Please share your expierience with Medication/Anxiety - Mothering Forums
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#1 of 14 Old 08-19-2008, 12:18 PM - Thread Starter
 
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My DD is 5 years old and has been diagnosed SID and ODD with a possible mood disorder. I personally think after much research that she has more traits of Asperger's, but I am only her Mom and who am I to question a school psychiatrist who can figure it all out in a 15 minute eval?

So anyway, I am really struggling to find the resources we need. I do not feel like we have an accurate understanding of the situation and no one is offering us anything helpful for her. She was in a special ed preschool program and did fairly well there, but has now mainstreamed for Kindergarten and started FULL days last week (They are on an alternative year round schedule). She has been doing ok in the classroom, but has a horrible time on the playground. She hits, scratches and bites teachers and other children. She is having a much worse time at home now too. She has no control over herself and there is a complete lack of empathy for other people or remorse when she hurts them. The biggest problem we have been facing is her anxiety and it seems as though most of her problem behavior is rooted in anxiety. There are times she is so frantic and anxious about something (for example the dog getting hit by a car when we are going for a walk, someone taking or touching something, and sometimes I just don't know what it's about) that I can not calm her down. The biggest struggle we face is being around other children. It is almost impossible for be to spend time with my friends because they all have young children. It is so isolating for the whole family. The only time that DD is at ease is when she is alone or 1 on 1 with an adult.

I have always been against medication, but recently have begun to feel like it is our only hope for getting past this extreme anxiety. My husband has an anxiety disorder and has been on Paxil for the past 10 years, and the more I pay attention I see so many similarities between DH and DD

Does anyone have any experience with medication in a similar situation for such a young child. I just don't know what else could help. This is really a last resort, but we are not able to function in our household. DD is missing out on so much, we all are. Please share with me about your decision to medicate, what medication, and how it changed things?

Thank you for reading this and thank you in advance for sharing.
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#2 of 14 Old 08-19-2008, 03:36 PM
 
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I'm not really going to be able to be of too much help, as my child with anxiety has not been medicated. However, I have heard from several adults that withdrawal from Paxil is extremely rough, and one of my friends was hospitalized with many side effects after trying her doctor's regimen for gradually weaning off. Personally, I take Zoloft for my anxiety, but I do not know any children who are on that particular drug. I do know that one of my former students was taking 5 mg of Lexapro for anxiety, and according to her parents, it had wonderful effects...I also loved Lexapro but was unfortunately allergic.

I am sorry you're dealing with your child's anxiety. My anxious son also exhibits many traits of Aspergers, but he is not currently diagnosed. It isn't easy, I know.
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#3 of 14 Old 08-20-2008, 12:35 PM - Thread Starter
 
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We were finally able to schedule an appointment with a developmental psychologist for two weeks from now, so hopefully we can get some answers. I really don't want to think about medication until someone can give me the whole picture of what we are actually dealing with.

I broke down emotionally yesterday when I realized that I have been at this for the last 3 1/2 years. I have been begging for help and no one is listening. Why is it so difficult to get help?

I would still aprietiate hearing about your expieriences with your childs anxiety and what helps?

Thanks.
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#4 of 14 Old 08-20-2008, 01:32 PM
 
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I think it is smart to hold off on medication until you get a clear evaluation done on her from someone not affiliated with the school. I would take her to a psychiatrist and a nueropsychologist to be evaluated. I would actually try the neuropsych first if you are thinking autism at all because a psychiatrist will look to go the medication route quickly.

I must say, though, that if it is something that can be treated with meds successfully, I would try not to be too fearful of it. We really hesitated with DSD before medicating. She was misdx'ed (ADHD) and the meds made her worse. Getting the right dx was crucial. Once we figured it out (BP/ADHD), we knew that medication was the only way to go with her. We were very nervous from our experience up until then. We went ahead with medication, and we saw a complete turn around in her behavior. It has been amazing to see her go back to the normal child she once was. kwim

So, my point is to really work to get the most accurate dx you can before looking into medicating her. Don't be of the meds, though, if it can give her a chance at some normalcy. Just really know the meds and watch how they affect her. Good luck.

