Thinking of taking him off some medications...

[STRESSEDTOMAX]

Tommy has been on medications in some form or other for the last four years. It's been that long since we've seen our child medication-free. I think for that reason alone and the fact that not only has his weight gotten out of control, bringing his self-esteem down and giving the kids one more thing to pick on, but we're not even sure what he needs and doesn't need anymore. I agree that's it's probably unrealistic to think he wouldn't need ANY medications, but does he need FOUR? I doubt it. I feel as if I'm being very irresponsible and a bad parent if I am giving him all these medications and don't even know if he needs them. husband and I feel now may be the best time to do some of this since he starts partial next Tuesday and would be in a safe place. Except of course that he will be home after school. No matter what happens, I feel I really need a clearer picture of what is and isn't necessary. Any thoughts? That's actually rhetorical...lol.

 

[STRESSEDTOMAX]

I didn't mean I didn't want any ideas...lol...I'd love some!!

 

[BusynMember]

I'm a big fan of weaning off medication to see how they do off medications and for using as few medications as possible if necessary so I say GO FOR IT. But make sure a doctor is helping you wean him off. Often the weaning process itself causes instability so you won't really see the child for several months. Going on AND off medications, unless they are only stimulants, is quite a trip...I've done it.

 

[buddy]

I would recommend asking where to start and go slow. For sure one at a time or you wont know which thing is needed and which thing is not . What is he on anyway? do you mind sharing? if not, no biggie but we can probably tell you what we have seen or experienced if our kids have (or we ourselves have) gone off one of the medications he is on.

 

[Chaosuncontained]

Carson has been on medication since he was 4. For for ADHD (7 diff medications), then we added Abilify (later changed to Respirdone) and Celexa for depression.

I asked about taking him off of the medications and seeing what we have left...because, really? Nothing seemed to be working anyway (still impulsive, inattentive, moody, aggressive, socially inept...you get the idea).

The doctor said to me "Have you ever thought that '*this* is what he is like WITH medications--can you imagine what he would then be like WITHOUT them'? If you really want to we can wean him off one at a time and see what we are left with. That may take time. Then we will more than likely have to start him back on something--and THAT will take time. YOU are the Momma, if you want to do it I will help you do it. But don't think it's going to be easy--it'll be hard for him AND you." That is also when he recommended that perhaps I should have him evaluated by a Psychologist--two even, to get a clear picture of what Carson might need.

So, here we are. Both evaluations done (tho I've not seen either report yet) and an ARD meeting tomorrow. So, we'll see.

I know that the last day or two has been especially hard for your family. I think I also saw that you are getting him evaluated (he so needs an IEP for school). I am so sorry for the stress and chaos.

I hope it is OK to tell you that I am sending prayers up for you and for Tommy.

 

[BusynMember]

And so what if you have to put him back on medications? We were shocked when, in our case, our son was better off of them...not so lethargic and sleepy, much more alert, and happier. I don't see the down side. It's like the doctor is trying to talk you into keeping him on medication and not even checking him out without the medications...it could be that the medications are actually making him worse too. medications are not a one way street. They can improve the condition or they can make it worse. It's worth it for your child's sake to check it out. Your kid is one three medications. I would want my child on as few as possible. You may also want to get a second opinion on what is wrong with your child. I like to have a fresh pair of eyes look at my son at times. If Tommy isn't better than he used to be, and he's been with this psychiatrist all those years, maybe it's time for a new look. JMO

 

[InsaneCdn]

Four medications. Hmmm... unless there is a specific logic to all four, I'd be asking questions and probably pushing for a reduction/removal of which ever one is causing the most side-effects. I'm assuming he's taking 4 different classes of medications... not just 4 scripts. (if you have to count scripts, difficult child is on 7... but only three chemical compounds.) For example, stimulants is a class of drug - ritalin, concerta, adderall, etc. are all stims. Other frequent classes are SSRIs (one form of anti-depressent... there are other classes), atypical APs, etc.

Example of two scripts for one medication... Concerta 36 + Concerta 18... needs both for school days, just the 36 for weekends. (if he needed the same dose every day, the script would be for Concerta 54, because its much cheaper that way!).

Two scripts for one medication class... Concerta 36, plus low-dose fast-acting Ritalin to cover homework/evening event. Both are stims - in this case, even the same basic chemical compound.

 

[STRESSEDTOMAX]

Tommy is on AM: 10 mg Prozac, 1 Depakote (have to check strength), Tenex 1mg, PM: 2 Depakote, Tenex 1mg and Abilify 5mg. Martie...you caqn send as many prayers up for us as you want...lol. Carson reminds me a lot of Tommy. I understand what the doctor is saying...that's my fear...but I figure if we're gonna do it, we might as well do it while he's being supervised. I guess I just feel that I need reassurance that what we are giving him is really helping him. Believe me. I'm dreading it...

 

[InsaneCdn]

Do you understand which condition each script is supposed to deal with, and what the expected results are from that script? That level of knowledge might help in figuring out which script is doing the least good... which would be the first one to try taking out of the mix (slowly...)

