Need some thoughts on medications please

Discussion in 'General Parenting' started by Jena, Aug 24, 2010.

  1. Jena

    Jena New Member

    good morning:

    bringing difficult child to meet new art/biofeedback therapist today if i can wake her. she was up again last night. it isnt' a dad transitional thing, that did make it worse because dad lays with-her. it's a "her" thing. She's been doing it for soo many mos. now i've forgotten. Our day's end here around 3a.m. i'm totally worn down to be honest. Happy on my signature isnt' really the truth, depressed is more like it.

    so, here it goes. i'm going to list what difficult child is displaying, what i'm looking to help and maybe you guys can share with-me your experience with-medications pertaining to these things. i unfortunately got dropped by our old pyschdoc, looking for a new one. yet in the interim i have a pyschdoc's office and a nurse practioner who is now medicating her. crazy i know. she doesn't have the qualifications and i'm looking fora new one. yet in the interim i gotta find something for difficult child because school starts in two weeks and she just wont' make it in the door at this point.

    she is:

    obsessing - Obsessive Compulsive Disorder (OCD) is kicking in bad - not rituals obsessive thoughts, reoccuring especially at night.
    anxiety - severe.
    manic - i'm seeing it; hard to decifer some nites if it's that i'm seeing or the anxiety. i think their both present.
    depression ; is kicking in. self loathing somewhat; hopeless etc. why am i like this?
    wetting bed ; always a constant.

    i've tried:
    antipsychotics - a no go tried several either don't work or weight gain and side effects too severe.

    benzo's - would love to go there again. tried prozac while back she went manic on it had a very hard time; yet that was two years ago.

    antidepressants, mao's ; didnt' spell right sorry lol. she also went manic on these.

    the only thing i havent' tried is a mood stabilizer. which right now wont' combat what i'm looking to assist or help with.

    it's very hard with-difficult child as you can see. alot of medications do not work. we tried natural they dont' work. it's like giving her candy. tried roots, teas, natural supplements, all a no go so far.

    any thoughts would be greatly appreciated. this nurse doens't know her medications at all. so she sits there and is zero help and tells me to go home and research. insane, and yes need a strong pyschdoc yet can't find any here in n.y. at this point.

  2. Jena

    Jena New Member

    any thoughts........... i know none of us are doctor's here........ yet experience speaks volumes :)

  3. JJJ

    JJJ Active Member

    Two medications that helped Tigger with those:

    The best for him....Clonodine. It comes in tiny 0.1mg tablets and we brake them in half. He gets 1/2 tab three times a day and 1 full tab at night. That is a very low dose but he's doing okay with it. Too high a dose with make them drowsy (It is typical to be drowsy the first week while their body adjusts.) This is technically not a psychiatric medication and is 'on label' for high blood pressure but it really decreases the anxiety and hyperness/mania related to it.

    One that helped take the edge off...Buspar. He was only on it a short while but it got him through an anxiety filled few months.
  4. Jena

    Jena New Member

    JJJ - thanks. we did clonidine already, we cant' do that anymore.

    buspar - is that a benzo, quick hitting sort of medication. going to research now. thanks for thoughts. we are searching for a long term medication also. she has no self control yet with-her all stuff.
  5. smallworld

    smallworld Moderator

    You really need to get your daughter in to see a child psychiatrist who has a lot of experience with medications and will work with her over time to get the medications right. It's not a quick fix. There's also a chance that she might need more than one medication.

    Lamictal is a mood stabilizer that works on the depressive end of the mood spectrum. It is weight-neutral and has few side effects if titrated slowly.

    Sometimes kids who can't handle SSRIs on their own can handle low doses of SSRIs once they're taking a mood stabilizer; But it's very individual.

    Sometimes you can consider other types of antidepressants, such as SNRIs, tricyclics or atypicals.

    JJJ mentioned some good options. Buspar works for anxiety. Unfortunately, it made my son dizzy, and he couldn't tolerate it. Clonidine helps with sleep and sometimes impulsivity.

    Many kids who can't handle antidepressants have to take APs. They do work, but they cause weight gain. You have to weigh the benefits against the risks.
  6. Jena

    Jena New Member

    small i agree totally with-the dr. thing. i'm trying............ our last pyschdoc wont' take us back due to tapering off medications due to extreme weight gain and high sugars, also because she's known as complicated case apparentley and he didn't wanna deal.

    i'm searching for dr. now yet it isnt' easy thru insurance. that is def. what i need and have needed. doctors' here bite bigtime. good idea with-other ones. cant' do clonidine anymore. did that fora very long time had severe side effect while back with-blood pressure. great idea though.

    i'm going to write down what you wrote, also and keep searching.

    she's in shut down mode now. refusing therapy, medications, etc.
  7. DammitJanet

    DammitJanet Well-Known Member Staff Member

    Why no mood stabilizers? Buspar does work for anxiety and it isnt a fast acting benzo type medication. You also may get a doctor to try vistaril at her age.