Mama to Ava (12/03) , Leila (4/06) , Violet (11/08) , and bonus mama to Madison (7/98)
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#5 of 14 Old 08-20-2008, 04:49 PM
 
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My DS (6) has severe anxiety/OCD that manifested early on as SPD. We briefly tried Zoloft--that lasted two days because the side effect were unbearable (his doc thought it would be a good one to try first because I have been on it for years with no untoward effects). We also briefly tried Celexa and it didn't do anything.

He's now on a miniscule dose of Risperdal (literally miniscule--half a milligram a day) and it takes the edge off enough for his therapy to be really useful. The last three months have been a turning point for him. This is the first time in six years that I'm not walking around with a pit in my stomach, dealing with rages, etc. I actually enjoy being with him and he enjoys getting out of the house and has a normal life for the first time. Whenever parents who had been in similar situations swore to me that it would get better, I didn't believe them. But here we are.

I hope you find answers soon.
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#6 of 14 Old 08-20-2008, 05:08 PM
 
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I hope that the developmental psychologist will have some more helpful assessment for your dd.

I would ask them about the SID and your feelings about her having some traits of Aspergers and let them know how much it it is limiting your family's social activities and her problems with peers at school on the playground. That's really important for them to consider.

I just get the impression from what you wrote that she is overwhelmed by social pressures. (hugs)
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#7 of 14 Old 08-20-2008, 06:32 PM
 
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Originally Posted by FlowerMomma View Post
I personally think after much research that she has more traits of Asperger's, but I am only her Mom and who am I to question a school psychiatrist who can figure it all out in a 15 minute eval?

It is because you are her mother.. you KNOW her best.. and YOU do know enough.. more than enough.. to question any professional that wishes to diagnose your child in 15 minutes or less.. or even a professional that takes a very long and thoughtful time to diagnose...
Do not ever feel that you, as your child's mother, cannot question the testing, the diagnosis, the treatment..
You are your child's best advocate and sometimes their only voice..


My DS, now 7, as anxiety.. it took years but we feel that the current diagnosis.. SPD, Aspergers, Generalized anxiety disorder and seperation anxeity really do sum up his issues.. We tried medication for a short time (Zoloft) but he is a "hyper responder", meaning that medication acts differently for him and it is unpredictible. Medication isn't really an option for my son.
We have tried suppliments and seen some promise with Inositol, 5HTP and Grape Seed Extract.

It is very very hard, emotionally..metally.. physically.. to parent my child..to deal with my own anxiety in dealin with his anxiety (jeeze.. I wonder where he get's it from.. )
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#8 of 14 Old 08-21-2008, 12:37 AM
 
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I hear you loud and clear, Mama. Carter (who turned 6 just a few weeks ago) has severe anxiety issues. We had a terrible time finding help and I count it among the most difficult experiences of my life.

That said, Carter takes a small daily dose of Zoloft that does wonders for his anxiety and OCD. It doesn't bring it down to what I would consider a "typical" level, but it does get him to a manageable place. We were very, very lucky that the first med we tried a) worked and b) didn't cause any unbearable side-effects.

He started on Zoloft a little over a year ago, so right around his 5th birthday. My DP and I were very worried about starting such a young child on medicine, but life at our house was pure misery for everyone, and pure hell for Carter, so we held our breath and went for it. Thank goodness we did. Truly, he was consumed with his fears and his rituals and now he is able to live his life like the little kid that he is.

All that said, I'm glad you have an appt. with a specialist. A thorough evaluation from a specialist who actually cares about my kid was exactly what we needed. We're very lucky that this doc continues to work with us and is available to us all the time. In fact, if I call him, HE answers the phone! Can you imagine? I wish everyone with a SN kid could have that. But anyway, I hope that you find the dev. psych to be someone that gives you some confidence and will work with you in an effective way.

One thing we've learned is that we don't have a definitive dx to start treating. Carter is a bit of a puzzle and we're still watching and hunting, but life is much better since we started treating. We know that he may have an AS dx in his future, or perhaps something else, but for now we work with what we know and hold the rest for later.

Good luck! I'm looking forward to hearing about the appt. I hope it goes well and the doctor is just the person you've been looking for!

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#9 of 14 Old 08-21-2008, 05:03 AM
 
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My dd is only three and has other issues, temporal lobe epilepsy, disruptive behavior disorder, brain damage and anxiety at times. Right now she is doing really well on Tegretol (to manage her seizures) but it has had the added effect of greatly lessening her anxiety. If this doesn't last, the doctors have talked about adding risperdal or lamictal to the regimen.

