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Need advice : My son on abilify


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My nine year old has been on abilify for almost a year now. He started off at 2mg which seemed to calm him down some for a few weeks. So mouch so he even commented on how much he thought it helped him. Then we went up to 5mg because 2 stopped working. His angry rages and out burst and destruction of property just got out of hand. Problems at school were on the rise also. Even though he gets good grades on tests he refuses to do work unless he is captivated by it ex, egyptology, marine animals, astronomy. He cannot make friends because he calls people idiots and morons if they don't share his same interest. Well the 5mg didn't help either actually I feel like he got worse so trileptal 2x a day was added to the mix. That cause more problems as he was wired up like a speed freak and could go days with out sleeping. The Dr told me 2 options: ! was hospitalization, 2 was upping the abilify to 10 mg. Since my son freaked out at the prospect of going to the hospital for observation i opted for the 10 mg . Well he has not improved any at all. It has been almost a month and he is so violent and mean to my 3 year old daughter. He kicks stomps and tears things up if he doesn't get his way. You cannot rationalize with him as he refuses to listen harping on the same thing for hours at a time. He feels like he hates everyone that we are all against him ranting and raving until he finally crys and says we all hate him and are plotting against him. I am really at a loss. He embarasses me to tears when I have to go out in public with him because it never fails he will scream and hollar and tell me what a terrible mother I am. So my question is this...should I have him hospitalized for observation? And if so what exactly do they do there?

Thanks

Shannon

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Does your pdoc not know of any other meds?

Am I ignorant or is there some reason the lil guy can't have lamictal? Or lithium? Or geodon? (But I found geodon to be coma inducing)

I love my lamictal+lithium.

I am not sure he'll listen to anything now. I used to think my wife was plotting against me. But would have big apology sessions too. I still feel horrible at how horrible I was.

My advice, and I'm no doc, is put him in the hospital. I'm not sure he's taking his meds, and in his state, you don't need to feed his paranoia. Call the doc and ask him about lamicatal and/or lithium.

Don't let things like this go for months. Oh, and, if he's not having depression too, he's not bipolar.

I was in the hospital for trying to kill myself as a teen. They really didn't do much, in my opinion. But, I really hadn't started my downward spiral at that point.

Hey, good to have you. Hope someone can help you more than me. I really feel like I just ramble and say inappropriate things here.

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Hi and welcome. My first question is do you trust your doctor, has he earned your trusted? Does he explain things when asked? Do you ask? You need to know how long these med changes take to show up so your not waiting months for nothing. You need to know from him and ask yourself can you do these changes outside of a hospitol setting. I know he's only young but he is getting worse and maybe violent, due you want to deal with it, can you? These are questions only you can answer. But he definetly doesn't sound like he's on the right meds and needs a change, and as much as I hate to say it the hospital is usally the fastest and safest place for that. Good luck and pm e if you need anything.

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Abilify is a poor choice for the symptoms you describe IMHO. I don't know why his doc is stuck on this idea. Risperdal may make more sense. Abilify is not a typical atypical anti-psychotic. It doesn't blockade dopamine like the others. Sounds to me like he needs to have the dopamine spigot turned down a notch.

SZS

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I agree with sun, speak to the pdoc about switching to another medication such as Risperdal. It's another AAP so he should be open to it because it is in the same family. And at the same time I believe it more likely to help your son than the Abilify. Even if the doctor doesnt want to switch to Risperdal, at the very least Abilify clearly isnt working so he needs to understand that and to get your son off it and on to something else.

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To be completely honest if I was not a broke single mom of 3 I would definately have a different doctor. My ex is schizoaffective and the first meds he was put on was zoloft and abilify. I had specifically told the dr that abilify and zoloft didn't work for him. But he was so hell bent on wanting to say that my son had schizophrenia in the beginning. Then it was adhd and something called emotional distress syndrome and lastly now bipolar. But through all these different diagnosises the abilify has remained a constant. even when we tried the trileptal the abilify stayed the same. He is getting worse and I am tired of seeing him struggle. What bothered me most was before the trileptal was that he said hre didn't want to increase his abilify over 5 mg and yet we doubled it to 10, I have also noticed that since he moved up to the 10 mg he has been having more night waking and wetting his pants sometimes. His chewing and eating up pencils, crayons, erasers has increased too. I am just really at a loss. IT has been nice though to be able to talk to everyone that has responded as it takes the edge off of feeling so alone. There is no help from my ex as he has his own thing going on and everything he gets from social security goes to staying strung out and since he didn't ever work enough to earn the required credits the two children i have with him get nothing. That doesn't bother me as much as that he just takes no interest in their life and yet my son looks up to and thinks so highly of him. I also know he is totaly against our son receiving psychiatric care and being on medicines. But I just want my son to be happy.

