Re: Drugging your child ...

[Guest guest]

----- Original Message -----

> I forgot to ask this in my last post but I was wondering how many of

> you struggled with the decision to put your child on medication for

> their ocd or other problems.

*****Hi Esther, my child had an abrupt and severe onset when four, about to

turn five. At that young age she begged me to find some way to make it go

away. The rapidly ensuing psych evaluations, diagnosis of lifelong brain

disorder, and prescription for (scary at the time) SSRI took my breath away.

But it all happened so quickly, and my child was miserable and

dysfunctional, that we did not struggle with the decision to medicate. We

were just sort of stunned, and desperate for any hope of relief. At that

time, at her young age, in this area therapy was not an option for us.

I did spend a lot of time afterwards cringing that I was " drugging " my young

child, and did do a lot of second guessing when it turned out that we needed

to trial several SSRIs before hitting on the effective " right " one for her.

I have been challenged and called to task occasionally over the years by

teachers and others who believe we made the wrong decision, and no young

child should be medicated. Early on this sent me into a frenzy of

self-doubt about this decision, but in time I realized these people do not

understand the extent of my child's misery before successful medication. I

have come to believe that it's something that has to be lived to be truly

understood.

> brain disorders (sorry! I hope I

> don't offend someone by wording it like that! I'm not sure how to

> refer to ocd, adhd, odd, etc.)

*****OCD and etc. are biochemical brain disorders, I don't think there's

anything offensive in calling them that.

> Admittedly, the thought of going through what some of you have gone

> through with getting your child's meds regulated is intimidating.

*****SSRIs can certainly be mixed blessings, and no one enjoys the long

periods of time they can take before it's known whether they will be

effective in a certain person. Balancing meds in children with more than

one disorder *can* be very challenging since a med that helps one disorder

can worsen the other, and any may have side effects like any other type of

medication. I encourage anyone with a child with comorbid disorders to see

a pediatric pharmacologist or experienced pediatric psychiatrist for med

management, I don't think generally it's a job for the typical pediatrician.

Also, I wonder if people tend to post more often about their frustrations

and problems with medications? This may give a false impression that

medications always cause as many problems as they solve.

> Right now, my son's symptoms don't ~seem~ that

> bad but after reading some of your posts yesterday, I'm wondering what

> he's really going through. UGH. There's definitely something to be

> said for the modern medicine!

> I'm so confused and frustrated. On the one hand, I don't want to jump

> on any bandwagons and label my son unnecessarily. On the other hand,

> ocd, adhd, depression, Tourette's, etc. are very real!!!

*****You could have your son evaluated, and you don't have to share any

diagnosis that comes of this with the school (unless he needs formal

accommodations) or even family if you don't want to. It may be that your

son wouldn't qualify for any particular diagnosis anyway, and there are

behavioral therapies used to address each of the disorders you mention (with

the exception of TS--not sure) if you want to avoid medication.

I forget (forgive me) how old your son is, but have you asked him if he is

bothered by this or that problem and whether he would like to see if there's

a way to reduce it? The disorders you mention are diagnosed in part by how

much interference and distress they cause the person in their daily life.

HTH,

Kathy R. in Indiana

----- Original Message -----

> I forgot to ask this in my last post but I was wondering how many of

you struggled with the decision to put your child on medication for

their ocd or other problems.

>Admittedly, the thought of going through what some of you have gone

through with getting your child's meds regulated is intimidating.

Also, I used to work in a pediatric practice and the only kid I was

aware of who was on medication for brain disorders (sorry! I hope I

don't offend someone by wording it like that! I'm not sure how to

refer to ocd, adhd, odd, etc.) had to be on a few things because the

first one caused " A " which had to be counteracted with another med

which caused " B " , etc. Right now, my son's symptoms don't ~seem~ that

bad but after reading some of your posts yesterday, I'm wondering what

he's really going through. UGH. There's definitely something to be

said for the modern medicine!

>I'm so confused and frustrated. On the one hand, I don't want to jump

on any bandwagons and label my son unnecessarily. On the other hand,

ocd, adhd, depression, Tourette's, etc. are very real!!!

>Thank you, Chris(???), for sharing the response from your daughter,

" A " . Because of that I will definitely be keeping a closer eye on my

son. I struggled with some of the things, to a much lesser degree,

that your daughter did but I was never dx'd with ocd. The LORD knew I

needed my particular mother to be my Mom. From what I've been

reading, she was the therapist for me! :-)

>Looking forward to your insights,

>Esther

[Guest guest]

Thanks again for your reply. We are still possibly going up on the prozac or

we will switch to luvox. Can I ask about the tics. My son started tourette

typr stuff like saying no no no over and over out of control. Now he's whistling

and there's a lot of facial grimacing. We thought it was the adderall so we

switched back to concerta. Is this an ocd behavior as well. He's always done

something, the latest was pulling all his eyelashes out. How do you ever know

what is from what?? You can tell we're not so stable yet. But he's gone to

school

everyday this week. Thank God. Thanks for your support. Marcy

[Guest guest]

Hi Marcy, you wrote:

> reading all these emails and it's comforting to hear we're not alone. My

son

> is 12 and has ocd and add. We're having trouble gettting the right combo

of

> meds. Now he's on concerta and prozac 30 mg. The stimulants for the ADD

make the

> ocd worse. Straterra didn't work so well. It's so hard to know what to do

and

> the doctors don't know everything. From reading these posts it sounds like

> other kids are on combinations to address the ocd. Which is best?