    Lamictal is a mood stabilizer that works on anxiety, mania and depression. Topamax works on anxiety and mania though its not commonly used. Neurontin too. Im listing the more uncommon ones. Right now I am irritated with the AP's because I just realized seroquel caused my cholestrol to skyrocket so I am leery of them so cant feel right saying they are good for kids unless you really watch closely.
  8. Jena

    Jena New Member

    yes i agree seroquel is rough. it's come into alot of scrutiny past several mos. here. doctors getting kickbacks, etc. she didn't fare well on it although it did help with-all of it. yet she gained 25 lbs. and depression kicked in, kids made fun of her at school etc. than sugars went too high.

    overall this all bites bigtime. i'm soo done with-it all. i used to bounce back quickly i'm not anymore. if it keeps up i'll have to medicate for depression i think. sorry you had rough time with-the seroquel.

    this nurse practioner doens't know squat
  9. DammitJanet

    DammitJanet Well-Known Member Staff Member

    My lamictal, topamax combo works really well. Im also on a boatload of other stuff for all my other junk too though. Gosh when I have to list my entire medication list I feel like I am spouting a pharmacy
  10. Jena

    Jena New Member


    you know what though, it's all that which gives you information and experience and being extremely helpful. alot of times when i speak to these doctors they are asking me to research the medications. i need someone to take charge of this situation with-her finally a strong dr. who is bold and aggressive yet compassionate when it comes to her. haven't had any luck thus far.

    just got a number for a psychiatric doctor and left a message, here's hoping theyl'l be able to help. called the new school she'll be entering also let's just say that was a joke. beginning to think i should home school and move far away with-her.
  11. totoro

    totoro Mom? What's a GFG?

    K is a very difficult child to treat, some of her diagnosis's I have not listed, like Tourettes and some of her Obsessive Compulsive Disorder (OCD) traits- some of these are just part of her other diagnosis's- She also has Hallucinations and Psychotic Tendencies.

    But right now with her Therapies and intense home schedule and structure we are able to keep her on just Lamictal and a very low dose of Focalin. We will likely have to change this soon because she is having an increase in break through mania.
    She has not been able to take AP's for various reason, but our kids change and over time they may be able to revisit different medications.

    We may put her on a tiny dose of an AP again and see if it can touch her break through issues.
    She did not do well on Lithium or Depakote, this does not mean we will never try them again.
    She has been on over 20 medications in about 4 years. Hormones and age change how they react to medications. Never know especially with AP's and MS.
    We are on our second trial of Lamictal, this time it is working great- might need and adjunct.

    We just never know with our kids- they are very complicated. Took me awhile to figure mine out, just like Janet. I am pretty good on Lamictal, Topamax, Xanax and Trazadone.

    Good luck- A great psychiatrist is hard to find
  12. Jena

    Jena New Member

    have you been with same treatment providers entire time? i'm sorry it sounds like a struggle for you also, all these years right? and it always seems like somehow we are back at square one with-our children. how do you cope thru it all? i used to cope pretty well, i dont' anymore i'm wearing down.

    help me out with-this........ what type of provisions do you make at home to help her? Our life is forever changing especially with the influx of my step kids two days a week and that always changes dependant upon their mom and her whims.......

    like right now i can't get her to take a shower. sounds absurd yet she wont. bribed her with-ill go get you some school clothes yet that isnt' working either.
  13. susiestar

    susiestar Roll With It

    Well, I was going to say that the nurse practitioners that I have dealt with, esp in the pediatrician psychiatric field, were vastly better than the psychiatrists. This sure is NOT the case with yours. It is rather scary, in my opinion, to have the nurse want YOU to figure out what to give her. Of course she and the doctor may feel that the way you question them is a PITA so they want little to do with you (which is incredibly unprofessional of them!). If this nurse will write an rx for anything you want, take a voice activated recorder to the appointment in your pocket. The state group that licenses her NEEDS to be aware of this as it is highly dangerous!!

    I would NOT use neurontin or Lyrica (next generation of neurontin) with her. The pharm co that made it marketed it as helping to stabilize moods for patients with bipolar. They paid a LOT in fines because there is very little evidence of it doing anything for bipolar. I am aware that some docs still like to use it, but the evidence had to be VERY strong or the FDA would have done zilch about it.

    Many of her symptoms could be bipolar or autistic, in my opinion. Or just anxiety based. it is so hard to figure this stuff out!!! At this point it seems like giving her a few months on mood stabilizers might be an excellent idea. It can take up to 6 weeks at the therapeutic dose to see if it is helping, and you may need to try a few of them, but they might make a big difference.

    I hope the appointment with the new doctor is wonderful.
  14. Jena

    Jena New Member

    Susie hey how are you? thanks for the response. i'm just jotting all this down. i'm not going back to the nurse practioner. i'm awaiting call back from pyschdoc difficult child's peditrician recommended today. here is hoping. yet it's helpful to have all this info. it seems alot of times the doctor's are truly clueless at least one's i've had to deal with.

    difficult child was diagnosis with bipolar several times by several diff. pysch doctor's. who knows though her anxiety and Obsessive Compulsive Disorder (OCD) and some manic symptoms is what im seeing lately. i try to stay more focused on treating the symptoms these days than getting the diagnosis. time has taught me that much.

