psychiatrist apt. Confused of course!

[totoro]

Well of course psychiatrist called us back when we were gone!!! A week and a half after I had called her 3 times... Then her office called to cancel our apt next week and could only get us in today, I took it!

psychiatrist apologized for not calling us back and basically said she is SO overwhelmed right now and is training a new worker to try and aleviate some of her stress, return calls etc. She said she doesn't get messages sometimes and the stack is high, if it is an emergancy let them know, she also said she didn't know what we should do if we have a crisis, like if difficult child 1 became psychotic or needed to be hospitalized!!! She agreed that N Idaho hospital's were not a good idea and the the one hospital were she works never has open beds!!! She said call them before hand and hope to get lucky... Of course she said if it is during the day call her. I felt a bit better that she apologized, but not very good about our hospital situation.

She felt good about the Abilify and we talked about difficult child 1 and I told her how difficult child 1 screamed the whole drive down and begged me to let her stay home, "Please Mommy don't make me go, don't make me talk to the doctor, I want to go home, please Mommy". Sobbing and trying to get out, I was scared for a bit and throwing out bribes and trying to console her, finally I promised her she could have a blanket over her head the whole time and not say a word!!! She calmed down a bit. I had a movie playing and nothing would calm her....
She calmed after that.

So psychiatrist had no suggestions to help us but wants to try BusPar... I was a bit concerned and let her know that difficult child 1 has had some serious psychotic episodes, and I was under the impression that you need to be stabilized like with a Mood Stabilizer before adding other medications???
She said that the Abilify acts like a mood stabilizer at times for some and we can work on the symptom that is the worse... She then said have we ever tried any stims? I said no again for fear of inducing mania etc because she is BiPolar (BP)... I said again I am really leary of trying any thing without having her stable first... she said we could also add a small amount of an AD later or if the BusPar doesn't work we could think about a Mood Stabilizer...
So I really didn't get an answer as to why she wanted to go this route, I do know she doesn't like doing the blood draws... for the medications like Lithium etc... But I had mentioned Lamictal and she said maybe we could try that later, and mentioned the rash....
So we have another apt in a month and she did spend 20 minutes longer than our apt. time...

I just haven't seen this route before and don't really know anything about BusPar??? I know on crazymeds they say you need to take it with an AD... SOme love it some hate it, it seems 50-50. I don't know... anyone????

Thank you

 

[flutterbee]

Buspar is an anti-anxiety medication. I would share the same concerns as you re: the mood stabilizer and having difficult child stablized before introducing other medications...especially AD's. It does say (re: buspar) to tell your doctor your medical history, especially of: bipolar disorder.

I really can't help you with your questions, though, because I only know of one person who takes it (without AD's, by the way), but she's an adult and is not bipolar...so really, apples and oranges.

 

[timer lady]

I'm sorry to hear that you are still struggling to find medical help for your difficult child. Unfortunately, you don't have the prescription pad. And having said that, when I "insisted" on a certain medication from one psychiatrist or another, it blew up on me a few times. I lost credibility with them.

It's the typical medication merry go round until you find a psychiatrist who understands these disorders in children. A psychiatrist who knows that the diagnosis will likely change many times over before you "hit" on or actually know what you are dealing with.

Take some deep breaths, totoro - this is a new day. Sending positive thoughts that you can find difficult child help soon.

 

[LittleDudesMom]

Totoro,

I can't speak to the medication issue (not being familiar with medications or a difficult child with b) but I can understand you not being comfortable with the decisions psychiatrist has made/suggested. You did your best to express your concerns.

Now, you can try it or not - that's now totally up to you. But I have heard so many stories about the medication trials difficult children have been on to find the right medication or the right medication combo - sometimes you just never know.

One thing that bothered me about your psychiatrist was her comment that she doesn't know what you all would do if difficult child went into crisis mode. That's scary. Maybe you should be doing a little research on the subject yourself looking into local and not-so-local options.

Hope you were able to get some sleep and today dawns with some answers and a better day for difficult child.

Sharon

 

[oceans]

When my son was hospitalized they were talking about buspar because of a question of anxiety, but then they were thinking that maybe anxiety was not really the issue, so they stopped talking about it. They then added another AD to the one he was already on, and that did not help. I finally talked them into adding the Lamictal, and he is doing well on that. He has been on it for quite some time and never got a rash. It took me 1 1/2 years to get someone to agree to try it, because it seems everyone is afraid of that rash.

