New to Group

[tired Cheryl]

Hello:

I am new to the group and just wanted to indroduce myself. After reading many of your posts it looks like I'll feel right at home here. I belong to an epilpesy group as well but my son's seizures do not cause me the daily problems that his behavior does so, I am glad to have found this forum.

I do not believe there is anything more isolating than being the parent of a child with a conduct disorder. It must be like what having leprosy was like in the bad old days. I feel like it adds insult to injury after I have my son hit, yell, and spit on me daily to have "normal" adults shun me on top of it all. So, I am hoping to find a "safe zone" here.

My story is not unique by any means so, I will not bore any of you with the details. Low-lights from this week: son kicked out of third private preschool, SD refuses to admit him into their PPCD program because he tested academically normal, after being spat on many times in the past had son spit in my mouth, three-hour marathon meltdown.

My son has a neurologist for epilepsy and sees a psychologist at the Children's Hospital weekly for behavior therapy. He was evaluated two weeks ago by a neuropsychologist as well as the SD. SD says that he is not academically impaired. I get the results from the neuropsychologist next week.

My questions for the group:
1.Is there really a good way for the doctors to differentiate between ODD, Intermittent Explosive, and Bi-polar disorders in pre-school age children?

2. Anything on Risperdal! I was terrified to put my son on this drug but after this week I relented. He started taking 0.25mg on Tuesday night and no change so far. It did not make him sleepy like neuro said it would. Darn. I am worried about weight gain-is this as common as I have read about? Does this medicine help anyone out there?

3. Coping Mechanisms that you can suggest for being out in public with difficult child
I am thinking about getting a t-shirt made for my difficult child that says, "Don't Blame My Mom, It's my Frontal Lobe." I am not joking.


Thanks,
Cheryl

 

[mrscatinthehat]

Welcome to the group. I didn't have my difficult children at that age but I wanted to welcome you. There will be others soon.

Beth

 

[mawmastewart]

Hi Cheryl,

This forum is called "a safe place to land" for a reason. I, and many others I am sure, totally identify with the leprosy analogy. You won't be shunned here! Welcome with open arms and available shoulder!

If you market your t-shirt I'll buy 7, one for each day of the week. Maybe we could make another that parents can wear that says, "Don't blame my kid it's a nuerotransmitter/brain development disorder" but then... putting it on a t-shirt won't make believers of parents who are ignorant and only have easy child's. Too bad!

I'd like to make one that lists all the discipline techniques I've tried. "Please don't recommend: James Dobson, Shepparding a Child's heart, 3,2,1 Magic... I KNOW what a time-out is and if you try to give me advice I might need to take one or use the belt on YOU!"

Or how about plain and simple: "you think you can do better... help yourself"

Ok.. I'm outta control. I will be watching your post because I too am probably starting Risperdal with my difficult child next week and I want more info!

You are safe here. Enjoy the virtual respite.

Peace,
Phoebe

 

[Sara PA]

When your son is having one of those meltdowns, does he seem like himself or is there something ....not there? Are you aware that partial seizures, particularly those centered in the temporal lobe, can manifest as emotional seizures? I noticed my son's "tantrums" had a seizure-like quality when he was about 18-24 months but the doctors blew me off. Fifteen years later I learned that I had been right all along. He has temporal lobe partial seizures.

Risperdal and all antipsychotics can lower the seizure threshold. I'm frankly surprised that the neuro would prescribe it. How much Trileptal is your son taking? And how much does he weigh?

 

[jannie]

Hi Cheryl--

Sorry you are going through this. I understand what you are going through and it isn't easy.

When my child was having major difficulties in preschool and was not eligible for special education preschool programs I contacted advocates who helped me find a therapuetic preschool for my child. I'm not sure where you live, but perhaps you can find a program. This program serviced children with average intelligence who were experiencing emotional issues due to things such as anxiety, adhd, abuse, mood disorders etc. At first I thought...oh my child doesn't need a program like this, however, it wasn't working in the typical preschool. It was a very positive experience. The class was taught by a teacher, a social worker and an aide.

Another strategy was reading and implementing "The Explosive Child" by Ross Greene. Many many people on this board recommend this book. I suggest you get a copy of this book.

