how long should a medication increase take to see an affect?

[BusynMember]

50 mgs. Wow. My son was on 500 mgs. Yeah, it's low. If it were my child, I"d still want to try a mood stabilizer. I have bipolar myself and they tried me on antipsychotics. I personally just found them dulling and I didn't care for how I felt.

 

[lillians]

i have found depending on the medications that it can take any where from 24 hours to 3 weeks to see a real differencemy son is on resperidal , 3 daily and concerta 72 strength daily and when he is late taking them he knows and is in trouble,,,oue dr how ever thinkjs our daughter who is giving us holy hell needs notta and is experiencing normal teen stuff--- after raising 5 grown already i know what normal teen stuff is--not this,,

 

[Jena]

hi guys,

thanks for all the input, I had to log off last night things were getting hectic. I thought her sitting downstairs, it was quiet, candles lit would calm her. LOL. who am i kidding?? Poor thing she almost got stuck in recliner, because she was jumping around so much trying to balance on the back of it, than switched and almost got her head caught in the end of it.

Monday's are hard we have a full house to handle. So, there aren't many options of where to put her. I had to break down last night and allow her to go on webkinz, to harnass all that energy. As smallworld said if this is indeed manic behavior, which I truly think it is I can harnass and redirect if i catch it in time. She was all over the place last night and crying inbetween saying i can't keep my body still i'm so so jumpy and so so wide awake. So, by 3 a.m. she went down finally. I"m seeing double ofcourse today.

And, yes I had to fold and put her in bed with me at 3 a.m. i couldn't take it anymore. I held her close and it finally calmed her. She was bk. up at 7 a.m. fed her, she got dressed, and off to school only 15 min. late with letter in her folder to the teacher to "be ware" today have no clue what type of day will occur.

Smallword is the one with whom lead me back to seroquel. It combats her anxiety to an extent which is great, and it also quite frankly seems like the missing piece in her. For the first 3 weeks there was such a dramatic change, I'm sticking with this medication. Her bouts of depression or crying at bedtime has almost ceased, now it's kicking up again, her anxiety was lowered enough to maker her able to get thru day at school and talk to other kids, (which by the way she has never done before, ever), and she's been sleeping which is so important at this age.

Also, difficult child has multiple confirmed diagnosis's. So, we have the Obsessive Compulsive Disorder (OCD) (obsessional thinking, bigtime) combined with major depressive disorder diagnosis february after her neuropysch evaluation., than we have the adhd (her attention sways alot), yet she's a little higher than borderline on that, we have some tic's on her face, the social anxiety, and the generalized anxiety disorder which is huge problem, sensory issues and ofcourse the BiPolar (BP) which the dr. as well as other doctors believe is the "key" cause forher sleepless nights, nasty behavior both verbally and physicallly, argumentative behavior, etc.

So, that's why it's a little difficult with her because she is full spectrum and a complicated case as per her last pyschdoc and the current one. So, it's a watch and wait game with her to see her response.

Yet as we all know it's a combined effort here. It's not just a pill. Little difficult child has to begin to learn that being her is unfortunately going to require some self discipline and practicing the "tools" trying to be taught to her. Yet she's so so thick headed this isn't always easy.

So, i'm placing call to dr. since now the seroquel is like candy to her, and i'll await his return call. I am giong to say to him "so, what is our plan with difficult child" like smallword said. We dont' have one. I Have my own plan, yet this dr. needs to take more responsiblity and thought and time with her. This will only get more complicated as she grows and begins puberty as we all know. I need a strong, competent dr., who is willing to sit down and troubleshoot with me, nto someone who is giong to mainly be my prescription pad.

Sorry i rambled i'm tired i tend to do that. I gotta laugh though, my interview is tmrw. so now i'm a bit nervous. Juggling a job, especially this job and her if she's giong to kick up again is giong to be interesting. Yet, I have to say I wanted to kill boyfriend over that turkey/stuffing issue yesterday ye tnights last night he's very very good and so so patient. He had to get up early for another long day, yet his tolerance level and accpetance of difficult child and who she is, is quite astounding sometimes. So, we both shared a pot of coffee today to get thru our days.

 

[klmno]

Good morning! A couple of thoughts, not necessarily suggestions- I'm wondering if maybe psychiatrist is trying to use seroquel alone and not add in a more typical mood stabilizer at this point due to her young age? He might be trying to hold off on lithium or lamictol until she's older and is more confident about the diagnosis and to use the safest medication alone first.