Thanks again sorry I write so long

Shannon

.

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Shannon,

The posted considerations are good.

Even considering all the possible med change suggestions, the hospital may be the safest place to try them.

BUT... there can be a lot of 'separation' issues with hospitalization. Lots of misunderstanding by your child. It appears you are in a situation where you need to make a choice rather quickly, but it might be a good idea to check out the hospitalization program to see what's involved and how you feel about it and ALSO, even though he does not want to go, see how you can turn it, somehow, into a 'positive' for him so he does not feel punished or abandoned.

If he goes, be sure to visit as much as is allowed.

And, really, see if there's some way you can afford a psychotherapist. There's a world of difference in the way they see things and the way pdocs see them and meds aren't the total answer.

See if you can find one that follows 'Object Relations' theory (Winnicott) or Attachment Theory (Bowlby). This is just from personal experience.

Then, consider looking around to at least talk to other pdocs just to be sure you are comfortable in their perceptions of your child's problems.

Remember that if you have other children they are all affected in some way by this and should all be involved in some level of therapy.

I know it's easy for me to make all these suggestions when you are on the $$$ paying end, but...

Take care.

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Shannon,

It is time for the hospital. It seems obvious that he is getting progressively worse despite his treatment. His doctor seems to be ignoring most treatment algorithms. At least in a hospital an attending might be able to suggest another means of addressing his current state. If Bipolar is the diagnosis, lithium should be the first choice.

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As for insurance, and stuff like that, I know that the coverage I get isn't even something I pay for as insurance. I work for the govt and all of us are covered by some Behavior Health Something. Sixteen dollar copay. I'm not sure how things work out in other areas or other things like that, but it's always worth a call. This isn't normal health stuff, so it's often covered separately/differently.

Don't know if that helps.

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Hi Shannon,

I'm going to go out on a different limb here.

The hospital sounds in order at this point, but from what you've written i don't see it making much of a difference for your son. He will yell and scream at the staff, yes they are used to it. as a person once in the neighboring ward, i'm telling you there is a lot of kids screaming and destorying things. it would get it out of his system, allow med adjustment, but he is probably still going to feel the same way about authority and feel like his problems are beyond his control, which at the impressionable age of nine, looking at facing a life with MI, is scary.

He must be scared, you must be scared, i don't know how you are managing to hold together with all of this. please gather support from this group. If what i'm saying is not supportive and plain scary, do disregard it

i think the hospital in order is the monstrosity of the wilderness, a huge pile of wood to hack to pieces, canyons to scream into, a reminder that life is so small in comparison, down time, books in his subjects of interest that seriously challenge is bright intellect, a dictionary for the words he doesn't understand. I don't know where you find this, especially when broke, but he needs people older than him as friends. he has got to learn patience if his thoughts move the speed they do. the patience to fish, the patience to get to know someone, the patience to learn respect, the knowledge of manhood aside from his father's, and ultimately the respect for womanhood which you and your daughter deserve. That all is a huge situation to create, but the kind of life experience that could transform some lasting change, and let him know that there is room for his person in the world, that everyone is not against him in an effort to push him towards conforming to something his mind just won't have. I feel so much for you, for him, and it is easy to argue for how crucial a point this is in his life.

If there are any Uncles or church groups (regardless of your place spiritually, a church will always be a support for those in need), backpacking summer camps anything. Maybe the best would be to contact the local boy scouts. Maybe one of the older groups is doing a spring break trip and your son could go along, perhaps as a badge in mentorship. I guess that's a lot to ask of the world, especially of trust and of men, but it's a thought, note: i am prone to manic and creative-to-the-point-of-damaging ones. I think the tendency of a worried mother, mind you i am not one (yet, although i think enough to be one sometimes), is to try and control the enviornment of the kid more and more, when what is needed is a leap of trust, an uncontrolled and somewhat scary situation, which your son has no choice but to seize control of. His MI, regardless of the final correct diagnosis, is a huge thing he is going to have to learn to battle himself, as much as you want to get him help, he has to make a cognitive choice and i doubt there is any pill capable of doing that. Abilify really slowed me, so confused and slowed, unable to take the next step, my mind fought it sooo hard, wheels learned to spin despite it, not good. For millenia nature has dealt with our pysches, your son deserves the chance to see beyond his world. I guess i'm biased, my boyfriend is an eagle scout from TX, and i grew up in mountains. Anyways going out on a limb with an alternative. Between PBS and the library, there is enough info to prepare him for an experience that, yes would be scare, but by that virture, transforming

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I have to take exception to what usernametaken, is suggesting.