Medication makes a huge difference for my child. Although I was hesitant at first, my child needed more than just therapy and behavior management. It took several trials before finding something that worked and still...it works for some time and then it stops working, so we need to find a different medication. Risperdal worked well for my son. He was on it for about 8 months...along with trileptal. We discontinued the risperdal due to weight gain and other issues, but it helped. Many people have found positive results with it. Tenex was one of the first medication that really helped my child with his anger and impulse control. So far, how the abilify and trileptal mix is the best. The medication makes life livable...we still have our problems.

Sara asked a good question about the seizure. I know nothing about seizures and antipsychotics. Definately discuss this with the neurologist.

It is hard to differentiate beween ODD< IEP and BiPolar (BP) in young kids. My guess may have to be about the length, frequency and intensity of the rages. It may also have to do with triggers.

It sounds like you are doing alot. Maybe the neuropsychologist testing will give you some answers to unknown questions.

Sending hugs

 

[tired Cheryl]

Hi, Phoebe:

I am ROFL about what you wrote:

"I'd like to make one that lists all the discipline techniques I've tried. "Please don't recommend: James Dobson, Shepparding a Child's heart, 3,2,1 Magic... I KNOW what a time-out is and if you try to give me advice I might need to take one or use the belt on YOU!"

Or how about plain and simple: "you think you can do better... help yourself"

THANKS for starting my day off great. Last night was night four of Risperdal. This am difficult child woke up bossy but not hostile (mornings are usually CRAZY here due to his hostile behavior) so, things are starting off good today :smile:

THANKS
Cheryl

 

[tired Cheryl]

Hi:

Thanks for the great advice. I will definately get the Greene book actually my mother in law told me about it I Googled and that's how I found this group.

The Risperdal was first recommended when difficult child was at Children's hospital having VEEG in June. He had two major meltdowns one of which was directed at the director of the Epilepsy MOnitoring Unit. This doctor is an epileptologist and was the first doctor to recommend the Risperdal. he and difficult child's neuro tell me that they have lots of epi patients on this medicine. I did ask about lowering seizure threshold and they do not see it. I also did an extensive search of the medical literature (I am a veterinarian) and found two papers saying that Risperal does not lower seizure threshold. My concerns are about the obesity, diabetes, TD, etc...


Do you guys have personal experience with it lowering seizure threshold?

difficult child is taking 240 mg Trileptal twice day and he weighs 38 lbs. I was very hesitant to start ANY medications and it took them months to convince me that this was the medication for him. I am very conservative medication-wise but things are getting worse so, I had to relent to the Risperdal.

When he is having a meltdown it does appear to be one of the "sides" of the non-seizing him. When he has a easy child seizure he usually looks like he had a stroke, mouth open, can't talk, staggering etc. Meltdowns vary but are usually very aggressive and very verbal LOL During his VEEG they did observe the two meltdowns and there was no seizure activity associated with them.

Whew! I think that covers your questions. Thanks for asking. Off to work.

Thanks!
Cheryl

 

[Marguerite]

Our experiences with risperdal show that it really does depend on the person.

difficult child 1 is ten years older than difficult child 3. Both started on risperdal at the same time - difficult child 1 was 18, difficult child 3 was 8. We quickly found that difficult child 1 was so sleepy we had to only give him a quarter risperdal at night. He had to be ready for bed when he took it because he would be asleep within half an hour. No way could we increase the dose.
difficult child 3 took a quarter tablet in the morning, and another quarter at night. About a year later this was increased to quarter in the morning and half at night. It did not sedate him in the slightest and he was on 3 times te dose of his big brother.

difficult child 3 did not gain weight, apart from what you would expect. He was still fairly skinny.
difficult child 1 doubled his weight in six months. He started skinny and became pudgy. Remember, he was on the lowest possible dose.

The benefits were there, but only slightly. And it was costing me a fortune, so I asked to take them off the risperdal. By this time, difficult child 3 was studying at home and difficult child 1 had finished high school. It was about 3 years later.

