Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 In a message dated 7/23/2006 12:09:03 A.M. Eastern Standard Time, tamara_naranjo@... writes: He jeopardized 's life, however, by disregarding serious side effects and not making time for timely checkups. I feel that I need to warn people.................................. My husband says I should send a copy to our insurance company. Any suggestions? Tamara - Yes! I found a list of state licensing/medical boards & on the AMA website. This is where you want to address your complaint. I agree with your husband as well - definitely copy them on your letter, if for no other reason but to inform them so they can reevaluate whether or not this doctor should be a part of their provider list. Here is the website - find your state & write that letter. Who knows how many other people went through the same as you have with this doctor & just never bothered to say anything to anyone. _AMA (Ethics) Complete state information_ (http://www.ama-assn.org/ama/pub/category/13365.html) Good luck Tamara! LT Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 Tamara, wow, I am so sorry to hear of your experiences. I assume that you are seeing a new pdoc at MGH soon? Was westwood able to help him the second time around, did they do any better? Hang in there, It will get better! > > came home from the hospital yesterday, his second time > there in 6 weeks. Both times, he was hospitalized after becoming > suicidal on an SSRI. It's possible that his main problem may be > bipolar disorder. Thankfully, he has an appt. on Tuesday with a new > p-doc. > > His former p-doc put his life in danger. For weeks he attributed > 's scary behavioral side effects to anxiety. At the last > appt., he instructed me to double the 20 mg. of celexa to 40 mg. then > follow up with him at his next available appt. – 5 weeks later (!). > The previous visit, after ran from us twice, he increased his > risperdol. For a while, the higher dose of risperdol made the > behaviors a little less intense and frequent. From the beginning, I > knew it was the celexa that was causing him to become increasingly > agitated, out of control and always on the edge of a meltdown. He > had disturbing episodes of disinhibition and strange fits where he > would say nonsense syllables and spit. A few times he complained > that the sound of people talking sounded like a foreign language or > nonsense because he had so much noise in his head. His meltdowns > were always followed by desperation, where he would cry and yell that > he's a rotten person for behaving so badly, he hates his life and he > wants to die. > > My therapist agreed to manage his meds until we found a new p- doc. > By the time she saw she was so disturbed and concerned for his > safety that she thought he should be hospitalized while getting off > of celexa. She felt that because he was so impulsive, he shouldn't > be more than arm's length from me while tapering off the 20 mg. > celexa in 5 mg. increments every 4 days. The first 2 days were > awful. The second night she called and urged me to take him to the > ER, but I resisted. The next day, however, his behavior escalated to > the point where he said he would kill himself. I was so afraid of > how he would react to having to go back to the hospital that I gave > him something to help him fall asleep, then, at my therapists urging, > I called the police for help getting him there. He calmly went with > the paramedics in the ambulance and he waited fairly calmly in the > ER. When he found out that he would have to be admitted to the > children's unit again, he freaked out – screaming, punching the bed > and walls and yelling " what did I do? " " I just want to go home " and > that he would rather kill himself than go back there. That was one > of the saddest days of my life. > > What I don't understand is how my therapist recognized a child in > danger of hurting himself while the other doctor thought nothing of > his behavior. My therapist said that if we hadn't brought him to the > ER that day, she would have been obligated to call the police or DSS > because she was afraid we couldn't keep him safe. > > Another example of the p-doc's irresponsible med management for kids > is how he handled 's side effects from prozac. After 2 > weeks of activation-type side effects – agitation, bad behavior, > etc., he started having dizzy spells, intense anxiety and panic, > worsening OCD thoughts and noises and sounds in his head. The p- doc > is only in once a week and he has no voice mail. When someone from > the practice called me back 8 hours later, I was told that the dose > (10 mg.) was much too small to cause any side effects and anxiety > rather than prozac was the cause of his symptoms. If I wanted to > take him off of it, I should do it cold turkey and send him to > school. That was the first day of 6 weeks of missed school. > > The former p-doc has a great reputation. He apparently is great with > kids who have ADHD. He jeopardized 's life, however, by > disregarding