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Post-psychiatrist visit and update on difficult child 2
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<blockquote data-quote="gcvmom" data-source="post: 203166" data-attributes="member: 3444"><p>Thanks MWM. I am aware of the issues with Paxil withdrawal. When husband has missed a dose or two, it becomes VERY obvious to us, even himself, that he's missed a dose. That's the type of response I think of when someone is having a withdrawal symptom.</p><p> </p><p>The signs I've seen in him in the past four or five days are definitely more subtle. More like his depressive and obsessive symptoms creeping back in, breaking through. And perhaps I am more sensitive because I lived with him UNmedicated for 17 years, many of which were miserable because of his undiagnosed illness. And for the last two years, I've thoroughly enjoyed a more stable and happy husband. <img src="data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7" class="smilie smilie--sprite smilie--sprite1" alt=":)" title="Smile :)" loading="lazy" data-shortname=":)" /> Time will tell us more and I'm just going to document the best I can. </p><p> </p><p>As for the Seroquel and difficult child 2, as far as I know there is no blood test used to establish therapeutic levels -- it's strictly managed by symptom response to the medication. The psychiatrist said most of his patients that are at the higher end of dosing take the entire dose in the evening and it gets them through the whole day. We see very clearly with difficult child 2 that he only gets about 15 hours of coverage. His behavior begins to slide very obviously after that magic time. It happened in the psychiatrist's office yesterday. We got there 1/2 hour before he would typically get his afternoon dose, and by the time we left, difficult child 2 was becoming more impulsive, more restless, more inattentive, more uninhibited. </p><p> </p><p>Oh, and we've been titrating this medication since last June. We started out with a low dose of the short acting... I think it was 100mg, and went from there over the summer. </p><p> </p><p>Mornings are great for this kid since bumping the Seroquel XR to 600 -- he his tired, but he does what he needs to do with very little reminders or redirection on my part (dresses, eats, clears dishes, brushes teeth, gets backpack ready) -- it's a sharp contrast to the past. He still struggles with impulse control, focus, attention, staying on task, remembering assignments -- all things you'd think were ADHD related, but he can't take ADHD medications.</p><p> </p><p>He did SOOOOOO much better last night with his homework on the 400mg. He didn't get as frustrated. He paid attention and let me work with him on things he didn't understand -- and he was able to grasp and retain what I was teaching him. His thoughts seemed more organized and he was able to remember what happened with assignments and things that happened in class. It's like he was just more present in his body and able to recall things better. I believe this will continue to improve over the next week or two as he adjusts to the new levels.</p><p> </p><p>Furthermore, his tremor and handwriting have improved since starting Seroquel -- not sure if it's the medication or if his Sydenham's is resolving/remitting (which it can do over time).</p><p> </p><p>Anyway... I appreciate the concern about overmedicating.</p></blockquote><p></p>
[QUOTE="gcvmom, post: 203166, member: 3444"] Thanks MWM. I am aware of the issues with Paxil withdrawal. When husband has missed a dose or two, it becomes VERY obvious to us, even himself, that he's missed a dose. That's the type of response I think of when someone is having a withdrawal symptom. The signs I've seen in him in the past four or five days are definitely more subtle. More like his depressive and obsessive symptoms creeping back in, breaking through. And perhaps I am more sensitive because I lived with him UNmedicated for 17 years, many of which were miserable because of his undiagnosed illness. And for the last two years, I've thoroughly enjoyed a more stable and happy husband. :) Time will tell us more and I'm just going to document the best I can. As for the Seroquel and difficult child 2, as far as I know there is no blood test used to establish therapeutic levels -- it's strictly managed by symptom response to the medication. The psychiatrist said most of his patients that are at the higher end of dosing take the entire dose in the evening and it gets them through the whole day. We see very clearly with difficult child 2 that he only gets about 15 hours of coverage. His behavior begins to slide very obviously after that magic time. It happened in the psychiatrist's office yesterday. We got there 1/2 hour before he would typically get his afternoon dose, and by the time we left, difficult child 2 was becoming more impulsive, more restless, more inattentive, more uninhibited. Oh, and we've been titrating this medication since last June. We started out with a low dose of the short acting... I think it was 100mg, and went from there over the summer. Mornings are great for this kid since bumping the Seroquel XR to 600 -- he his tired, but he does what he needs to do with very little reminders or redirection on my part (dresses, eats, clears dishes, brushes teeth, gets backpack ready) -- it's a sharp contrast to the past. He still struggles with impulse control, focus, attention, staying on task, remembering assignments -- all things you'd think were ADHD related, but he can't take ADHD medications. He did SOOOOOO much better last night with his homework on the 400mg. He didn't get as frustrated. He paid attention and let me work with him on things he didn't understand -- and he was able to grasp and retain what I was teaching him. His thoughts seemed more organized and he was able to remember what happened with assignments and things that happened in class. It's like he was just more present in his body and able to recall things better. I believe this will continue to improve over the next week or two as he adjusts to the new levels. Furthermore, his tremor and handwriting have improved since starting Seroquel -- not sure if it's the medication or if his Sydenham's is resolving/remitting (which it can do over time). Anyway... I appreciate the concern about overmedicating. [/QUOTE]
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