It took about three months, but difficult child 1 went from beer keg to six-pack. Trousers we'd bought for him now fall off him. He didn't lose all the weight he'd originally gained, because he'd also done some growing up in that time. How now is trimmed fine, muscular and slender.
Going off risperdal at 11, difficult child 3 went from 40 Kg to 35 Kg. The doctor was really concerned, although difficult child 3 was eating fairly well. The biggest problem with him has been reminding him to eat - when he remembers he will eat a huge amount, but it is very hard to drag him away from what he is doing, including schoolwork. Now he's hitting puberty, his appetite nags at him more. He's gained back some of what he lost, I think he's back up to 40 Kg again and is 160 cm tall (about 5'). Still too skinny, but not as bad as difficult child 1 was at that age, nor easy child 2/difficult child 2. She could in her tummy and you could see her spine - from the front.

What benefit did we see? The risperdal seemed to 'smooth' the peaks and troughs of the stims. It also seemed to calm down some of the Obsessive Compulsive Disorder (OCD), although in the end difficult child 1 did better on Zoloft. For us, there simply wasn't enough "wow" factor to the effect of the risperdal, to justify the exorbitant price we were paying, plus the adverse effects on difficult child 1.

It really does depend on the child - we had such a huge difference, just between siblings.

Marg

 

[Kjs]

Welcome.

My son was 2 years, 11 months when after being removed from day-care..Took him in to therapist because of anger issues. How can someone so young have anger issues. Other parents thought it was us. But, was told it was ODD. We refused any type of help..until 5th grade. He asked for help then. Now it is 8th grade and every year has been a struggle. Because he advanced a grade it is even harder because he just is not as mature as others his age.

He has good days, months(when there isn't school). But he totally drains me.

Good luck. Lots of support here.

 

[Sara PA]

The studies you read about Risperdal not lowering the seizure threshold -- was it limited to tonic-clonic seizures or did they look at partial seizure activity? I have seen anecdotal reporting of a number of children with behavioral disorders -- often Early Onset Bi-Polar (EOBP) - whose raging gets worse while taking an antipsychotic. I believe it's a red flag for the behaviors being caused by seizure activity.

The Tileptal dose is lower than the recommended dose for his weight. Initial dose is 600 mg/day; target dose for 20kg is 900 mg/day. Since Trileptal is considered (through it's similarity to Tegretol) to be a mood stabilizer, have you considered a high dose of Trileptal rather than an antipsychotic? However, I must warn you that a lot of parents report an initial worsening of behavior when Trileptal is started or increased.

Have you considered that his behavioral issues are partial seizure activity? I have links....

The Pediatric Neurology Site: Seizures
http://www.childbrain.com/seizure1.shtml

MEDLINEplus Medical Encyclopedia: Seizures
http://www.nlm.nih.gov/medlineplus/ency/article/003200.htm

Partial (focal) seizure
http://www.nlm.nih.gov/medlineplus/ency/article/000697.htm

Medications which may lower seizure threshold
http://www.australianprescriber.com/magazine/24/1/8/9/#

Possible Temporal Lobe Symptoms
http://www.pni.org/neuropsychiatry/seizures/ptls.html

Temporal lobe lesions
http://www.patient.co.uk/doctor/Temporal-Lobe-Lesions.htm

Temporal Lobe Epilepsy
http://www.patient.co.uk/doctor/Temporal-Lobe-Epilepsy.htm

Abdominal Epilepsy
http://www.meridianinstitute.com/abepilep.htm

Fear as the main feature of epileptic seizures
http://jnnp.bmjjournals.com/cgi/content/full/70/2/186

The Merck Manual of Diagnosis and Therapy: Seizure Disorders
http://www.merckmanuals.com/profess...seizure_disorders.html?qt=epilepsy&sc=&alt=sh

 

[AllStressedOut]

All 3 of my difficult children were just put on risperdal. The middle difficult child is leaving for camp Monday and we didn't have the medications in time to start him on it and send them with the nurse, so he hasn't begun yet. My oldest difficult child (11) and youngest difficult child (7) just started last week. I have not seen any sleeping pattern change, but there have been less problems at school with youngest difficult child in the two days he's been on it. Strange for it to happen that quickly, but it has been better. I can't get oldest difficult children teachers to communicate with me daily, so I'm not really sure how it's affected him yet.

Welcome to the board!