serious side effects and not making time for timely > checkups. I feel that I need to warn people. I want the doctor to > know that he failed and that he could be responsible for > another child committing suicide. I also want to tell parents that > they need to trust their gut and not believe everything doctors say. > I'll start by sending a letter to the p-doc and his practice. My > husband says I should send a copy to our insurance company. Any > suggestions? > > Thanks for reading this long e-mail. > > Tamara > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 Tamara, I feel for you ,and have been in your shoes. This sadly seems to be the " norm " . I'm afraid I may be heading for that path again with my son this time. I have been trying to fight this system for years with these " Unknowlegable " supposed child psychiatrists.My daughter is 9 and has been on 23 different med combinations with 2 hospitalizations and 3 partial hospitalizations, mainly because they couldn't get it right!. I have tried writing letters to the hospitals and to representatives, but have never gotten any responses. There seems to be only power in numbers. If you or your husband or anyone else out there knows how we can stop all this, I'll be right behind you to do what I can. hugs! Judy mom to Brittany-11-NT -going into 6th gr-high honor student -Brittany's twin-3-29-95--4-7-95 -9-bp,ocd,odd, 50 mg seroquel 75mg trazadone 75mg zoloft going into reg 5th gr class-504plan iel 4-ocd, speech problem-going into kindergarten-speech therapy, 2.5mg prozac Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 Tamara, I feel for you ,and have been in your shoes. This sadly seems to be the " norm " . I'm afraid I may be heading for that path again with my son this time. I have been trying to fight this system for years with these " Unknowlegable " supposed child psychiatrists.My daughter is 9 and has been on 23 different med combinations with 2 hospitalizations and 3 partial hospitalizations, mainly because they couldn't get it right!. I have tried writing letters to the hospitals and to representatives, but have never gotten any responses. There seems to be only power in numbers. If you or your husband or anyone else out there knows how we can stop all this, I'll be right behind you to do what I can. hugs! Judy mom to Brittany-11-NT -going into 6th gr-high honor student -Brittany's twin-3-29-95--4-7-95 -9-bp,ocd,odd, 50 mg seroquel 75mg trazadone 75mg zoloft going into reg 5th gr class-504plan iel 4-ocd, speech problem-going into kindergarten-speech therapy, 2.5mg prozac Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 > Yes! I found a list of state licensing/medical boards & on the AMA website. > This is where you want to address your complaint. I agree with your > husband as well - definitely copy them on your letter, if for no other reason but > to inform them so they can reevaluate whether or not this doctor should be a > part of their provider list. LT, Thank you for the information! I will do what you suggest. Tamara Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 I wanted to respond to your post. First of all, thanks for sharing what happened to your son. I think this type of thing is not uncommon even though it is very unfortunate. I'm very sorry you have had to go through such a trauma and I truly feel for you. I would like to offer some advice about what might be helpful to your son in the future. You didn't, as far as I can see, mention his age, but I assume he is still a minor. First, there are a couple of really good books you should read which addresses many of the concerns in your post. The first book is called The Antidepressant Fact Book by Breggin. The second book is called Your Drug May be Your Problem(same author). These books address the dark side of the meds as well as how to safely get off them. The second thing is that as you look around for a new psychiatrist, it would be good to have all your sons experiences with meds documented in writing, make sure the new pdoc understands the importance of " starting low and going slow " with the meds, that he is sensitive to your concerns about side ffects, and also it would be very beneficial if the psychiatrist is aware of and is open to alternatives to meds like lifestyle changes and supplements. The third thing I suggest that you consider is getting genetic testing for how your son metabolizes meds. There is a genetic test that is relatively easy to perform called cytochrome p450 testing(insurance will sometimes pay for it especially if it is ordered by your doctor). What this test does is test for certain important enzymes needed to metabolize meds properly. Every body metabolizes meds differently and that is one major reason why some do well on certain meds and others don't. People's genes have an important effect on how much ability they have to safely use and get benefit out of meds. The enzymes that P450 cytochrome testing tests for are key in the metabolization of many meds including psychiatric ones. In my