If there isn't anything organically or chemically going on with your little one, I would probably try to stay off meds and manage it behaviorally/cognitively. Most of these meds have heavy side effects, some which can cause even MORE anxiety. For instance, my dd has to have blood draws every two weeks to moniter her med levels and this is a huge source of anxiety for her....so it is a catch 22.

My dd also goes to behavioral health at the children's hospital 2x a month and just the therapy alone has had a lot of benefit. I would probably try something along that route first. Can your little one see a private psychiatrist?
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#10 of 14 Old 08-21-2008, 01:45 PM
 
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Here is a summary of my thoughts/experiences with medications for anxiety.

First, if she is having anxiety, possibly contributed to by OCD or Aspergers or whatever, its okay to treat the anxiety without having an exact diagnosis. Among the typical mental health anxiety-related diagnoses, the medications prescribed are going to be the same, pretty much. I wouldn't worry too much about hunting down an exact diagnosis first. You'll want an accurate diagnosis eventually. Sometimes the response to specific medications can actually help figure out the diagnosis.

Most, if not all, anxiety diagnoses can be helped a whole lot by desensitization techniques, behavioral techniques, and/or cognitive therapy. However, if her (and your) quality of life is severly affected by her anxiety, it can be a huge relief to take some of the edge off so that she can focus better and have more successful experiences with anxiety-producing situations. The more practice she has successfully dealing with stressful situations the better she will handle the next stressful situation, and meds can help her get there faster. Once starting meds, combining a medication regime with teaching skills for dealing with anxiety will help her the most and the fastest. As she gains skills in managing her anxiety and overcoming her fears, the meds can be slowly decreased.

Secondly, some meds are better than others in terms of side effects and long-term use.

Here's some common ones that are generally best tolerated and usually have the least side effects:

Anti-depressants commonly used (also used for anxiety particularly if its OCD-related anxiety)
Zoloft (for most people has the least side effects)
Prozac
Celexa
Paxil (has some withdrawal issues usually managed by very slowly decreasing the dose) (also isn't that often prescribed anymore)

Mood stabilizers (also often used to treat seizure disorders)
Depakote - can have a calming effect.
Tegretol - similar to Depakote
Lithium - ugh; probably the most dangerous of the lot
Mood stabilizers can cause liver damage and other physical problems - generally not a good choice for anxiety alone

Antipsychotics/ major tranquilizers
Risperidal - most commonly prescribed for children. It just has an overall sedative effect. Almost always causes weight gain. It has the potential of causing some nasty side effects associated with all the antipsychotics (drooling, odd postures, bizarre facial movements) but this is pretty rare. Typical dose for children is .5mg to 1mg. Very commonly prescribed for behavioral issues, particularly aggression.

Anti-anxiety - the drug class specific to anxiety. Its rarely prescribed to children because the ones that work are addictive and the other ones don't work so well.
Buspar - non-addictive. Also hardly ever works.
Benzo's - (ativan, valium, klonopin, etc lorazepam, diazepam) on an as-needed basis only (with at least a few days between each use).
diazepam, etc). Highly addictive and abrupt withdrawal can sometimes cause great discomfort including seizures in some children. If a child has infrequent episodes of anxiety/aggression/agitation that last longer than an hour or so, this type of medication may be a good choice when given on an as-needed basis with at least a few days between each use.

Inderol/Enderol - a blood pressure medication that helps to prevent adrenaline spikes associated with panic-type anxiety or phobias. It has no side effects that I know of and is really safe. But it only is helpful for specific situations, like if you have a fear of public speaking and have to give a presentation. Kind of works, sometimes.

For most of the kids I know with almost continuous anxiety/agitation, a good medication plan might be:

Try the antidepressants also known for effectiveness with OCD first. Might have to try more than one.

If no relief there, try risperidal at a small dose (starting with .25mg is a good choice), with the option to give another .25 to .5mg as needed.

