The Good, The Bad, and The Out and Out UGLY

[mazdamama]

Have not had a chance to update here on what has been going on since I last posted. I did take my Daniel to the psychiatrist and I DID get his medications changed. He was kept on the Clonidine 0.1mg at night and the Depakote ER 500mg at night but what was added was Haldo 0.5mg and Lexapro 10mg. He takes the Lexapro in the morning with 1/2 tab of the Haldo and then a whole Haldo at night. Everyone, including Daniel has noticed a huge change in him. No more tears or screaming at me and no threats. That is the Good...except for the fact he is teasing David more because he is in such a good mood.

Now for the bad. David had a very bad day with the therapist and she contacted psychiatrist who upped his Abilify...2.5 mg in am and 2.5 at night...he was on 2 mg at night. The bad is Mom did not give this child his medication tonight. He will get his Focalin XR and Celexa in the am but not the Abilify. I am checking something out. The reason why is the UGLY and oh my, it has been UGLY.

I am wondering if he has been misdiagnosed with the ADHD because of the behaviors associated with Autism, and of course he is developmentally delayed. Where I was having problems with this little guy it has increased 100 fold since she upped his Abilify. He is in constant motion and constantly aggressive. Tonight while watching fireworks he was hitting me with a stick, screaming at me, calling me an idiot and threatening to kill me when he gets bigger. If his brother even looks at him funny I am hearing this high pitched scream that just goes through me like a knife. He was exhausted when we got home tonight at 9:30 because he has been non stop since 7:30 this am. Without giving him the Abilify I want to see if there is any slowing down. It seems as though stimulants for ADHD are just really stimulating him when they should have the opposite effect.

Lord, I am just exhausted with this child today. Please give me patience with him tomorrow.

 

[TeDo]

It can be very dangerous to abruptly stop some medications. If you have issues with a medication or want to "try" something, check with your psychiatrist FIRST. Because my son is on the autism spectrum but also has ADHD (no question), he is on a non-stimulant ADHD medication (Strattera). Stimulants did the opposite of what they were supposed to do. Some people here have their children on other non-stimulant ADHD medications but I can't remember the names of any of them. But then again, my son has atypical reactions to many medications so not sure if there's a correlation or if it's just my son. This is just from my experience so take it for what it's worth.

Please be careful with the medications. Now you have me nervous.

 

[mazdamama]

I am a nurse so know the chance I am taking. I will see how he is in the morning and decide on the morning dose but I know this child is tooooooooooooooo super hyper these past few days,

 

[TeDo]

I hope I didn't offend you. It's just that monkeying around with medications is so scary to me. I have seen & heard about so many bad things happening. I am also quite a worrier when it comes to kids. That's just my nature (proceeding with great caution into unknown territory).

Good luck and let us know how things went.

 

[mazdamama]

No offense taken. Just really do not know why they have him on this in the first place. I have already noted to both the therapist and the psychiatrist that his pedi has done labs and his AIC is higher then it should be so they really should have changed the medication altogether. I was able to control him for the most part on the lower dose but his behavior in the past few days has wanted me calling the cops on this little 4 ft 61#s fireball. He throws things at me even when I am in bed. Demands food constantly but then does not each much of it. Opened the van door before I had it stopped yesterday and almost gave me a heart attack. Does really bad things and then jumps out with "I'm sorry" and then does it again immediately. Calls me an "idiot" and "stupid mom". David had his issues but he has never been this mean and aggressive constantly. Everyone loves him because he is generally always a very sweet kid unless you try to keep him from his atlases or globes. Bought him a new globe yesterday and he had it broken by the time we got home...now it is a ball that he threatens to throw at me. BRAT!! The only change is this medication so I am concerned about it enough to at least lower the dose back down since it is impossible to reach his psychiatrist this weekend. I would be told to take him to crisis stabilization unit and the one near here is a DUMP and he would not cope there with his size since most there are teens.

 

[susiestar]

First of all, abilify is NOT NOT NOT a medication for adhd. I don't know WHO told you it was, but they were mistaken, misinformed, lying or nuts. It is NOT effective on ADHD. None of the medications you listed are. SOMETIMES a beta blocker is used (blood pressure medication) because it makes people tired - some docs try to use it off label for adhd but it isn't terribly successful. Otherwise adhd is treated with stimulants (adderall or ritalin or related medications, usually extended release formulas) or strattera. Strattera is similar to prozac but isn't terribly effective for depression, it was found pretty much by accident to work on adhd. If bipolar is suspected, or other mood disorders, then strattera is NOT a desirable first choice because medications from that class can trigger mood cycling. Otherwise it can be very effective.