opinion, the more you know about your son's genetic profile in this regard, the better off you will be. The enzymes usually tested for are 2D6, 2C9, and 2C19. There are a number of labs in the country that do this testing. The Mayo lab at Mayo clinic does the testing, but a doctor must order the test. Also, a company called genelex does it and you can order it directly through them without your doctor having to order. The website for them is www.genelex.com . They have a great website that explains everything you need in order to understand this stuff as well as how to get started. They also have great customer service if you just want to get your questions answered or need help getting started. Best of luck in the future with your son-please keep us posted. Debbie Let down by doctors came home from the hospital yesterday, his second time there in 6 weeks. Both times, he was hospitalized after becoming suicidal on an SSRI. It's possible that his main problem may be bipolar disorder. Thankfully, he has an appt. on Tuesday with a new p-doc. His former p-doc put his life in danger. For weeks he attributed 's scary behavioral side effects to anxiety. At the last appt., he instructed me to double the 20 mg. of celexa to 40 mg. then follow up with him at his next available appt. - 5 weeks later (!). The previous visit, after ran from us twice, he increased his risperdol. For a while, the higher dose of risperdol made the behaviors a little less intense and frequent. From the beginning, I knew it was the celexa that was causing him to become increasingly agitated, out of control and always on the edge of a meltdown. He had disturbing episodes of disinhibition and strange fits where he would say nonsense syllables and spit. A few times he complained that the sound of people talking sounded like a foreign language or nonsense because he had so much noise in his head. His meltdowns were always followed by desperation, where he would cry and yell that he's a rotten person for behaving so badly, he hates his life and he wants to die. My therapist agreed to manage his meds until we found a new p-doc. By the time she saw she was so disturbed and concerned for his safety that she thought he should be hospitalized while getting off of celexa. She felt that because he was so impulsive, he shouldn't be more than arm's length from me while tapering off the 20 mg. celexa in 5 mg. increments every 4 days. The first 2 days were awful. The second night she called and urged me to take him to the ER, but I resisted. The next day, however, his behavior escalated to the point where he said he would kill himself. I was so afraid of how he would react to having to go back to the hospital that I gave him something to help him fall asleep, then, at my therapists urging, I called the police for help getting him there. He calmly went with the paramedics in the ambulance and he waited fairly calmly in the ER. When he found out that he would have to be admitted to the children's unit again, he freaked out - screaming, punching the bed and walls and yelling " what did I do? " " I just want to go home " and that he would rather kill himself than go back there. That was one of the saddest days of my life. What I don't understand is how my therapist recognized a child in danger of hurting himself while the other doctor thought nothing of his behavior. My therapist said that if we hadn't brought him to the ER that day, she would have been obligated to call the police or DSS because she was afraid we couldn't keep him safe. Another example of the p-doc's irresponsible med management for kids is how he handled 's side effects from prozac. After 2 weeks of activation-type side effects - agitation, bad behavior, etc., he started having dizzy spells, intense anxiety and panic, worsening OCD thoughts and noises and sounds in his head. The p-doc is only in once a week and he has no voice mail. When someone from the practice called me back 8 hours later, I was told that the dose (10 mg.) was much too small to cause any side effects and anxiety rather than prozac was the cause of his symptoms. If I wanted to take him off of it, I should do it cold turkey and send him to school. That was the first day of 6 weeks of missed school. The former p-doc has a great reputation. He apparently is great with kids who have ADHD. He jeopardized 's life, however, by disregarding serious side effects and not making time for timely checkups. I feel that I need to warn people. I want the doctor to know that he failed and that he could be responsible for another child committing suicide. I also want to tell parents that they need to trust their gut and not believe everything doctors say. I'll start by sending a letter to the p-doc and his practice. My husband says I should send a copy to our insurance company. Any suggestions? Thanks for reading this long e-mail. Tamara Our list archives, bookmarks, files, and chat feature may be accessed at: / . Our list advisors are Gail B. , Ed.D., Tamar Chansky, Ph.D.