Bad reaction to medications?

[IT1967]

My difficult child 2 had a terrible reaction to Zoloft and it caused something to snap in him. He has always had ODD, but it just got WAY worse since we tried that medication. This horrible reaction caused the psychiatrist to Rx Risperdal, which I detest, but which has helped my difficult child 1 a lot.

My problem is, I don't think the Risperdal is working so well for difficult child 2. We have increased it to .5 3xday, the dose difficult child 1 is on, and I'm not seeing a ton of improvement. Every day after school for most of the past week (we're 2 or 3 weeks into the Risperdal), he is having BIG meltdowns - mainly directed at difficult child 2, but defiant toward me as well. Usually after that, things settle a bit. I probably know the answer to my own question here, but ideally difficult child 1 would take the medicine first thing in the AM, at lunch, and at bedtime. Neither of my kids will agree to take the medication during school hours, so I give it to them immediately after school - 3PM. That timing works perfectly fine for difficult child 1. Maybe it's too long between the AM and after school dose for difficult child 2? He is incredibly medication sensitive. We tried 3 or 4 ADHD medications before we got the right thing for that. I have a call in to the psychiatrist, so I'll see what he says. My guess is he'll tell me it's too long between the doses. I just don't know.....

 

[TerryJ2]

So, is he just worn out from school and takes it out on you when he gets home? What would happen if you drove to school one day at lunchtime and gave him a .5 mg dose just to see what would happen?
Definitely, talk to the dr.
You know the weekend is here, so you can rearrange the doses. Just saying ...

 

[InsaneCdn]

Risperidone is a medication that has to build up in your system. I'm not aware of 3x/day dosing. psychiatrists here will sometimes split dose to reduce some of the side-effects (light-headedness, for example, is worse at higher doses but splitting the dose seems to reduce impact).

This caught my attention, though:

Every day after school for most of the past week (we're 2 or 3 weeks into the Risperdal), he is having BIG meltdowns -

Read more: http://www.conductdisorders.com/forum/f6/bad-reaction-medications-52814/#ixzz2MK3zzz9W

His dxes are ADHD, Generalized Anxiety Disorder (GAD) and ODD?
Take that ODD and stuff it somewhere else, because... chances of there being something ELSE going on is sky high.
been there done that.
After-school melt-downs? been there done that too.
They almost stuck the ODD label on my difficult child too, but... we fought back.

Result?
Multiple additional dxes.
And that is NOT unusual.

ADHD can stand alone as a diagnosis. I have a child like that.
More often, it will either be a case of ADHD plus other stuff, OR it will be something else entirely (Aspie, Autism Spectrum Disorders (ASD), Bi-polar...)

Who gave the dxes, and what kind of testing was done?
Has he ever had a comprehensive evaluation?
Occupational Therapist (OT) evaluation?

 

[buddy]

I'm with Terry ....this weekend maybe try earlier? Still not exactly the same with school pressure but????

 

[IT1967]

Over the weekends, I have been spreading out the dosing much more evenly (AM, lunch, bed) - always do that with-difficult child 1 as well. I will have to pay close attention this weekend to see how he does. Last weekend was the first weekend we started the higher dose, so I can't use that weekend as a comparison. My difficult child 1 has had more testing done than difficult child 2, and truthfully, I think difficult child 1's issues are worse than difficult child 2. difficult child 1 had the IQ testing which revealed she's gifted, but I actually think difficult child 2 is even more intelligent. Especially in math. I just heard back from his teacher - I emailed asking how the week went, and teacher said he had a fantastic week, so maybe confirming again the dosing timing. I'm glad to hear that school is going better for him. Maybe he's just keeping it together so hard at school, he just falls apart afterward. He does seem to settle down more after these after school blow-ups.

@InsaneCanadian, I agree that ODD isn't exactly a diagnosis I'm happy my kid has, is there some reason you fought so hard to avoid it?

 

[InsaneCdn]

Because... ODD gives you absolutely nothing except confirmation that YOU (the parent) are not crazy. There are no interventions, accommodations, or medications that work for ODD.

My gut said there had to be some reason for the behavior.
We ended up with a whole list of reasons.

A kid who is truly just ADHD, will be JUST ADHD. I have one of those. Not even any secondary anxiety - at least, not once we got the ADHD medications working (inattentive type, needs help with managing focus). ZERO behaviour issues (well... typical teen stuff, but that doesn't count).

Other stuff?
Half the kids with ADHD also have Developmental Coordination Disorder (DCD) - and many times that gets missed or dismissed (he'll grow out of it, there isn't anything we can do anyway). Developmental Coordination Disorder (DCD) is HUGE. Occupational Therapist (OT) helps. Technology helps. Getting major rewrites of the entire PE curriculum helps (didn't succeed on that one, but we tried...)
Many kids with ADHD have one or more LDs.
Something like 70% of kids with ADHD and a Learning Disability (LD)... have an Auditory Processing Disorders (APD) as well. And other than the classical form where the person has trouble comprehending verbal language... most of the other APDs get missed.

Kids with ADHD are at high risk for secondary anxiety and secondary depression... likely cause is the other missing dxes.

Those after-school melt-downs? biggest causes for our house were... undiagnosed Auditory Processing Disorders (APD), and un-accommodated Developmental Coordination Disorder (DCD).
We're getting more accommodations and interventions now, and difficult child is doing better as a result.