 

[STRESSEDTOMAX]

I just googled them all. The one that jumps out at me as maybe not good for him is the Depakote. Its normally used to treat seizures and manic episodes. The only reason I can think they're giving him this is because it can be a mood stabilizer. I can see the need for the Prozac (anxiety, Obsessive Compulsive Disorder (OCD)) and the Tenex (attention and impulsivity) but I'm not real clear on the Depakote and Abilify. The Abilify has been approved as an adjunct with the Prozac and for irritability assoc with Autism Spectrum Disorders (ASD).

 

[InsaneCdn]

Did you check out side-effects for each one?
Sometimes a medication is "logical" but its the side-effects that come back to haunt you...

Then take ALL of that logic with you to the psychiatrist...

 

[BusynMember]

in my opinion that is way too many medications. As one who has taken medications since age 23 (I'm 58), that would zone me out so bad I would barely be able to function, let alone be productive. I would definitely see a neuropsychologist and a new psychiatrist. Your kid is on a mood stabilizer, an antidepressant, a drug that slows your heart rate (Tenex...used for ADHD/anxiety) and an antipsychotic. He is on the whole gamut of medications and he is probably gaining weight, always hungry, or suffering some effects from so much medication. Like wow.

My teen daughter was on Depakote and she threw it out. She said it made her "stupid" (she couldn't think and it can cause cognitive slowness). She also got an ovarian cysts from it and was in tremendous pain. Prozac had bad effects on three of us in the family. And there are two more drugs? What is this psychiatrist thinking? in my opinion it's worthwhile to find somebody else who is not one who will try to give your child a medication for every single symptom. As you can see, it doesn't work to do that anyway! I get so mad at psychiatrists sometimes. I've been on the "over-medicated" side and it feels worse than the disorder than the medications are for...lol!

 

[STRESSEDTOMAX]

He has gained A LOT of weight and is ALWAYS hungry. Like I said, the main one that seems like it might really be questionable is the Depakote. Prozac has changed my life for the better and they say sometimes what works for the mother, works for the child. Here's what's kind of weird:
The psychiatrist we were going to was for Child and Adolescents and told me up front he wasn't big on medications. I also directly asked the neuropsychologist if he thought he was overmedicated and he said not really..not for all the different symptoms he's having...

 

[DammitJanet]

Im thinking the hungry is coming from the depakote. I dont see a true reason for that with the diagnosis's you list. That isnt to say your doctor's dont feel a need and I am not a doctor. I can understand all the others though with ADHD I would wonder why a stimulant isnt on board unless you have had issues with them before. In my book a stimulant is always the easiest.

I am probably not the person to ask about a ton of medications. I take a boatload but I dont see a way to cut them out. I know what happens when I dont have them and it isnt pretty.

 

[InsaneCdn]

Rather than asking about dropping a particular medication, present your concern in terms of side effects that you believe are excessive and/or dangerous in the long run (like the weight gain and extreme hunger). This does not come across as though you are challenging the psychiatrist's capability with medications... instead, these are additional concerns that need to be addressed.

With the current concerns... I'd say a psychiatrist is likely to be less concerned directly with the weight gain. But, the extreme hunger, and the low-blood-sugar/behavior links... are definitely a concern. For example - if a kid is consistently overeating, but not getting low blood sugar between meals and therefore no behavior impact, it might be necessary to live with the weight gain to get the other benefits. But... this is a bit "over the top" and VERY hard to manage.

While you are at it, consider whether there are behaviors and/or other challenges that are not being addressed... because, if the psychiatrist is going to look at adjusting medications, they might as well (and good ones will prefer to) look at the whole picture.

For example... Sometimes there is a range of medications for one particular issue (adhd focus, for example)... and each of these also have side effects. Side effects can be cumulative... one appetite-increasing medication, combined with another appetite-increasing medication, might be a bigger problem than either medication alone. Side effects can also cancel each other out... one appetite-increasing medication, combined with an appetite-decreasing medication (such as the ritalin family), can be advantages IF the difficult child needs both medications to treat other symptoms/issues.

"Different drugs" to balance out side-effects is worth doing. Other than really main-stream non-mind-altering drugs, I don't like to use "more drugs" to solve a drug side-effect problem. We needed an old standby to deal with stomach problems due to a medication side-effect - ended up being transient problem (treat it, then fine after 6 weeks...).

 

[TiredSoul]

I am questioning the same thing right now. I want to tak difficult child off his medications and see how he does. It's been 4+ years also and really the things that initially brought us in to have him evaluated are still there. He doesn't get in trouble at school as much anymore but I attribute that more to structure and accomodations and maturity.

I am curious to know from Choas if you are going to go thru with taking your difficult child off the medications? My doctor has pretty much said the same thing but when I read the Concerta website for example it suggests periods of no medication to see if it is still needed.

 

[InsaneCdn]

Jules... with stims like Concerta? all it takes is ONE day when they forget to take it... and you KNOW if they still need it. (I do everything in my power now to make sure this does NOT happen... including triple-checking medications before school. Mine are medication-compliant - not resistant - so, if its not taken, its definitely "forgotten")

Longer-acting stuff - SSRIs, for example - take time to build up, and therefore take time to leave your body... so, short trials without medications don't work for these.