( http://www.worrywisekids.org ), Dan Geller, M.D.,Aureen Pinto Wagner, Ph.D., ( http://www.lighthouse-press.com ). Our list moderators are Birkhan, Castle, Fowler, Kathy Hammes, Joye, Kathy Mac, Gail Pesses, and Kathy . Subscription issues or suggestions may be addressed to Louis Harkins, list owner, at louisharkins@... , louisharkins@... , louisharkins@... .. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 > The third thing I suggest that you consider is getting genetic testing for > how your son metabolizes meds. There is a genetic test that is relatively > easy to perform called cytochrome p450 testing(insurance will sometimes pay Hi Debbie, Thank you for your support and advice. is 10 years old. On someone's suggestion here a few weeks ago, I've been keeping a thorough timeline of his reactions to meds and a separate, condensed timeline with just dates & dosages. I'm going to drop it off at the new p-doc's office before his 1st appt. on Tuesday. I think I read that the problem metabolizing meds effects something like 5% of children. A couple of questions: 1) if he does have difficulty metabolizing certain meds, does finding that out just let the doctor know to go slowly with meds, or would he be able to actually determine, in advance, which meds would be more easily tolerated? 2) would the testing indicate other conditions that could effect his ability to get insurance coverage in the future, or would they just test for that specific condition? I will look for the books, though I have a feeling I'll be afraid to have him on any medication after reading about them. Tamara Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 I had the same experience with my son (7yrs old). He was suicidal on 2 different SSRI's and a combination of drugs did not help him either. The doctor keep saying that he wasn't convinced that it was a side effect of the meds. I came to the realization that for us nothing could be worse than suicide and so when the doctor failed to return my calls, I took him off the meds. The doctor explained that he was in remission and I didn't believe that for a second because he went into " remission " in 1 week with no intervention outside my discontinuing the meds. His therapist was not much better. SHe went away for the summer and gave us no work to do or any direction in the midst of developing an IEP and 504 plan. I found a CBT group and got a second psychiatric opinion. I have pursued a suspected developmental disorder that might explain some of his anxiety. I vowed that I will do whatever I have to to avoid meds. Your insurance company probably will not be interested to hear your allegations about the doctor unless fraud is suspected. The state board of medical examiners would be the place to report these issues if you like. Just wanted to tell you that I share your frustration and pain. I hope things get better soon. Bonnie > > came home from the hospital yesterday, his second time > there in 6 weeks. Both times, he was hospitalized after becoming > suicidal on an SSRI. It's possible that his main problem may be > bipolar disorder. Thankfully, he has an appt. on Tuesday with a new > p-doc. > > His former p-doc put his life in danger. For weeks he attributed > 's scary behavioral side effects to anxiety. At the last > appt., he instructed me to double the 20 mg. of celexa to 40 mg. then > follow up with him at his next available appt. – 5 weeks later (!). > The previous visit, after ran from us twice, he increased his > risperdol. For a while, the higher dose of risperdol made the > behaviors a little less intense and frequent. From the beginning, I > knew it was the celexa that was causing him to become increasingly > agitated, out of control and always on the edge of a meltdown. He > had disturbing episodes of disinhibition and strange fits where he > would say nonsense syllables and spit. A few times he complained > that the sound of people talking sounded like a foreign language or > nonsense because he had so much noise in his head. His meltdowns > were always followed by desperation, where he would cry and yell that > he's a rotten person for behaving so badly, he hates his life and he > wants to die. > > My therapist agreed to manage his meds until we found a new p-doc. > By the time she saw she was so disturbed and concerned for his > safety that she thought he should be hospitalized while getting off > of celexa. She felt that because he was so impulsive, he shouldn't > be more than arm's length from me while tapering off the 20 mg. > celexa in 5 mg. increments every 4 days. The first 2 days were > awful. The second night she called and urged me to take him to the > ER, but I resisted. The next day, however, his behavior escalated to > the point where he said he would kill himself. I was so afraid of > how he would react to having to go back to the hospital that I gave > him something to help him fall asleep, then, at my therapists urging, > I called the police for help getting him there. He calmly went with > the paramedics in the ambulance and he waited fairly