Weaning off Risperidone

[miche]

My daughter (age 6) was prescribed Daytrana (a nightmare), then tenex (no effect) then Risperidone (current medication) for her undiagnosed behavior issues. Temper tantrums, rages, non-compliance, general nastiness, hyperactive whatever you want to call it.

The Risperidone seemed to work after about a month (went from .25 mg to .5 mg a day). However now the doctor is convinced that because it worked, she is bipolar (we have no family history of any kind of mental illness at all). We are seeking other opinions.

Bottom line -- we are afriad of the side effects and possible long term damage when we haven't even seen a psychiatrist yet. (psychologist, pediatrician, and behavioral pediatrician thus far) They all think we DONT need to go the psychiatric route nor do we need any tests done.

So we've decided to take her off the risperidone and start from scratch with therapy.

The doctor is not returning my calls -- how do I wean her off from this? She's only been on it for 6 weeks, only 2 weeks at the current dose.

 

[susiestar]

First off, I would not wean off this with-o a doctor's supervision. Second, what kind of pediatrician tells you that because risperdal works she is bipolar?

You NEED to see a child and adolescent psychiatrist. If they will not do a referral get a new doctor who will. Raise a stink if you have to.

Risperdal is an atypical antipsychotic. It can help people with bipolar or any one of MANY problems. Wiz took it for YEARS to help with aggression and he has Asperger's - not any kind of mood disorder.

Risperdal is not a diagnostic tool. It is a medicine. If they think she is bipolar then they need to work with first line mood stabilizers and the risperdal.

ALL medications have side effects and are scary. You need to weigh things carefully. I always asked if her behavior with-o the medication would hurt her more than the medications would. For Wiz it was a safety issue. No medication like risperdal and we would all have been dead. Or he would be. He was that dangerous. he was also that suicidal. Now he doesn't need them, but it took a LOT of work to get him there.

PLEASE get a doctor's supervision before you change the medications. PLEASE insist that you need a psychiatrist AND a neuropsychologist evaluation. If you have to find one on your own, gofor it. If you are near OK and want the name of a developmental pediatrician who IS a psychiatrist and insists that his staff do a complete round of testing on each new patient, let me know. This is the doctor that Shari took weegfg to recently - the one who seems to have found the key to helping weegfg. He truly is excellent.

I am sorry they are being so difficult.

 

[RWHangel]

This sounds all too close to home. I send my sympothies to you as my 6 year old is going through very simular problems she also spent a short time at a psychiatric hospital for suicide talk. I totally agree raise a stink call your ins. company change pediatrician doctor what ever you have too. It took us a year and lots of tests to get where we are now and she only has been on medications for about 4 months total and is on 3 differant kinds to help her. That desicion did not come lightly either. Absolutly insist on seeing a psychiatrist they are the only ones that can really get the testing and ensure proper diagnosis and proper medications. Mine is on Concerta for ADHD, Resperdone for aggression and psychotic features, and Clonidine for sleep disturbance ADHD so on. Please Please be your childs voice and demand to see a proper doctor and get the proper tests to know what is wrong.

My prayers are with you.

 

[BusynMember]

I would have a doctor help you wean her off.

And then I'd get a neuropsychologist evaluation. Risperdal helps more than just bipolar. There are other disorders and you don't want her being misdiagnosed, which happens often at age six.

How was her early development? Her relationship with peers? Did she ever have speech delays or quirks? Play with toys correctly? Can she hold a conversation? How is school?

I would be leery of any doctor who makes a diagnosis based on a reaction to a medication. From long expeirence with mental health professionals for both myself and my autistic spectrum son I prefer NeuroPsychs for diagnosing because they do intensive testing (6-10 hours) and don't just jump to in my opinion fast, baseless conclusions. I like how careful they are and how involved the testing is. My son was also quickly and wrongly diagnosed with bipolar because "his birthmother was a drug addict so he must have bipolar." He doesn't. But he was on heavy medications for three years until we finally decided to get another type of testing and another opinion (he is much better now). I disagree that psychiatrists do the best testing (and I've seen plenty). I think NeuroPsychs do much better testing and they look for both psychiatric and neurological disorders--and they can mimic one another.

in my opinion therapists are extremely poor diagnosticians and that isn't where to go to find out what is wrong. They CAN be very helpful once you know what you are dealing with, but they tend to blame the parents and use behavioral methods that just don't work for differently wired kids.

Good luck, whatever you decide to do.

 

[smallworld]

I agree with the previous posters. A positive (or negative reponse, for that matter) is not diagnostic in and of itself. Risperidone treats psychosis associated with schizophrenia, mania associated with bipolar disorder, generalized anxiety, irritability and aggression. It is frequently used to calm children who have Autistic Spectrum Disorders.