While there is value in the suggestions themselves, in the context of being acutely ill, there is little to gain from them. If that was the answer then shannon's son would be diagnosed as a having a personality disorder. As her son is diagnosed with an affective disorder the current affective state should be assumed to be a result of pathology not environment.

That being said, if the current state can be brought under control there is potential for such things to be beneficial.

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His chewing and eating up pencils, crayons, erasers has increased too.

Hm. I'm not sure I own a writing implement without toothmarks, and my issue (in that respect) is ADHD. Some of his other worsening behaviors also overlap into the ADHD range. Some do not.

I'm going to go out on a limb and suggest that he's on too-goddamned-much Abilify, and that it's driving dopamine levels into the ground. He might not be sleeping not because he's over-stimulated and "wired" but from akathisia - in which case there isn't a comfortable position or location on the planet (been there done that, ended up gnawing a handkerchief to pieces one night) ... until the poor kid collapses from exhaustion.

In the unlikely-but-not-impossible case of bipolar with comorbid ADHD, monotherapy with an AAP might be the sort of thing to slowly proceed to send a kid completely out of control without him being able to explain well enough exactly what's he's feeling. It sounds like he's past the point an adult would tell the doctor to change meds or lose a patient.

My guess is that one of the anticonvulsant mood stabilizers would be better, or even lithium - in a hospital setting if the current MD isn't open to alternatives - and that IF there were ADHD in the picture it would be quite a while off the AP before he could tolerate a stimulant without crashing hard and obnoxiously hyper every day.

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exception taken

i generally dislike commenting about kids and parenting and what not

As her son is diagnosed with an affective disorder the current affective state should be assumed to be a result of pathology not environment.

That being said, if the current state can be brought under control there is potential for such things to be beneficial.

i believe my initial wording did not express this. yes the problem is pathological and pathology should be the first treatment, by competent doctors. my intention, albeit ill-communicated, is that looking towards the future it is natural to fall into paradigms which could strip the child of empowerment to confront the pathological realities of the future. mom is doing all the best and i do NOT say this is a result of enviornment by implying that a change in enviornment is going to fix/solve anything. merely posing something outside the box as part of a whole mental health diet. thank you for culling me on this glen. Shannon, apologies for any disrespect

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i am going exactly where null went to say that it sounds to me like he needs an AD(H)D screening. all those symptoms point to a need for strattera/a stimulant and not abilify. abilify is activating for a lot of people, and it sounds like it is making the little guy worse. i'd really rethink the abilify.

as for the hospital, i think that's the best thing to do. they can adjust his meds in a safe environment and observe him. there are also other pdocs there who will have different insights and may understand the problem in different ways.

good luck with him. there isn't any reason why he can't be a well-adjusted, happy little boy.

ps- i'd hold on both geodon and risperdal, based on my experiences with them. geodon made me homocidal and risp made me lose my periods (tampered with prolactin) and lactate. guys get lactation too.

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that poor kid. abilify clearly isn't working & may be making him worse. even if you don't go for hospital i hope you get another doc asap.

my sympathies to you and kudos for wanting him to be healthy, not just 'easy to control'.

i wonder, if you explained hospital would work really hard to find him a medicine that would make him feel good and not better? would that help? you might have to save the explanation until he is calmer: the poor kid sounds so out of control, i bet he's not rational at all.

i wish i had more to add other than please feel free to come on back here for support.

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Just wanting to say "thank you a lot" for everyone's responses. IT really helped me in some strange way feel not so alone in a world that really just feels way to big at times. I took my son an hour and a half away to the hospital last night. Fortunately he was a really good sport about it, better than I am now because I keep feeling like something is missing.

Here is someting I was not aware of, that when you are a child and say that you wish your sister had never been born that is considered a homicidal thought or that when you say the same of yourself it is considered suicidal? I was totally unaware of this. His treatment plan is for 11 days. The first thing is to get him off of abilify and find him something better suited to his needs. His social skills and anger problems will also be addressed. I feel bad to live so far away and not have transportation to see him during visitation. Really what I am getting at is that I hope I did the right thing. And with that said thanks again for putting up with a worried mother that added more than her fair share to her son's mental genetic soup.

Shannon

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Even with the transportation problems and distance, try to find ways to see him as often as possible - or at least communicate by phone. It's important. Logic and understanding on the child's part can't totally compensate for thoughts of abandonment and loss of parent. Send regular funny cards? Just be sure he knows directly that you're there.

(Advice, not 'guilt tripping', it's obvious you care and have communicated that to him.)

Hope it all comes together. Maybe this will actually serve to open communications even more. Always a good thing.

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