Seroquel??

[MICHL]

difficult child has been on abilify for years... his behavior is often off the charts aggressive & violent. recent psychiatrist is suggesting switching to zyprexa or abilify. he's been on zyprexa for years prior to abilify, and it was no better. And i can't recall for sure, but i think he also tried Seroquel and it did not have good results. I think he tried it for only a week before we stopped it, due to bad results, but i'm not 100% sure he trial it. It was long ago and i don't have access to those records. Should we trial it again?? note: He also takes Tenex, so i don't think two downers (seroquel + tenex) sound like a good idea...

TIA

 

[buddy]

My son takes Clonidine and Zyprexa. He did horrible on Risperdal and Seroquel but the Zyprexa seems to have taken the edge off. He still can be aggressive but not nearly to the extent he was.

Tenex/Clonidine types of medications are not downers in my humble opinion, but I guess that depends on how you define it. (I think of downers as anti-anxiety class/tranquilizers). They are anti-hypertensives (high blood pressure) medications and yes they can cause sleepiness, my son got over that quickly. It does make a huge difference in his impulsive aggression though. HUGE difference. Lately with a large increase in anxiety he was having real anger rages which also lead to aggression....a different trigger, sort of, so the zyprexa was just added. I was really scared because that class in the past was a disaster for us but this time it worked! Seroquel is in the same class as Risperdal, zyprexa...etc. the atypical antipsychotics (which my understanding are major tranquilizers)

When it comes to that level of aggression/violence, in my humble opinion we need to take more risks and try things. That kind of behavior can not only disrupt our lives, it can derail any progress or future they have. At least that is how I view it. If he had to be managed in a residential facility...short or long term, it is much worse because it interrupts my son's overall development and exposes him to new behaviors from other kids. Your child may be very different and do better in a residential setting but the goal would still be to find the right medications and therapy to allow him to live more independently and in a more typical environment...

It is so overwhelming to have an aggressive (verbal and/or physical) child. I am actually achy over it lately! Hang in there....Will be interested to see what you decide, we all have a very different path.

 

[keista]

Seroquel - not good results
Zyprexa - not good results
Abilify - not good results.

When's the last time difficult child was off of medications? If it's been a long time, then you might want to consider taking him off for a while and see what happens. Since you're not planning on changing the tennex, and don't think that's causing any adverse behavior, leave that.

Other things to consider/remember - Why he started the medications in the first place. What were the dxes at the time. Have you gotten any new dxes since starting medication?

Abilify did wonders for my son, but completely agitated DD1 and landed her in the psychiatric hospital crisis stabilization. I don't have specific experience with the other medications, but they also can have undesirable effects. What I'm getting at is, after all these years, what's causing his aggressiveness? The medications or his dxes?

 

[Wiped Out]

Seroquel was horrible for my difficult child but each child is different. However, each child is different. We generally have not gone back to medications difficult child has been on and didn't do well but we recently put difficult child back on Straterra (something I thought we would never do) since his moods are fairly stabilized and he has done o.k. on it (we were so glad it didn't send him back into mania).

 

[Liahona]

difficult child 1 has tried Seroquel before and it didn't do anything. But that was a long time ago. He has grown and changed a lot. We tried it again and now it helps. I also don't normally try medications over again, but after years of medication trials we were running out of medications.

 

[MICHL]

difficult child takes 37 1/2 mg abilify, and has for a long time, so he must have a very high tolerance to it. That is the max dosage. I just got a call from husband that difficult child punched him in the nose which broke a blood vessel, lots of blood, but nothing broken. He called 911 and EMS came to look at him, said he was okay, and to "relax". We have run out of choices for medications, he's pretty much tried them all. I'm pretty sure he trialed Seroquel in the past and that it even increased the aggression. The diagnosis's and an imbalance in his brain are causing his aggression, not the medications. This is the type of behavior that led us to medications, and they do help, but not enough, and he doesn't even want to improve. He refused to go to all but a fraction of the anger mgmt class we signed him up for. He was born very difficult, from day one. He had several evaluations, and all point to only Pervasive Developmental Disorder (PDD)/not otherwise specified, ODD & ADD.

 

[helpangel]

Wow that is a whopper dose of Abilify they decided Angel had maxed it out at 30mg; I don't think I saw her stable for 48 hours the entire time she was taking it. The aggressive outbursts were off the charts and food took on a whole new meaning to her. If they do discontinue it I urge that they do it slowly as they took Angel off cold turkey and it threw her into the worst psychosis ever for her (26 days inpatient).

The behaviors you listed and looking at diagnosis's in signature those don't look to me like ADD medications. in my opinion ODD is a symptom more then a diagnosis. The tenex (antihypertensive) ok if had the hyperactivity but then would call it adHd. Sorry I'm rambling, just a little puzzled - have they ever tried a mood stabilizer? Not meaning to be dispensing medical advise just curious why they chose an antipsychotic medication like Abilify? Both my girls have had ODD, adHd diagnosis's in past that were later ruled out.

Oh thread was about Seroquel out of the 5 AP's Angel has tried its her most successful; she also was taking seroquel & abilify together at one point. That might be an option for your son so they could back down a little on Abilify as side effects usually occur at higher doses. Seroquel is the only AP my 15yo has tried and is working well for her also. It is quite sedating till they adjust to it in the beginning though.

With my girls they needed to get fairly stable before they could get any benefits from therapy or anger management. I hope you get this resolved soon as I know raging children can get pretty strong and he's not getting smaller.

 

[keista]

From reading other ppl's experiences, it seems worth a shot to try a medication that was tired pre-puberty after puberty. The body is very different, so the medication can work very differently.

Good to hear (not really, but I think you Know what I mean?) that the behavior was constant and the medications did actually help, if only a little. I am still wondering if psychiatrist would support inpatient time to do a medication wash and see what his baseline is now. It just doesn't sit right in my gut to have maxed out dosages and not gotten substantial relief from symptoms. Maybe since he's older they could get a more accurate diagnosis on him?

 

[InsaneCdn]

Keista? You're back at it.
I"m sitting here thinking, and you're typing the words in my head...

Ditto on the puberty thing... it DOES make a difference, often. medications that had no effect, or couldn't be tolerated pre-puberty, may work. on the other hand... medications that worked back then, may not be effective (or worse) once puberty kids in.

 

[keista]

Insane, great minds think alike!

And as always, MICHL, we are just brainstorming here. You're a seasoned member, but always worth a reminder that no one is offering medical advice here.

 

[DammitJanet]

I am also wondering if something else is going on here. I seem to remember some of your back story but not all of it because of my memory issues...sorry.

difficult child is your bio child right? I believe so. I am not convinced that ADHD and ODD is what is going on here. While the Pervasive Developmental Disorder (PDD) is going to complicate things, I think this has to be put somewhat on the back burner for now. His violence is completely out of control and at his age this is going to be a huge issue for him in the very near future. I am assuming that his Pervasive Developmental Disorder (PDD) isnt so noticeable that it would get him an insanity plea immediately. Most of the real world is going to expect him to follow real world rules.

When was the last time he had a psychiatric review or neuropsychologist testing? Im wondering if he could be bipolar or even something else all together. Temper Disregulation disorder, explosive disorder, something. There are different medications for these things. I realize he doesnt want to discuss this but he does have some form of currency that will motivate him to attend these meetings. You just have to figure out what it is.

 

[MICHL]

difficult child is my bio child. His very first diagnosis by the school psychiatric at age 4 was Regulatory Disorder type III http://drsaraht.com/regulatory.html

I believe i will have him trial seroquel again and cut back on the abilify to see how that works, and will ask about inpatient time.

Thank you all so much.