Only a child psychiatrist can diagnose pediatric bipolar disorder. If it is suspected in your daughter, you need to see a child psychiatrist. It is also a good idea to have your daughter evaluated by a neuropsychologist since she is young and many symptoms of childhood disorders overlap. A neuropscyh should be able to tease out what is going on. I live in Maryland and might be able to provide you with some names of providers. PM me if you're interested.

If you can't get your doctor to call back with instructions for weaning, you might want to talk with your pharmacist. I understand antipsychotics should be weaned and not stopped abruptly.

Hang in there.

 

[miche]

I would have a doctor help you wean her off.

And then I'd get a neuropsychologist evaluation. Risperdal helps more than just bipolar. There are other disorders and you don't want her being misdiagnosed, which happens often at age six.

How was her early development? Her relationship with peers? Did she ever have speech delays or quirks? Play with toys correctly? Can she hold a conversation? How is school?


Good luck, whatever you decide to do.

Her early development was fine -- she was always a challenging child -- very strong personality emerged at age 3 -- had some bad daycare experiences and teachers who tried to push her into being more mature than she was, but otherwise, just alot of temper tantrums and non-compliance. Early talker, early walker, very intelligent, is very bossy with peers but still has friends. She always played fine with toys, fine with converstations with anyone. School was rocky in Kindergarten mostly due to a bad 1st year teacher. Once she was switched, it was great. She is now in a private Catholic school and is doing very well.

Currently she is seeing a Behavioral Pediatrician. I am seeking out a Child Psychiatrist and have asked my regular pediatrician for a recommendation.

We are taking her off this medication, one way or the other. husband is adamant about this -- she is not violent nor dangerous so we think that the risks outweigh the benefits of calm behavior. I just wish the doctor would call me back. !!

 

[TPaul]

Dear Miche,
Might I ask what kind of side affects is she currently having taking Risperidone? You did not mention any negative side affects she is currently experiencing in you post. Are you worried about future side effects then if she is not showing any now?

If she is not having any problems now, I would keep her on the medications, because from your post she seems to being helped by it. Get her to a Psychiatrist and then go from there.

My son is bipolar, wife too. Though many times there can be bipolar condition to varying degrees in many families without anyone realizing that is was there. Certain quirks that family members might have had, some one being full of energy and super creative. Not all of the symptoms of BiPolar (BP) are seen as negative. Some very famous people through out history are believed to have been BiPolar (BP).

 

[tinytoy]

Hi Michelle: I am new to the group and am still learing ins and outs of how to post messages etc.

Reading about your child in the first few years was like reading a biography of my own daughter. She is 8yrs old and was diagnosed with ODD, depression, anxiety, and PTSD. She is on risperidone 0.5mg, and sertraline 5mg. I have seen an amazing difference in behavior with her on the risperidone. She doesn't have as many explosive anger moments, and it seems to have helped with her anxiety. I would suggest continue looking for a pediatrician Psychiatrist for a second opinion, even a third or fourth. I wouldn't wean your little one off the risperidol as the withdrawl effects could be severe, you never know what would happen.

Well good luck in your search for professional help and I will keep you in my thoughts.

Tinytoy

 

[miche]

Our daughter hasn't had any side effects to Risperidone. We have read up on what could happen, and the doctor has told us all about the weight gain, muscular problems, etc. that may never go away. We weren't told of any of this when she started the medications. I read the leaflet, but sometimes those side effects are so rare -- I guess in this case they aren't? Anyway, we're not willing to chance it. She's only been on the medications for a month.

What are the 'severe' withdrawl effects she might have? I haven't heard of those....she's also on a low dose -- .25 mg twice a day -- which she just started two weeks ago. We've started to give her .20mg today instead. husband is ADAMANT that we stop the medications. I'm not going to be able to talk him into keeping her on them, since I"m afraid of the potential effects as well. It's the term "antipsychotic" that scares both of us. I mean, we both have pretty normal families, nobody is even on prozac LOL. How could BiPolar (BP) just 'show up' in our daughter like that?

 

[timer lady]

Michelle,

I have to agree with T.Paul; if the medication is working don't mess with it at this point. At the age of 6 there will be many diagnosis's before you know what the problem is - if there is a problem. (I'm not questioning your concerns but some kids are just are socially off the mark or simply a PITA until they mature a bit more - I have a couple of nieces that were that way.)

Don't take her off this medication with-o a doctor's supervision.
In the meantime, get a copy of the Explosive Child (think that's the name) that may give you a few ideas until you get some ideas of what's going on.

Early Onset Bi-Polar (EOBP) early onset bipolar does happen - we have quite a few parents here with difficult children with that diagnosis.

Good luck.