some questions about getting a "medwash"

Discussion in 'General Parenting' started by feelinalone, Mar 13, 2008.

  1. feelinalone

    feelinalone New Member

  2. smallworld

    smallworld Moderator

    I'm going to try to answer your questions to the best of my ability. My responses are in italics.

    *How do you get a hospital "medwash"? I've heard this a few times now.

    I would think you would need the psychiatrist you're working with to recommend the medication wash and then recommend that your son be inpatient to do the medication wash. Some kids do not need to be inpatient to have a medication wash if it's done carefully and systematically and under the guidance of a competent child psychiatrist. Some kids need to be inpatient because the medication wash must be done quickly because of adverse reactions, and the medication wash will destabilize them further.

    *Does/will medicaid pay for it?

    You will need to call Medicaid. Does your son have a caseworker?

    *Since medicaid wouldn't even pay for the inpatient evaluations, how could I get them to pay for an inpatient medwash?

    Again, that's a question for Medicaid.

    *Since the psychiatric hospital told me difficult child can't "keep" going there (over the state line), could I get it done at hospitals in my community that don't have pediatric psychiatric units?

    It is safer to have a psychiatric medication wash done in a pediatric psychiatric unit. I'm not sure there is another unit that is safe for your difficult child to undergo a medication wash.

    *Would I need approval/referral from the psychiatrist? If so and if I can't get it from the psychiatrist, who could I go to?

    Can you start working with a new psychiatrist if you don't like the current psychiatrist?

    *How long would difficult child need to stay in the hospital to get all the drugs out of his system safely?

    It depends on the medications, the doses and his reactions once he's off the medications.

    *How safe is it? What kind of reactions/effects would I need to expect?

    Again, it depends on the medications, doses and the child, but here are some common reactions:
    Clonidine - spike in high blood pressure if not weaned slowly
    Prozac - increased aggression, anxiety, mood instability, mania, depression could occur but then could resolve over time OR he could need other medications because symptoms persist
    Abilify - same as above

    *How does the medwash compare to weaning off the medications at home in terms of safety?

    We've always done it slowly at home under the guidance of a child psychiatrist. I know medication washes inpatient are done more quickly.

    ****difficult child is still on: abilify, prozac and clonidine****
  3. slsh

    slsh member since 1999

    I think smallworld covered very well the answers.

    I guess my question would be what would you hope to accomplish by doing a medication wash? I don't know, maybe I'm just to old and tired to even contemplate it, but I *think* I would go more for a limited trial off of medications, starting probably with Prozac. Just a gut feeling based on nothing but... my expanding gut. ;)

    Without question, if you go this route, either a full medication wash or limited, you need to do it with the cooperation and under supervision of psychiatrist.
  4. SRL

    SRL Active Member

    Typically a medwash is done inpatient in order to start over with medications.

    No matter what health care coverage you have, doctor recommendation is usually needed for inpatient. I think it would be difficult to get psychiatrist approval if the psychiatrist didn't agree with discontinuing the medications. Doubly so if there isn't a high level of support and interventions in place.
  5. Loving Abbey 2

    Loving Abbey 2 Not really a Newbie

    You know I was just thinking about the same topic, I'm going to start another thread for my situation.

    I just wanted to lend some support. It can be hard with younger kids to figure out what is age, environment and disorder. Abbey had an adverse reaction to one of her medications but it was unclear which so we had to discontinue all of them immediately. Physically it was safe but mentally it was not. SHe threw herseslf down the stairs, tried to kill the cat, etc. So it is REALLY important to do this slowly and under close supervision.

    Good luck!
  6. Sara PA

    Sara PA New Member

    *How does the medwash compare to weaning off the medications at home in terms of safety?
    Medwashers done in hospital settings are often more abrupt and involve more than one drug at a time because there are time limits involved. That means home medication washes done right can be safer. Insurance simply won't pay for someone to do a gradual hospital medication wash let alone hospitalization for gradual medication wash and time to see how the patient responds after being taken off the medications.

    Keep in mind that it may take months for it to become apparent what the end results of a medication wash will be. There may be an extended period of adjustment for the brain to get use to not having the medication. The brain needs to find it's unmedicated "normal" state again (which may or may not be the same was the unmedicated state before medication).
  7. Steely

    Steely Active Member

    It looks like your questions have been answered well. I just wanted to throw in that given your son's violence, and the police needing to be called several times - all you would need to do in terms of getting him admitted now is have the police transport him to the local hospital once he has another violent outburst. Once there, you tell psychiatrists that he is unstable due to medication changes, and you need him to stay there until those are completely d/c. Of course the challenge lies in how long they will really keep him...........but at least that answers the question about how to get your son to a phosph and what to ask for.

    Good luck. I know how hard this! It stinks that any mom or kiddo has to endure this.
  8. dirobb

    dirobb I am a CD addict

    I have been thinking about admission and what about the psychiatrist. Do you have to call them 1st before taking your child to the hospital or if a CIT is involved is all that unnecessary?
  9. Steely

    Steely Active Member, not at least in Texas. Not if it is an emergency. They treat it just like you cut your foot, or broke your arm. Once you arrive at the hospital, the social worker and psychiatrist on call assess the situation, and then call your psychiatrist.

    Good luck.
  10. totoro

    totoro Mom? What's a GFG?

    Sorry you are having to think about this.
    We did ours with some support from psychiatrist, he explained how to do it. We had full support from our pediatrician, and therapist. K is also only 6... and husband was home full time as was I. So she was home at the time. We did each one separate. psychiatrist helped with all but 1. After he stopped calling!!! We went very slow and had PRN's in place. She missed some school as well... We did not really have an option for placement.
    We have about 1 + months before we get into our new psychiatrist... she is doing OK at best!!! It took us about 4 months total... with 3 medications. The lamictal was the longest.
    Good luck...