Also, it sounds like you're pretty aware that there is more to stability than any medication is going to give, more than likely. So, maybe see if psychiatrist will also provide counseling (if he won't, then I'm not sure you can expect a lot more than medication monitoring). Have you started asking around or looking yet for a therapist to help you and/or difficult child through some of this? I don't know what it's like where you are, but that search wasn't so easy for us- a lot of it was made more difficult by tdocs who said they could help with it, only to find after going to them for several mos that they really didn't have the first clue. Most wanted to either use a behavior modification plan or traditional family therapy, which might work wonders for some kids, but only made things worse for us. It has taken nearly 3 years to find the one difficult child is seeeing now and I have high hopes with him. So, I just wanted to let you know that in case you want to start lining up a therapist!!

 

[Jena]

klmno good morning

The doctor actually offered up lithium, yet we were trying to stick with a medication that would require little monitoring and blood draws, etc.

smallworld is the one who suggested go back to seroquel for difficult child. So, i went and suggested it. so, thanks smallworld because we have seen such huge improvements past mos. or so. yet now as you can see the medication has reached it's full potential at this dosage, even though i just increased 6 days ago.

I have a therapist for difficult child. She has been seeing her now, weekly. I"m not quite sure what i think of her yet to be quite honest. She's highly disorganized, takes her food deliveries in while we are in session lol. Yet believe it or not it creates a more "natural, calm" atmosphere with her behaviors I have seen.

yet she put us on a chart, behavior mod chart that I haven't started yet. We are also going to work on teaching difficult child relaxation techniques yet again. WE tried this for years with bio feed back machines, etc. i can relax cd's at bedtime, etc. yet as i tried to explain to the therapist when she's "out" there aint nothing but a medication going to get her down to be honest. I tried to tell her as well, it's gotta be "combined" effort here.

I want difficult child to learn to take responsiblity for her illness, we haven't told her what that is just yet. We have explained anxiety disorder, and she knows she has major sleep issues, and anger and alot of moodiness. One step at a time I say. I have to feed it to her in small doses so as not to overwhelm her and give her a "poor me" attitude.

This morning she was looking horrible, she'll look peeked and carppy yet she'll be awake and raring to go. Yet a few times she said "well since i was horrified last night by what was going on with me i think i should have the day off". LOL.

I said, no way, your going to school where you belong to learn, talk to your friends and get thru the day. I feel it is extremely important that "mental health" days for her are not allowed. I feel we have to continue moving through our days, and stick as close to the routine as possible especially after nights like last night. Life isn't going to "hold" for her on these days when she gets older. I want her to be strong. Yet i'm exhausted. lol and totally rambling because of that fact, yet you guys know i do that when i'm jacked up on caffeinne or exhausted.

I actually have no idea what i've just written lol.

 

[Jena]

ok i just read what i wrote lol. oh, i'm sitting here laughing with my 3rd cup of coffee that i'm soo dillussional right now.

i'm really glad to hear that you have found someone with whom you have such faith in to counsel. That is huge! So, i'm wondering if it isn't the traditional behavior mod, and not family therapy what is this t doing with your difficult child? out of curiousity.

Id really love to have a pyschdoc who wouldnt' just be my medication guy, yet who would also talk to difficult child besides the therapist.What's that line, it takes a village??? LOL

I have learned, all of you have taught me consistency in my approach regarding her mental illness, so i didnt' switch doctor's a few mos. ago when he anti up the thorazine, i said ok i'm giong to tell him that i think he's nuts, (which i did LOL) and than we will forgive, bury and move on. Yet difficult child doens't like him at all. She sits there wrenching her hands while he talks to her. I wouldnt' like him either, i see this guy once a mos he says oh so how you feeling? and I answer and we go?? where's the lollipop? Where's the do you have friends, what's your favorite color? do you like your teacher, etc???

 

[klmno]

Well, like everything else regarding difficult child's, what works for some doesn't work for all kids and age and personality and specific underlying problems probably have a lot to do with what is effective. But with my difficult child, the behavior contracts made him worse. I look at it like 1) the contracts try to change behavior by working on the kid from the outside in and 2) they reward and punish but don't do one thing to teach the kid how to do anything any differently. (Think TEC here).

So, after getting the evaluation from a highly reknown psychiatrist (who specializes in adhd and mood disorders in kids) and getting it in writing that difficult child's underlying problems are not defiance and that she recommends cognitive behavioral therapy and supportive psychotherapy, and getting a therapist on board who actually paid attention to this report, that is what difficult child is getting. At least, it does appear to me that this therapist is backing that up. To me this is 1) helping difficult child from the inside out and 2) not setting him up for failure

My favorite analogy in this is comparing difficult child's issues to a child with dyslexia. Rewards and punishments alone, while continuing the teaching method that works with most kids, will NEVER teach the dyslexic child how to read. The teaching method has to change and the child has to learn how to circumvent the thinking pattern that leads them to read/write differently. Of course, my difficult child still has to have rules and still gets rewards and punishments, but that isn't the focus of his therapy. How frustrating would it be to a dyslexic child if a teacher kept saying "why don't you write like everyone else? I've gone over this 3 times for you and everyone else gets it, so you are going to suffer the consequences now"? The child would be set up for failure and would ultimately become more angry and give up in all likelihood.