If side effects of risperdal are too problematic (e.g. weight gain, etc) probably go to a mood stabilizer instead of a different anti-psychotic.
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#11 of 14 Old 08-22-2008, 01:25 AM - Thread Starter
 
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thank you for all your comments. Today was a very rough day for us. DD is really struggling with school. It's a full day program, which is alot I know, but she starts having problems the minute she gets up in the morning. She has been kicking kids on the playground and refusing to participate in classroom activities. Today she gt so upset that she was throwing tables and chairs! They called me to come and pick her up. I am feeling very discouraged. Her teacher asked me (for the second time now) "can't they just give her some medication? I feel like everyone just thinks I should do that because it would be a quick fix. She was doing so well before school started I just hate to see her spiraling downward like this. I am actually tempted to pull her out of this school and either switch to a 1/2 day program or homeschool. I am just afraid that i won't be able to handle that with 2 other children and not alot of support. She is an intense child to spend all day every day with. Anyway, I am rambling... Thanks for listening.
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#12 of 14 Old 08-22-2008, 10:08 AM
 
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I know this is tough. If you feel your child has Aspergers than keep going. Tell the IEP team what you feel.. Ask for a evaluation/re. They have to eval your child again. It took us 3 years to get a aspergers DX. So keep pushing.

I always felt that people thought that I was crazy for seeing aspergers in DS. Until he started getting older and more problems kept coming.
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#13 of 14 Old 08-22-2008, 10:39 AM
 
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Originally Posted by BellinghamCrunchie View Post
Here is a summary of my thoughts/experiences with medications for anxiety.

First, if she is having anxiety, possibly contributed to by OCD or Aspergers or whatever, its okay to treat the anxiety without having an exact diagnosis. Among the typical mental health anxiety-related diagnoses, the medications prescribed are going to be the same, pretty much. I wouldn't worry too much about hunting down an exact diagnosis first. You'll want an accurate diagnosis eventually. Sometimes the response to specific medications can actually help figure out the diagnosis.

Most, if not all, anxiety diagnoses can be helped a whole lot by desensitization techniques, behavioral techniques, and/or cognitive therapy. However, if her (and your) quality of life is severly affected by her anxiety, it can be a huge relief to take some of the edge off so that she can focus better and have more successful experiences with anxiety-producing situations. The more practice she has successfully dealing with stressful situations the better she will handle the next stressful situation, and meds can help her get there faster. Once starting meds, combining a medication regime with teaching skills for dealing with anxiety will help her the most and the fastest. As she gains skills in managing her anxiety and overcoming her fears, the meds can be slowly decreased.

Secondly, some meds are better than others in terms of side effects and long-term use.

Here's some common ones that are generally best tolerated and usually have the least side effects:

Anti-depressants commonly used (also used for anxiety particularly if its OCD-related anxiety)
Zoloft (for most people has the least side effects)
Prozac
Celexa
Paxil (has some withdrawal issues usually managed by very slowly decreasing the dose) (also isn't that often prescribed anymore)

Mood stabilizers (also often used to treat seizure disorders)
Depakote - can have a calming effect.
Tegretol - similar to Depakote
Lithium - ugh; probably the most dangerous of the lot
Mood stabilizers can cause liver damage and other physical problems - generally not a good choice for anxiety alone

Antipsychotics/ major tranquilizers
Risperidal - most commonly prescribed for children. It just has an overall sedative effect. Almost always causes weight gain. It has the potential of causing some nasty side effects associated with all the antipsychotics (drooling, odd postures, bizarre facial movements) but this is pretty rare. Typical dose for children is .5mg to 1mg. Very commonly prescribed for behavioral issues, particularly aggression.

Anti-anxiety - the drug class specific to anxiety. Its rarely prescribed to children because the ones that work are addictive and the other ones don't work so well.
Buspar - non-addictive. Also hardly ever works.
Benzo's - (ativan, valium, klonopin, etc lorazepam, diazepam) on an as-needed basis only (with at least a few days between each use).
diazepam, etc). Highly addictive and abrupt withdrawal can sometimes cause great discomfort including seizures in some children. If a child has infrequent episodes of anxiety/aggression/agitation that last longer than an hour or so, this type of medication may be a good choice when given on an as-needed basis with at least a few days between each use.

Inderol/Enderol - a blood pressure medication that helps to prevent adrenaline spikes associated with panic-type anxiety or phobias. It has no side effects that I know of and is really safe. But it only is helpful for specific situations, like if you have a fear of public speaking and have to give a presentation. Kind of works, sometimes.

For most of the kids I know with almost continuous anxiety/agitation, a good medication plan might be:

Try the antidepressants also known for effectiveness with OCD first. Might have to try more than one.