I am sorry that there are so many problems with psychiatric care in the area that you live, but know that it is not just the psychiatrists where you are that are reluctant to try Lamictal, or a mood stabilizer. I find that to be the case here as well, and there are many more choices for help in this area. They all seems to want to try other alternatives first, and go to the mood stabilizer if nothing else works. For some kids, like mine, that meant years of instability.

I know that some psychiatrists do use AP's like a mood stabilizer. It works in some kids, but fizzles out with others (like my kid). She is probably thinking that since the Abilify is holding the mood, the next step is to work on the anxiety. Everyone reacts to medications differently, so it is possible that an anxiety medication might work with the AP. I don't know much about buspar, or needing to take it with an AD.

I thought you were titrating up the Abilify and the plan was already in place to add the mood stabilizer?

 

[SRL]

When anxiety is severe it is a catch 22--often you can't stabilize a child whose anxiety is sky high solely through medications targeting the BiPolar (BP).

Totoro, I can't keep medications and kids straight here: was it you who trialed Risperdal and had problems? Sometimes using Risperdal targets the anxiety through the back door and avoids the use of antidepressants.

 

[BusynMember]

Just plopping in to add that anxiety is rarely a stand alone issue. I have panic disorder/geralized anxiety disorder/Obsessive Compulsive Disorder (OCD) tendencies, but the big picture for me is bipolar. I would be leery of any psychiatrist who can't be reached (or at least a colleague of his/hers) after hours. My own psychiatrist is either on call or one of his partners is on call 24/7 (including Christmas). I hope you find satisfaction with this doctor and that the medications work. Lamictal causes a rash in only a small percentage of patients, and my oldest son takes it and LOVES it. He is also very high anxiety/Obsessive Compulsive Disorder (OCD) (extreme Obsessive Compulsive Disorder (OCD) without medications--he has to count the words that people say and his own breathing). In my layperson parent opinion, if it were my kid, I would not add an antidepressant. That can often cause more anxiety than it stops and can cause mania too. I have to take one, but I'm an adult, and I also had to try about ten of them before I found one that 1/worked 2/didn't cause such horrible side effects that I actually ended up getting worse. medications such as Risperdal, Seroquel, and Zyprexa can sometimes work well for anxiety without causing mania. Abilify too, but Abilify isn't a mood stabilizer. Buspar is a mild tranquilizer. Hugs and good luck.

 

[dreamer]

My dtr took BusPar for a couple years after having been on Ativan. It was not bad, but it also was not great, and eventually it was stopped becuz of concerns it might lower her inhibitions and impulse control.
My husband has been taking BusPar for years, and has worked up to a sorta high dose. My dtr did not use ADs when she took it. I also have trialed BusPar as a prn here and there, and I also am not on ADs. What I decided for me personally is that I do not like how I feel on Buspar, and do best if I go take a nap or take it before bed. I do not feel SUPER horrid, but - it is a vague thing I cannot put my finger on, slight and mild, but I just do not like it. "Fluttery" maybe?

 

[totoro]

Thanks everyone... Yes she did trial Risperdal and had the adverse side affects... and yes I thought my last meeting with psychiatrist we had discussed starting a mood stabilizer, Lamictal, and instead at this meeting she focused on symptoms. Anxiety being what she really picked up on. It is like she is picking apart each sympton and going to try and medicate each one?

I am going to call out pediatrician and get her opinion, she seems to be the only one here who is listening.
I read and listen to what you guy's have to say and I try to really stay open minded... and maybe this will work, but sometimes I just have that feeling... you know a very cautious, is this what I should be doing feeling???

I certainly don't want to put her in a corner and demand what medications I want!!! Even though that is what I wanted to do! LOL

Ugh... anyway I am fasting this a.m. and waiting for insurance to show up to do blood draw!!! They convinced husband that if I die without insurance how can he afford to pay someone for what I do! True but kind of funny, he is all upset thinking what if I die.

Thanks again

 

[house of cards]

I soo understand the frustration trying to get a p-doctor to try a mood stabilizer, I am going through the same thing. And then they want to give medications that you have heard will cause horrible problems if you are right about the diagnosis. It is a very uncomfortable position to be in. No, we aren't doctors and don't know all the info that they do...but nobody loves our kids more and researches looking for answers more then we do. I wish you good luck.