******My daughter's official dx is OCD +tics, but she has " aspects " of both

TS and ADHD too. Her doctor has always suggested that we treat the OCD (her

worst problem by far) with medication and any ADHD-type symptoms

behaviorally, due to the problem of balancing meds for these two disorders

without worsening each. I realize this approach may not work well for a

child whose ADD and OCD are equal problems.

For a long while she took Zoloft along with a small dose of Paxil (both

SSRIs) for the OCD, along with Risperdal (an atypical antipsychotic) for the

tics. It is unfortunately trial and error to find which combos of meds may

work best in a particular child, I don't think it's possible to draw too

much from what has worked for other kids.

Some docs are very cautious when prescribing meds for children, for example

your son may need a higher dose of Prozac to address his OCD symptoms. From

your description he is still experiencing significant anxiety and OCD so

there is a lot of room for improvement. Successful CBT/ERP can also reduce

OCD symptoms, some kids can comfortably reduce or quit their SSRI altogether

after this. That would obviously be very helpful in your son's situation

where he apparently also needs medication for the ADHD. Better anxiety

control through the proper SSRI may make the idea of therapy more palatable

to him.

I'm not a doctor...just another Mom whose been through the medication

situation. You may also want to consider having your child seen by a

pediatric pharmacologist who would be an expert in balancing the type of

meds your child needs (depending on how long the current doctor has been

trying to balance his meds to afford him relief.)

Take care,

Kathy R. in Indiana

[Guest guest]

Hi Marcy, the picture gets clearer once your child is more stabilized!

Getting there is the trick...

Basically OCD, tics/TS, and ADHD are like the corners of a triangle.

According to my child's doctor, many kids with one of these diagnoses will

have some symptoms of the other two--and in some cases a child may have two

or all three of these disorders full-blown. The medication that treats each

of these disorders can unfortunately worsen the other two. So, stimulants

to treat ADD or SSRIs to treat OCD may worsen or bring out tics, for

example. My daughter is one who had a lot of problems with SSRIs causing

(or in her doctor's words, " potentiating " ) tics.

It *is* hard sometimes to tell tics from compulsions. One difference is

that OCD compulsions are done to relieve anxiety caused by an obsession. So

a child will be feeling scared or having a bad thought, and do a compulsion

to make this stop (it only works briefly, then the thought comes back so the

child has to do a compulsion again.) Tics are different, there's no anxiety

or scary thought, but instead there may be an " itch " or discomfort feeling

that is relieved by doing the tic. Can your son tell you which he is

feeling when he whistles or grimaces? That may help you tell the tics from

the compulsions. Whistling or grimacing could be OCD compulsions, almost

anything can be, but I think more often they are tics. I think you are

probably right thinking that the Adderall brought these out.

My daughter's doctor told me he sometimes " diagnoses by pharmacology " in

other words, if he gives a med that should reduce tics, and a certain

behavior reduces or goes away, then likely that behavior was a tic. Or if

it gets worse, he may then think that the behavior is instead an OCD

compulsion.

FWIW my daughter told me she'd rather tic than have OCD symptoms any day.

The only exception was a blinking tic which drove her nuts. For this she

was started on Risperdal which basically killed all her tics in a few

days--occasionally one or two would get going again but they'd peter out

quickly.

All I knew to do when my child was trying different medications was to take

short notes of what I noticed day by day. That way when my daughter's

ticcing got really bad about a week after starting a certain SSRI, or she

began pulling the dog's hair out, I could tell the doctor that so that

adjustments or changes could be made. Otherwise everything was just a big

confusing mess to me.

That's great that your son has made every day to school this week!

Kathy R. in Indiana

----- Original Message -----

> Thanks again for your reply. We are still possibly going up on the prozac

or

> we will switch to luvox. Can I ask about the tics. My son started tourette

> typr stuff like saying no no no over and over out of control. Now he's

whistling

> and there's a lot of facial grimacing. We thought it was the adderall so

we

> switched back to concerta. Is this an ocd behavior as well. He's always

done

> something, the latest was pulling all his eyelashes out. How do you ever

know

> what is from what?? You can tell we're not so stable yet. But he's gone to

school

> everyday this week. Thank God. Thanks for your support. Marcy