can relax and know your child is doing the best he can, and you can plan for the future accordingly. medications won't fix the problem.

BUT...until you see somebody who understands Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE), I'd wonder if he even has it. This is out of a psychiatrist's area of expertise. It isn't as easy to diagnose or as well known as it should be. The only reason I know anything is because I adopted a child who was exposed to drugs. And if she said "yes" to crack, she didn't say "no" to alcohol. Luckily I lived near Chicago, which has an excellent Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE) clinic. Sometimes it requires travel. Another good book is "The Broken Cord" by Michael Dorris.