New psychiatrist visit and diagnosis

[smallworld]

You can see the effects of Risperdal within a few days. But full efficacy is reached at about one month.

I know I said this before, but I would strongly recommend seeing a pediatric endocrinologist. Blood glucose issues fall under that specialty.

 

[AllStressedOut]

Are the tests different with an endocrinologist? If they are the same test, can I just bring in test results for an evaluation by one?

 

[smallworld]

3sacharm, our three psychiatrists are not big fans of atypical APs either because of the side effect profile and because they haven't been around long enough to know the neurodevelopmental effects on children. That's why my older two kids aren't on APs. But my youngest is because she has a severe eating disorder and Zyprexa treats it. When we lowered her Zyprexa this summer, her eating disorder symptoms returned.

 

[smallworld]

ASO, I don't know if the tests are the same, but you should always bring in previous lab results to a new doctor. It may also be that the endocrinologist will interpret the tests differently (because he knows more about the issue) or have more specialized tests that can pinpoint exactly what's going on. Furthermore, the endo may give you more precise info on treatment -- for example, what your difficult child can and cannot eat, which could make a huge difference in his and your life.

 

[AllStressedOut]

I'll ask my husband if he can find one in our insurance plan and get us in there. Thanks for the recommendation!

 

[flutterbee]

I hesitated responding because my opinion may not be all that popular. I also have a nasty cold and am having a hard time gathering my thoughts, so bear with me.

I would never be comfortable putting a child on such strong medications as risperdal after only one visit. Especially when the diagnosis the psychiatrist is handing down seems to conflict with the neuropsychologist report. I simply do no think you can diagnosis anyone - child or adult - in one visit. Too many things share similar symptoms and one thing can easily mimic another.

Another thing I've found is that some psychiatrists and tdocs seem to specialize in one area and then you find that most of their patients end up with that diagnosis. For example, I had a therapist who specialized in borderline personality disorder. Most of her patients had that disorder. Now, some did have that disorder and saw her because she specialized in the treatment of it. However, she didn't exclusively treat Borderline (BPD) patients, yet she seemed to have an inordinately high number of patients with it. Because she specialized in it, she was always looking for it and she found it even when it wasn't there. I had the diagnosis of Borderline (BPD) for a while, however I only exhibited symptoms or traits when I was extremely depressed. When the depression was gone, so were the traits. Does that make sense? I wasn't really borderline, the depression mimicked some of the behaviors and that's what she saw instead of looking at other possible causes.

I've run into the same thing with psychiatrists. I've found psychiatrists who seemed to have a lot of patients with bipolar disorder. It was something they specialized in and they "saw" it in a lot of patients.

Have you ever read the DSM? So many disorders share a lot of the same traits and symptoms. To be able to distinguish between one or another takes time...certainly more than one visit.

Just my two cents.

 

[AllStressedOut]

What is DSM?

I would agree that it seems whatever these docs specialize in is what the majority of their patients have. The problem is, finding a doctor who doesn't specialize in something and/or isn't drawn to one diagnosis over another. It seems impossible.

 

[flutterbee]

The DSM (currently being used is DSM-IV - which is the fourth version) is the Diagnostic and Statistical Manual that contains the criteria for all of the various disorders. Every so often, a group of psychiatrists get together and decide what needs to be updated, added, removed or changed and they come out with a new version. I believe, but am not sure, that they are working on the DSM-V now or in the near future. I've heard talk, anyway.

The thing is when you have no definitive medical tests that can diagnosis one thing or another, I feel that you need to take the time to really look at everything going on and treat things as a rule out basis. Not only with mental health, but with physical health, too, where there are no definitive tests. It seems that our medical profession is too quick to jump to a conclusion. Whether that's catering to insurance or a desire to provide answers to patients, or a combination of both, I don't know. Personally, I'd rather wait for answers and know they are right.

 

[BusynMember]

The problem is, if he has Autism Spectrum Disorders (ASD), he also needs aggressive interventions. medications alone won't do it and talk therapy doesn't help Autism Spectrum Disorders (ASD) either. So it's good to know if it's there.