calmly in the > ER. When he found out that he would have to be admitted to the > children's unit again, he freaked out – screaming, punching the bed > and walls and yelling " what did I do? " " I just want to go home " and > that he would rather kill himself than go back there. That was one > of the saddest days of my life. > > What I don't understand is how my therapist recognized a child in > danger of hurting himself while the other doctor thought nothing of > his behavior. My therapist said that if we hadn't brought him to the > ER that day, she would have been obligated to call the police or DSS > because she was afraid we couldn't keep him safe. > > Another example of the p-doc's irresponsible med management for kids > is how he handled 's side effects from prozac. After 2 > weeks of activation-type side effects – agitation, bad behavior, > etc., he started having dizzy spells, intense anxiety and panic, > worsening OCD thoughts and noises and sounds in his head. The p-doc > is only in once a week and he has no voice mail. When someone from > the practice called me back 8 hours later, I was told that the dose > (10 mg.) was much too small to cause any side effects and anxiety > rather than prozac was the cause of his symptoms. If I wanted to > take him off of it, I should do it cold turkey and send him to > school. That was the first day of 6 weeks of missed school. > > The former p-doc has a great reputation. He apparently is great with > kids who have ADHD. He jeopardized 's life, however, by > disregarding serious side effects and not making time for timely > checkups. I feel that I need to warn people. I want the doctor to > know that he failed and that he could be responsible for > another child committing suicide. I also want to tell parents that > they need to trust their gut and not believe everything doctors say. > I'll start by sending a letter to the p-doc and his practice. My > husband says I should send a copy to our insurance company. Any > suggestions? > > Thanks for reading this long e-mail. > > Tamara > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 After reading so many stories, I'm very wary of meds for my 7 year old. And, we are determined to explore all other options, should it become necessary for him. So far, he seems to be doing better with CBT and ERP, but who knows if this is truly better or a waning period. I'm so grateful for the information here in this group, as well as the support. I feel so much for your families, almost like I know them. And it is upsetting to read about setbacks and difficulties. But, great to hear about triumphs. I just wanted to mention that. It's so hard to talk to friends and almost impossible to talk to relatives about this. And I truly appreciate this group. Remember to take care of yourselves too. That is so important. My dh and I have been really consciously trying to " spoil " each other through these last few months, while we've gone through the worst of it. Funny, we remember to take care of others, but leave ourselves out. I used to feel guilty taking time for me, but not anymore, it's critical Anywho, back to the topic, I will check out thoroughly any medications before we try it. It's so hard to know the right things to do. You want to trust your doctors, but they make mistakes, lots of them. On the positive side, Ben hasn't said " bad thought " in two days. That is new. So things are looking up for us, today. Take care all. mom to Ben 7 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 After reading so many stories, I'm very wary of meds for my 7 year old. And, we are determined to explore all other options, should it become necessary for him. So far, he seems to be doing better with CBT and ERP, but who knows if this is truly better or a waning period. , I know when I joined and read about meds and problems I looked to alternative options too. We first used inositol powder but then later tried Celexa. I was " on the alert " when he went on Celexa as to any changes, suicidal thoughts, etc. He did well! So I consider us lucky in that our first SSRI wasn't a bad experience, as others have had to trial a few and then find one that helps without any bad side effects. He stayed on Celexa all through 9th and 10th grades. If your son and family aren't in too much distress then, of course, therapy alone may well work. Even when on meds, therapy is the *key* to overcoming OCD and eventually trying to be " med free " , meds don't cure it. And many recommend trying therapy first, just that some are so in distress by the time they seek help that medication is needed to lower anxiety/OCD for therapy to begin to be effective. Nothing you don't know, I know, but for all the posts you read about the bad times, many who do well don't bother posting the good results and medication has given so many their lives back! I myself know that if I trialed a med for that if he had any behavioral side effects that seemed harmful to himself or others or sunk into depression or actions or some type thing, I'd