Many people are afraid of giving stimulants to children because risk of addiction. Research actually shows very clearly that treating adhd in children as early as possible with stims can actually keep them from becoming addicted to drugs. The stimulants work to help synchronize their brain and body and they don't go looking for things like pot or other illegal drugs to self medicate. Continuing treatment into adulthood is also effective - those that stop stimulants and don't use strattera but go with-o medication are likely to start looking for other ways to create the effects of stimulants, and they often do this with illegal medications. I looked into this quite a number of times over the years as we treated my difficult child for adhd.

Adhd is actually a symptom of many autistic spectrum disorders, not a separate disorder. Quite a few autism specialists have explained this, as have 2 neuropsychs. It is treated as a separate disorder because if listed as a symptom the insurance co's don't want to pay for treatment, stupid as that is. It is also listed separately because schools are more willing to work with kids with adhd than with autism, and esp with both mroe than one or the other. non-psychiatrist type people seem to grasp the reality of adhd more as a separate disorder rather than as a symptom. It is discounted in importance if they are told it is a symptom and then treatment is not followed or initiated. NOT saying YOU or anyone specifically does this, just that it is the trend.

Abilify may be activating him, but changing a medication like abilify with-o a doctor's instructions can be dangerous. Keeping him on it a few days until the doctor can help you safely lower the level is far less risky than stopping it suddenly. I know it is hard, but try not to adjust medications with-o the doctor's okay.

I am glad that Daniel is doing better - that is an awesome thing. Assuming the bro's are twins biologically, you may want to consider exploring if the medications that help one will help the other. OFten people in the same family react similarly to a medication. Not always, but often. My mother is allergic to codeine in that she vomits it every time. So does my oldest and my daughter feels sick to her stomach from it. Many of the medications that my mother cannot tolerate I also cannot tolerate, and we also react well to many fo the same medications - some we have positive reactions that are NOT typical from but we do it and so do her sisters and their daus.

 

[mazdamama]

As a nurse I should have checked out this medication for usage before posting last night. Just so darn exhausted. Will give him his am dose and then give the medication tonight and call doctor tomorrow.

Got up this morning only to find that he had opened a new box of Lucky Charms, dumped them all over the island counter and had eaten all the marshmellows. He was into something else that he had been warned about getting into and I popped him on the sodden goodnite. He ran down the hall calling me and idiot and then came back out with the wet goodnite and said he was going to throw it at me. He must've thought better of it because he put it in the trash instead. I am not looking forward to this 4th at all. Hapy 4th of July to you.

 

[mazdamama]

Probably should've added that this little guy of mine got himself kicked out of summer school due to hitting and kicking not only the teacher but other students and a member of the office staff.

 

[BusynMember]

What does your mom gut say? Do you believe that, even with his delays, he has ADHD? Are you comfortable with his medical team?

 

[mazdamama]

NO, I am not happy with his medical team at all. In this small town we really do not have much for psychiatric children's care. The people he sees come from another town once a week to see this counties children. There is another company that does the same....both are mainly for medicaid patients, something my children do not have.

When we were at his theraphy session Tues the therapist said she was going to send out a case manager so that I could get some help with him at home. COOL! Well, this really nice man that I know comes out on Friday to talk to me about case management. I know this guy and he knows me and the boys...he is involved with the staffings we keep having at the Children's Advocacy Center about Daniel. He tells me that the only way he can be case manager is for me to sign David up with the other company in town (the one he works for) and continue to use the same therapist and psychiatrist he sees with the other company. He even admitted it is an assinine solution.
We discussed it and I am calling the nurse in charge of Daniel at the insurance company (Children's Medical Services) and see if David can also go to Winter Haven where Daniel goes. First I need to talk to Daniel's therapist and see if there is even a therapist there that deals with autism.

Mom's gut...no, he is not ADHD. He can sit for hours drawing complete and accurate maps...just don't bother him or the maps. The energy within him is keeping him from gaining any weight and the anxiety is something to see if a map of his gets lost. Lately it is hour upon hour his screaming that he is starving but he will only eat junk then and even junk he rarely finishes. Luckily he loves pudding cups but they have to be kept up as he ate 10 at one shot. He wears me out with his demands and his sneakiness.