If no relief there, try risperidal at a small dose (starting with .25mg is a good choice), with the option to give another .25 to .5mg as needed.

If side effects of risperdal are too problematic (e.g. weight gain, etc) probably go to a mood stabilizer instead of a different anti-psychotic.
I'm sorry but I beg to differ with the above bolded statement. The anti-convulsants that are used to treat bipolar are known to cause blood sugar problems. Depakote given to a girl before the age of 20 has been linked to causing PCOS (it did in me). They also have many more side effects. Lithium being the most dangerous is a myth, plain and simple. For bipolar it has a 85% success rate which is the highest out of any of the drugs. It is the only one that has an anti-suicide effect and is one of the only true mood stabilizers (the anti-convulsants work better for mania than depression). It does have side effects, the most serious being the risk of developing hypothyroidism. IMO, though, I would rather develop hypothyroidism than diabetes. You need to drink lots of water because it is processed through the kidneys and it can cause bedwetting in children. The main bonus is that lithium actually helps heal the brain and builds up brain matter. It offers a protective benefit again future episodes. Honestly, people spout the party line about lithium being so dangerous without doing proper research or having any personal experience with the drug.

In regards to risperdal, this is only anecdotal but my son hasn't experienced any weight gain on it. A lot of people do though.

In a child with a possible mood disorder my main advice is do NOT put her on an anti-depressant. If she is bipolar that will throw her into a full-blown manic episode. I think you need to get a really thorough psychiatric assessment. 15 minutes is assinine! My son's assessment included a team of professionals and took about 20 hours! My son's final diagnosis was bipolar disoder and anxiety disorder. The anxiety is being controlled with the bipolar treatments for now (he is on lithium and risperdal). The psychiatrist who diagnosed him said that when a mood disorder is present it is best to treat the bipolar first and then see which symptoms are left over. Good luck to you!

Shawna, married to Michael, mommy to Elijah 1/18/01, Olivia 11/9/02, and Eliana 1/22/06
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#14 of 14 Old 08-22-2008, 10:49 AM
 
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Have you done a lot of research on sensory integration disorder (aka sensory processing disorder)? It does greatly affect behavior and does influence the security a child feels and can disrupt the child's life and it can look like other things.

It can cause tremendous anxiety and cause great difficulty interacting with others.

www.sensory-processing-disorder.com has lots of good information. They also have a newsletter archive to talk about creating a sensory diet for your child.

My daughter has some sensory issues and her behavior has resulted in selective mutism in the school system. But at home with her sisters and me and with her next door neighbor friend, she had chronic negative behavior, meltdowns, impulsiveness, demanding/controlling behaviors.

In an effort to control what was happening to her, she tried to control me and her sisters. She would have angry mood swings (though she seemed to understand that she was allowed to express her anger with words, not with her hands, eventually). The years between 3 and 4.5 were pretty horrid, though like I said, she wouldn't hurt anyone at school (she shut down instead because she was so anxious).

To top it all off, she and I were having a really bad dynamic for a while. I was trying to be the adult, but often I would get too wrapped up in my fatigue and anger in trying to cope with her moods. And she of course was my emotional barometer, so when I couldn't cope, she became worse. When I was in a strong place and able to attend to her strong need for attention/connection, she was much less apt to have behavioral issues.

We took her to a pediatric neuropsychologist, who helped us understand what was causing her issues.

When we found out what was going on, it was wonderful to find out what it was, and be certain of what it wasn't (I was thinking Asperger's too).

If dd had exhibited behavioral problems in school (outbursts of anger or melting down), I would have no qualms about pulling her out and working with her at home. I would rather do that then medicate just so the teachers have a better time handling her.

We will begin formal therapy sessions in a few weeks (after school starts again if the mutism persists which I think it will as we just had her diagnosed in May).

I may eventually turn to medications if working on the sensory issues don't help. But I already see improvement in her because we've been providing plenty of time at the park (the playground equipment is perfect for working with sensory issues). I think, in time, once the sensory issues are worked out, the brain learns to cope a whole lot better and self-regulation comes out of that.

***
Oh, but I did want to add, we've had an regression with behavior a bit the past two weeks, but I attribute that to the fact dd knows school is starting up again, so it's very stressful.

Mama of 3 girls: 7.5 , 6 , and 4.5
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