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Update, answers to questions, medication cocktail
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<blockquote data-quote="mindinggaps" data-source="post: 763934" data-attributes="member: 29823"><p>Dear [USER=18958]@Copabanana[/USER] - as always you raise excellent points and ask very good questions. There is lots to discuss here.</p><p></p><p></p><p>Firstly, regarding this recommendation you are spot on in my opinion. The minute high and dangerous levels of rage and aggression are identified, to the best extent possible parents should seek comprehensive psychiatric evaluation and commence treatment as soon as possible. Obliviously, this isn't accessible to all, but lots of research does show that early intervention leads to better longer term outcomes. I believe I am an example of this approach. </p><p></p><p>My symptoms emerged very young. This was in the late 80s, it was a different time. My parents had to fight hard to seek help and ultimately found experts who were willing to do experimental trials with medications. At this time the usage of psychiatric medications in young children was almost unheard of, but my parents enrolled me in a clinical trial for Prozac because they were worried about the long term impacts of the rage and aggression. I will be forever grateful for this because it gave me a chance. Properly medicated, I was able to exist in normal classrooms, engage in regular activities and proceed through life. Without medical intervention, this would have been impossible and the trajectory may have been very different. Of course, nowadays there are much more standard approaches and medications along with other treatments are more readily accessible. Acting quickly and administering proper treatment is a must in my opinion.</p><p></p><p>Before answering your question about cause, I'd like to touch upon another subtle benefit of early intervention which is building understanding in the young patient. There is often a desire to sugarcoat issues, but sometimes clear communication on the issue is required and young patients must understand their situation - they <em>need</em> medications in the same way someone with type 1 diabetes requires insulin. Psychiatrists were clear to me regarding this fact and it led to better compliance and deep understanding of the situation. Do not hide it. Growing up, all caregivers and those responsible for me were aware of the Prozac treatment and knew that without it, aggression and rage were inevitable. In conjunction, I knew I needed the medication and did not <em>want </em>to experience rages - as a result I was diligent with adherence and could also sense when dosage adjustments were required, requesting changes as needed. I always had clear discussions with psychiatrists and they also trusted that I would be transparent. This is something which continues to this day because I learned how to do it at a young age.</p><p></p><p>Typically, a properly medicated patient will want to comply and a good psychiatrist will work to ensure things are going well. I view my cocktail very pragmatically and see it as something which is a constant work in progress. I can provide more details here and have some clear and interesting examples of useful exchanges with the psychiatrist which led to changes in the cocktail - let me know if helpful.</p><p></p><p>Now, regarding the cause, I believe it is a mixture of biochemical dysregulation, genetics and external factors. Many examples of rage and aggression can be attributed to different activities in areas of the brain stemming from either stress at a young age, stress in the mother during pregnancy or environmental factors. Ultimately, who knows and in some sense I don't think it matters. We can get very caught up asking why, but this doesn't help move the actual situation forward. Knowing the underlying reason is something many parents seek, but it can be a philosophical question rather than a useful one - that energy is likely better spent taking action. Digging for the background also doesn't impact treatment plans, which are often the single most important aspect of long term prognosis. For my parents it was more helpful to know that strict adherence to Prozac prevented rage and aggression than it was to know the background for it.</p></blockquote><p></p>
[QUOTE="mindinggaps, post: 763934, member: 29823"] Dear [USER=18958]@Copabanana[/USER] - as always you raise excellent points and ask very good questions. There is lots to discuss here. Firstly, regarding this recommendation you are spot on in my opinion. The minute high and dangerous levels of rage and aggression are identified, to the best extent possible parents should seek comprehensive psychiatric evaluation and commence treatment as soon as possible. Obliviously, this isn't accessible to all, but lots of research does show that early intervention leads to better longer term outcomes. I believe I am an example of this approach. My symptoms emerged very young. This was in the late 80s, it was a different time. My parents had to fight hard to seek help and ultimately found experts who were willing to do experimental trials with medications. At this time the usage of psychiatric medications in young children was almost unheard of, but my parents enrolled me in a clinical trial for Prozac because they were worried about the long term impacts of the rage and aggression. I will be forever grateful for this because it gave me a chance. Properly medicated, I was able to exist in normal classrooms, engage in regular activities and proceed through life. Without medical intervention, this would have been impossible and the trajectory may have been very different. Of course, nowadays there are much more standard approaches and medications along with other treatments are more readily accessible. Acting quickly and administering proper treatment is a must in my opinion. Before answering your question about cause, I'd like to touch upon another subtle benefit of early intervention which is building understanding in the young patient. There is often a desire to sugarcoat issues, but sometimes clear communication on the issue is required and young patients must understand their situation - they [I]need[/I] medications in the same way someone with type 1 diabetes requires insulin. Psychiatrists were clear to me regarding this fact and it led to better compliance and deep understanding of the situation. Do not hide it. Growing up, all caregivers and those responsible for me were aware of the Prozac treatment and knew that without it, aggression and rage were inevitable. In conjunction, I knew I needed the medication and did not [I]want [/I]to experience rages - as a result I was diligent with adherence and could also sense when dosage adjustments were required, requesting changes as needed. I always had clear discussions with psychiatrists and they also trusted that I would be transparent. This is something which continues to this day because I learned how to do it at a young age. Typically, a properly medicated patient will want to comply and a good psychiatrist will work to ensure things are going well. I view my cocktail very pragmatically and see it as something which is a constant work in progress. I can provide more details here and have some clear and interesting examples of useful exchanges with the psychiatrist which led to changes in the cocktail - let me know if helpful. Now, regarding the cause, I believe it is a mixture of biochemical dysregulation, genetics and external factors. Many examples of rage and aggression can be attributed to different activities in areas of the brain stemming from either stress at a young age, stress in the mother during pregnancy or environmental factors. Ultimately, who knows and in some sense I don't think it matters. We can get very caught up asking why, but this doesn't help move the actual situation forward. Knowing the underlying reason is something many parents seek, but it can be a philosophical question rather than a useful one - that energy is likely better spent taking action. Digging for the background also doesn't impact treatment plans, which are often the single most important aspect of long term prognosis. For my parents it was more helpful to know that strict adherence to Prozac prevented rage and aggression than it was to know the background for it. [/QUOTE]
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