  15. ML

    ML Guest

    It is so hard. I hate that manster is on three medications! And I put it off as long as I could. For so long I thought about the consequences of medication and finally weighted it against the consequences of NOT medicating. The psychiatrist recently said the one medication that would hit all the symptoms was risperadal but because he is already overweight and pushing the diabetes levels, those side effects would just not be worth it. The combo that takes the edge off for him is clonidine, zoloft and ritalin. I encourage you to keep looking for the right combinations. I feel your exhaustion and I will pray that you find some relief! Hugs, ML
  16. barneysmom

    barneysmom Member

    Hi Jena,

    Did she say specifically why she doesn't want to take a shower?

    Gfg13 has had sleep problems since forever. I have tried joint compressions, incense, breathing, aromatherapy, massage, accupressure points -- you know the drill. For sleep we have tried melatonin, Elavil, Trazodone (none of these worked) Remeron (made him manic), Seroquel (worked great but he got the dreaded TD).

    I'm not comfortable with him wandering the house either. Now he must go into his room at 10 PM and stay in there. We leave our bedroom door open a couple inches anyway so the dogs can get in and out. Regarding medications -- we are re-visiting Trazodone and it seems to be working (only on the third night).

    Did you mention if you had tried clonidine? That worked well for gfg17 for quite awhile. Gfg13 is on Intuniv -- a long-acting Tenex which is similar to clonidine. Intuniv is supposed to help with aggression and attention.

    Also sometimes beta-blockers are given for anxiety, like Inderal. Slows the kid down a bit. Regarding benzos -- some kids need benzos for a bit to break the cycle until they can be stabilized (in my experience).

    Gfg13 is very anxious -- he's a picker too, especially during the school year, he would have a lot of open scabs, and tons of somatic complaints due to anxiety. I've thought about Buspar for him too. That was going to be our next step after Intuniv.

    Oh we also tried Prozac as an AD with anti-anxiety effects. Didn't work at all. we notice terrible bruising on his arms -- a sub took him to the guidance counselor about it. Turns out the SSRI's cause bruising. Who'd a thunk? Tried Depakote -- cognitive dulling and flat affect.

    HTH some. Just brainstorming with our experience.
  17. Jena

    Jena New Member

    wow, that sux and by the way all of you guys sounds like doctor's lol. i thought i was bad with-the lingo that loses my husband at times......

    sounds like you are where i am. you must be exhausted. seriously exhausted. yes tried clonidine for years had serious side effect had to stop that affected blood pressure went way way too low. i hated that medication.

    isn't it kinda crazy there is no natural supplement to help our kids??
  18. barneysmom

    barneysmom Member

    Well there is Calms Forte -- that is OTC, not sure what it has in it -- it's a homeopathic. I've tried it a couple of times and it worked gently. Valerian. Magnesium supplements for anxiety. Omegas. Chamomile.
  19. totoro

    totoro Mom? What's a GFG?

    Sometimes it is just the whole "pick you battles", K will just refuse to shower... I can tell that pushing her will send her up too far. If there are other more pressing things that she needs to do then the shower takes a back seat. Other times, because I know once in the shower it helps K calm down, I will push her a bit more. I think it is one of those- gauging the mood type of things. We are pretty lucky still though- K is not a manipulative kid.

    Like homework- I can tell if her mind is racing too much and she is just spinning (her mind) and can't focus no matter what we do and she is becoming way too agitated we may revisit it. Otherwise too bad, we just don't do it.

    We do a lot of heavy work especially right after school- she is on fire after holding it together all day. She comes out of that school like a whirling dervish.

    We will have her do push ups, swim, ride her bike, sit ups, yoga, squeeze her... whatever she will tolerate. if she is depressed we go the other route- let her read or get a snack and just chill. Maybe even go on the computer or watch tv.

    Right now our lives are kind of on hold because she is not able to do much after school. But this is our reality. We can only swim because the in-laws live right around the corner and we keep it short.
    Can't even bike right now because it is over 100.
    We will see about the medications next week and go from there- it is so tiring some times and she gets tired of it all.

    One of the huge things for us if that we have always kept her involved- the psychiatrist talks to her first and then us and then all of us. if medications are changed she shows K on a chart and explains it all to her. We take some time to think about it if we don't know already how we feel.
    We are always open with all of it with K and ask her how she feels and what we can all do better etc.

    We are on our 5 psychiatrist! we lived in a very small town and had to travel- first to Chicago for the diagnosis. Then 2 horrible psychiatrist's in Idaho. One very brief visit here in AZ with another horrible psychiatrist and now with our wonderful psychiatrist for 2 years now.
    We moved from Idaho just to find better help for K. We are now looking for a better school placement for her. A day school.

    Of course what works one day will not work tomorrow!
  20. Jena

    Jena New Member

    barneysmom hi. thansk we tried all of those. none work.