because i still don't know how to respond directly to comments ... LJ? no problem. I can maneuver that blogosphere. Blogspot? it befuddles me. Anyway, here's an updated post. If you haven't read the first post on Aspie Boy's new meds, read that one first: http://threesmithkids.blogspot.com/2010/01/just-one-more-thing-on-my-list.html
OK, so since everyone had wonderful comments, I realized i didn't give enough history on Aspie boy's mental health issues so my readers can give more direct help. Although I'm totally loving all of this attention, literally eating it up! so nice to be loved, even in virtual life.
Aspie Boy has a gentic disorder and is symptomatic for Asperger's and ADHD. In other words, he has a genetic cause for his issues. He has a host of minor medical issues including a geographic tongue, reflux, chronic constipation, severe allergies and minor skin issues. He wears ankle-foot orthotics for chronic toe-walking. Then, the icing on the cake is all the spectral issues. His IQ is 80, just 2 derivations above MR so he is cognitively impaired and developmentally delayed. He has a paradoxical affect to just about EVERYTHING both Rx and OTC which makes medically treating him very difficult. (with an MRI we did to rule out a seizure from a minor concusion, it took adult sedatives to take him down at age 4 and even then he only stayed mildly sedated for 20 minutes with a FOUR HOUR scream-fest side effect as he came out of the drug). He also has incontinence issues, typical of developmental delay.
When he was diagnosed at age 4, the neuropsych and neurologist and specialist, without reading each other's charts all said the same thing: expect to see bipolar with onset of adolesence with possible seizure activity around age 10 through puberty.
Bio history: First mom is bipolar with a schizoid affect. First dad's history is unknown other than he was in the mild/moderate resource class with a seizure disorder and genetic disorder.
So he's on lots of meds to treat his medical ailments and we've tried the following meds for the spectral and ADHD issues:
Clonidine - no success
Methylphenidate - OMG, NEVER again
Tenex - a reprieve from the stimming and helped him sleep but as his body has adjusted, it has become less helpful. Increasing the dose made him volatile and moody. He'll stay on this one though at the 2 mg level
Melatonin - we started at 3 mg and are at 5 mg currently
mineral and vitamin supplements - no affect
GFCF - not even going to bother. He just has too much going on for it to be worth the effort, plus he has extreme sensory issues including vomitting to food textures. THAT's not fun.
Sometimes it's really hard to determine if the ADHD is more sensory driven than anything else so we do alot of at-home OT techniques to reduce his sensory input which helps for a little while but gosh, I'm not an OT and I can't do sensory input for him all day! Trampoline, water and deep compressions are optimal.
See, I'm well versed in the spectral stuff AS WELL as RAD. *beams at self* I'm multi-skilled. lol
OK, so the new med is Trazadone, 50 mg. The info says specifically that it is used in low doses for insomnia. This choice was made after 3 years of upping his Melatonin and getting success but only for a little while and upping his Tenex and discovering it made him very moody and angry.
Right now, he's so crazy, I can't do a thing for him! He's in bed because typical of spectral kids, routine is law but falling asleep? not so much.
So here's what happened to Sissy and why I'm seeing direct parallels:
Sissy tried every ADHD med on the books with only minor success. We moved to straterra. nope. She had extreme sleeping issues and bed wetting issues so the doc put her on a low dose of elavil (25 mg) last September. Getting the appropriate sleep tossed her into a manic state. She was put on Depakote at 500 mg in November with a diagnosis of bipolar (although until she's an adult and her bipolar is legitamizable, her charts read "mood disorder") She was on depakote for four months and was only minorly stable. We put her on wellbutrin, she had some seizure-type activity. By September we were taking her off wellbutrin and depakote and putting her on lamictal with abilify to carry her moods. That didn't work. She switched to respiradone (2 mg) and the RTC added toffrenol (sp?) in December.
Bio history - first mom went to RTC at age 13, diagnosed bipolar at the RTC, put on lithium with ECT to stabilize her moods. She never went home. Bounced from group home to RTCs to foster until adulthood.
All the kids have different first dads with different medical/mental health issues because typical of adults with severe mental health issues with cognitive impairment, they pair up with other adults with severe mental health issues with cognitive impairment. Fun. It's like playing chess with a blindfold on.
gotta love DNA.
I'm waiting for the day someone hands me an honorary PhD in psychiatry.
OK, now that you know all of the medical story, give me more of your excellent advice! lol