My teen has been on zoloft for about 14 years. He seems to be over stimulated all the time and aggressive., lots of self injurious head banging, pinching of others. It's like it cannot snap out of a behavior, as if he is really seeking sensory satisfaction. I'm concerned about risperdal weight gain and don't want him lethargic. I want him to continue to enjoy life and be happy with less behaviors. Propranolol was added and I don't think it helps. Any suggestions?
as counterintuitive as it may seem, increasing the dosage of stimulant medication may be something to look into. I myself proved to be extremely tolerant to them and require a dose that makes most pharmacists cringe. The dosage i needed was far beyond the recommended limit, but my doctor stuck with me every step of the way making sure I stayed on top of doctors visits to see if the dose was damaging my physical health. After countless EKGs, blood tests, etc...my body's reaction is no different to it than my mind's. I thought there was no treating my symptoms, turns out this was only true if I "colored inside the lines like the rest of the kids" and pretended everyone is made from the same mold.
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I think by far, the best researcher is, or could be, the parents.
All my life I have seen studies and reports of research tending to support the opposing views of drugs and therapy. I believe they are earnest in the findings, just that there is a never ending flow supporting one or the other, or some un-quantified mix of the two.
None of them can come into my home and concentrate on my child.
For most of us the studies and reports are general because the authors cannot worked with our particular child.
Ultimately, they give me choices. Too many choices, perhaps, but that's all. I can read which drugs might help my child, which therapies might work, even have been shown to work, in general. It's akin to a lot of people knocking on my door with their best guess.
Parents have to choose and constantly analyze their child's behavior, trying to attribute the slightest change to some,thing. What made that happen? It's a scary effort. Are we harming or helping long term?
If only it were simple. Shows how complex our mind is.
For far too long people have dismissed ADHD as a laughable disorder. It is accused of being over diagnosed, over medicated and at the end of the day, a behavioral or parenting issue.
I believe none of this to be true.
I have worked with a Psychiatrist over the past 5 years on a medication regiment and behavioral changes to address my disorder and I continue to struggle, despite making great headway.
I began therapy after spending most of a day with a revolver to my head. I had recently come home from an addiction treatment facility where I had been successful in quelling my alcoholism. I expected great things for my life...and became quickly dismayed at what was in store for me.
As a child, I acted out constantly, as a teenager I had rampant anger problems and social phobias and as I moved into adulthood, I drank my overwhelming sense of frustration away. It was my medication. In hindsight, I now see that alcohol has a similar focusing effect to stimulant medications, often seen in the "one track mindedness" of an intoxicated person.
Since i was suicidal, it was clear that antidepressants were needed, but the use of them put me in a hypo manic state indicative of bipolar disorder. Subsequently I was placed on anti-psychotic medications to prevent mania and eventually mood stabilizers were also added to the mix. I became a shell of a human being.
All the medications I was now on made me drowsy, a fact I mentioned to my doctor. He decided to add Provigil, an anti-narcolepcy drug also approved for general wakefulness with third shift sleep disorder.
The introduction of this drug was a breakthrough for me, but the doctor I was currently seeing was a refill merchant, not a therapist. I found a doctor that was both.
When I mentioned the overwhelmingly positive effect of Provigil on my mood, the new doctor immediately questioned me about ADHD...something that had never been considered before this point. It turned out that stimulant medications were far and away the best treatment not only for my ADHD, but for my bipolar as well. The inability to focus during a manic episode can be maddening. If you want to understand the sensation, try to listen to every conversation around you at a cocktail party, all at once, while generating your own views an opinions on what is being said, in real time.
I commend my doctor for taking chances on me. As an addict, I would take my ritalin or adderal, which would improve my mood and naturally lead to me wanting more. More medication, the better I felt. This quickly got out of hand. The ups and downs of pill form stimulants reinforced my addictive tendencies and my therapy turned into another form of substance abuse.
To this day I remain on an extremely high dose of stimulant medications, doctor after doctor have been sure that the dose is an unhealthy one. However, every EKG, blood test, physical exam, pulse/blood pressure reading have indicated that my body is not in a hyper-animated state.
Currently, my regiment consists of Wellbutrin, Zoloft, Abilify and Daytrana. The last medicine is a "ritalin patch." I put it on my skin and go on about my day. The high dose i mentioned is 2x30Mg patches 2x daily. Yes, a total of 4 30Mg patches per day. The patch is a blessing for an addict. It's not abusable, there's no "highs or lows" to it and it doesn't create an oral reinforcement behavior like pill medications did for me.
The point of all this information? I decided I wanted to live when I put that gun down. I did not want to merely exist or scrape by, but LIVE. I wanted comfort in my own head, not the madness of my unmedicated mind. My doctor and I are now focusing on behavioral therapy more and more, as it seems clear I found the proper regiment of medications to create a stable foundation upon which to rebuild my life.
...you asked if we do more harm than good in perusing a medical treatment for our children with ADHD...my answer should be clear. Not only would earlier treatment have saved me a lifetime of torment, but spared me the countless risk taking activites associated with ADHD that eventually led to rehab, and a long debate with a handgun.
Listen to your children. Observe. Never be afraid to try something outside the box. Stay determined, and do not underestimate this disorder. I may be a severe case...but so could your child.
I truly hope this helps someone out there in internet land.