be wanting to go ahead and take him off certainly! Especially suicidal or violent! And I would take him off if he had those results. But the next med might not have the same problem. But most doctors/mental health professionals know that a med can cause initial side effects which usually pass, and want the patient to try it for a month at least, which many take 8 weeks to even take effect so the docs prefer an 8 week trial. The thing is, my thoughts, that they don't always realize just how serious things may be in the home and might tend to shrug parent comments off, since docs are used to initial effects, etc., comments on agitation or sleepiness, etc. I've heard many " sighs " where I work (mental health center) because parents stop medication for their kids too soon (within a week or two) and then still want the psychiatrist to " fix " their kid due to their having bad behaviors and/or want their child out of the home, etc., and what psychs do is prescribe medication. (I'm thinking of the children's dept here, where in our county it seems OCD is very rare for treatment so this isn't OCD related behaviors) I will say the therapists and other workers do wonderful jobs with the kids/teens, some good programs. Anyway, just some rambling thoughts! Will be glad to share our inositol powder experience with you. It worked well for thru middle school. He recently went back on it due to bad thoughts and other returning OCD, but he's not sure it's helping this time. It did take quite a few weeks to really kick in and help him last time too though, but others have had quicker success. Then some have had no success with it either. Might not help at all this time, will just have to wait and see. He's managing OK right now overall, compared to how bad off he was a few months ago. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 Thanks I've thought about the inositol after reading about it here. If we go through another bad period, I will try that first. Luckily, we were already homeschool, always had planned to, so we don't have many of the school issues we might have otherwise. Any info on the inositol would be great. Thank you. Re: Let down by doctors After reading so many stories, I'm very wary of meds for my 7 year old. And, we are determined to explore all other options, should it become necessary for him. So far, he seems to be doing better with CBT and ERP, but who knows if this is truly better or a waning period. , I know when I joined and read about meds and problems I looked to alternative options too. We first used inositol powder but then later tried Celexa. I was " on the alert " when he went on Celexa as to any changes, suicidal thoughts, etc. He did well! So I consider us lucky in that our first SSRI wasn't a bad experience, as others have had to trial a few and then find one that helps without any bad side effects. He stayed on Celexa all through 9th and 10th grades. If your son and family aren't in too much distress then, of course, therapy alone may well work. Even when on meds, therapy is the *key* to overcoming OCD and eventually trying to be " med free " , meds don't cure it. And many recommend trying therapy first, just that some are so in distress by the time they seek help that medication is needed to lower anxiety/OCD for therapy to begin to be effective. Nothing you don't know, I know, but for all the posts you read about the bad times, many who do well don't bother posting the good results and medication has given so many their lives back! I myself know that if I trialed a med for that if he had any behavioral side effects that seemed harmful to himself or others or sunk into depression or actions or some type thing, I'd be wanting to go ahead and take him off certainly! Especially suicidal or violent! And I would take him off if he had those results. But the next med might not have the same problem. But most doctors/mental health professionals know that a med can cause initial side effects which usually pass, and want the patient to try it for a month at least, which many take 8 weeks to even take effect so the docs prefer an 8 week trial. The thing is, my thoughts, that they don't always realize just how serious things may be in the home and might tend to shrug parent comments off, since docs are used to initial effects, etc., comments on agitation or sleepiness, etc. I've heard many " sighs " where I work (mental health center) because parents stop medication for their kids too soon (within a week or two) and then still want the psychiatrist to " fix " their kid due to their having bad behaviors and/or want their child out of the home, etc., and what psychs do is prescribe medication. (I'm thinking of the children's dept here, where in our county it seems OCD is very rare for treatment so this isn't OCD related behaviors) I will say the therapists and other workers do wonderful jobs with the kids/teens, some good programs. Anyway, just some rambling thoughts! Will be glad to share our inositol powder experience with you. It worked well for thru middle school. He recently went back on it due to bad thoughts and other returning OCD, but he's not sure it's helping this time. It did take quite a few weeks to really kick in and help him last time too though, but others have had quicker success. Then some have had no success with it either. Might not help at all this time, will just have to wait and see. He's managing OK right now overall, compared to how bad off he was a few months ago. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 23, 2006 Report Share Posted July 23, 2006 Hi, You are welcome. To respond to your first question, the testing would reveal what particular enzymes would be deficient as well as what other medications would probably be better to use. For example, if someone was found to be deficient in 2D6(slow metabolizer), that would mean that certain meds like prozac and a whole bunch of other commonly prescribed psychiatric meds could have a high likelihood of creating severe and sometimes dangerous side effects if used. The good thing about testing for the two other enzymes(2C9 and 2C19) as well as the 2D6 is that if someone tested as being a normal metabolizer in those two other enzymes, then meds that relied primarily on 2C9 or 2C19 could be used. As a result, the meds wouldn't be nearly as likely to have bad side effects. Essentially, by using this testing, it is much easier to make the right decisions about meds. Furthermore, it is important to know that there are 4 different main types of metabolizers-poor metabolizer, intermediate metabolizer, extensive metabolizer, and ultra extensive metabolizer. By knowing exactly which type of metabolizer a person is, a doctor can more accurately determine the right dosage of a medication instead of putting the person at a level that would be appropriate for most people, but not the specific individual. As far as insurance is concerned, the test is only for that condition and there would not be other conditions that would be tested for (unless you specifically requested it) or revealed to the insurance company (at least as far as I'm aware). Really, this type of testing is a lot like testing for any other genetic condition and I am not aware of any way it could be used to discriminate. Also, the percentage is higher than 5% because if the individual is an intermediate metabolizer, the percentage goes up. The lower percentage of about 5%-6% is often quoted in reference to poor metabolizers. There is one thing to be aware of and that is that this is a very new medical technology that most doctors have heard about, but know very little about. This means that it might be somewhat of a challenge to get some doctors to order it because they often don't have much, if any, experience ordering it. You might actually find yourself in the position of having to explain to your doctor how and where to order it. It can be intimidating to ask a doctor to order a test he or she has next to no familiarity with. If the doctor is willing to order it, that is a good sign and means that once the results come back, he can probably interpret it and use it for your sons benefit. I hope all this makes sense to you, answers your questions, and has been helpful. Debbie Re: Let down by doctors > The third thing I suggest that you consider is getting genetic testing for > how your son metabolizes meds. There is a genetic test that is relatively > easy to perform called cytochrome p450 testing(insurance will sometimes pay Hi Debbie, Thank you for your support and advice. is 10 years old. On someone's suggestion here a few weeks ago, I've been keeping a thorough timeline of his reactions to meds and a separate, condensed timeline with just dates & dosages. I'm going to drop it off at the new p-doc's office before his 1st appt. on Tuesday. I think I read that the problem metabolizing meds effects something like 5% of children. A couple of questions: 1) if he does have difficulty metabolizing certain meds, does finding that out just let the doctor know to go slowly with meds, or would he be able to actually determine, in advance, which meds would be more easily tolerated? 2) would the testing indicate other conditions that could effect his ability to get insurance coverage in the future, or would they just test for that specific condition? I will look for the books, though I have a feeling I'll be afraid to have him on any medication after reading about them. Tamara Our list archives, bookmarks, files, and chat feature may be accessed at: / . Our list advisors are Gail B. , Ed.D., Tamar Chansky, Ph.D.( http://www.worrywisekids.org ), Dan Geller, M.D.,Aureen Pinto Wagner, Ph.D., ( http://www.lighthouse-press.com ). Our list moderators are Birkhan, Castle, Fowler, Kathy Hammes, Joye, Kathy Mac, Gail Pesses, and Kathy . Subscription issues or suggestions may be addressed to Louis Harkins, list owner, at louisharkins@... , louisharkins@... , louisharkins@... .. Quote Link to comment Share on other sites More sharing options...
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