It took some effort and a lot of talking to get people in difficult child's life to see that I was NOT trying to get the rules of the world to change for difficult child, but that he would never be able to live by those rules if he wasn't taught how to short-circuit his own impaired, negative thinking. Just like with a dyslexic child, the ultimate goal is for them to be able to learn to live and function in this world just like evryone else. Using a different method to get them there doesn't mean they end up in a different world with different rules.

I was thrilled when this therapist said to me "my house rules regarding video games, what I cook for dinner, and the other things typically negotiated in family therapy are not what caused these issues with difficult child and changing them will not solve the issues". Specifically, the objective with difficult child's therapy is to 1) help difficult child work through his issues regarding his father not being in his life and coming to understand that it's his father that made a stupid decision, not that difficult child is inherently bad 2) help difficult child to learn better coping skills and not make self-destructive decisions 3) learn to deal with mood cycling- triggers, preventative and maintenence techniques, 4) accept himself for who he is and not feel like a freak about it so that he can realize and tap into the potential he does have instead of concentrating on the things that make him feel different

 

[Jena]

Wow, I just got back from the 4 hour drive to get the letter i need for tmrw. what an interesting thing you just wrote. The comment you made regarding dyslexia was astounding, such insight and truth in that. I never quite though of all of it that way. I almost wish we could put your response that you just wrote up to see what you said and how you said it so that others could see it as well. HOpefully ppl will view our conversation and this thread.

It is so very true, therapy seems to just be reward/punishment etc. like the behavioral chart. They seem to think that with repitition this will change my difficult child, yet it will not. We have tried behavior charts before with no real positive out come to them. We always get to that point when difficult child says ok i don't care if i get a happy face or a check for today.

You really have a great way of looking at this, and i'm glad you shared it with me. I really do learn something new each day being in here. by the way i'm on 7th cup of coffee lol. I'm waiting for dr. to call back to discuss how we are dealing with tonight. I need some sleep so i can do well on that interview tomorrow and difficult child well sleep for her would be good also.

WE were going to go out tonight date night and leave easy child in charge, yet i changed plans. I want her to have a calm, routined night so we are all giong to play monopoly together and order in.

I have to run back out to get difficult child, but i'm def going to read thru what you wrote again. thanks for taking the time to write it.

 

[klmno]

Thank you for being so complimentary!! It is difficult to find a therapist to do cognitive therapy on a child- some will say it can't be done. The younger the child, the more difficult it is. But, I thinkk it probably can be inter-mixed with play therapy or something if the child is too young to understand all their own feelings and articulate their feelings. The bigger problem for me was learning to call and talk with tdocs before sending difficult child to them and asking them point blank if they did cognitive therapy on a kid this age, then making sure that I saw signs that they were following through with it. And, of course, since by son has been in legal trouble, I definitely needed something in writing from a more qualified professional stating that this is what difficult child needed- not behavioral modification.

If they think changing the consequences and rewards is going to "cure" the child, then why are they saying the child is bipolar or some other diagnosis that needs medications? If my parenting caused the problem or can fix the problem, then let's take the kid off medications and I'll change. Those are the kinds of thoughts that ran through my mind until I saw the psychiatrist that spilled all this out.

Again, that doesn't mean this is the best answer or will work for all situations. It just came about for us after many trials of the typical stuff not being effective, and makiing difficult child worse. Then, maybe I could relate a little better because I went through therapy myself as a young adult, so when psychiatrist said all those things, it really hit home and added up in my mind. Now that I have gotten the school on board- actually, they started by just trying that approach a little and then they saw it was effective and difficult child was doing better, there is a domino effect regarding difficult child's behavior at school and his relationshaips with teachers, admin staff, etc. (At least so far this year- the true test will be to see how this holds up when tested by spring-time mania LOL!)

 

[Jena]

hi,

Well, when someone says something that makes me say "ah-ha" i'm going to let you know, i've officially been enlighted lol!!!! I used to teach special needs kids, and the approach you speak of, or the mindset regarding it is what i used when teaching. I often found it much more rewarding and interesting to find the right "approach" to teach them.

You made that comment and I sat and said to myself "yes ofcourse". It's funny I can be insightful with other things, yet at times because I think I'm in the "box" I can't view it without the emotion and an "out of the box" approach I'm often not as insightful when it comes to my own difficult child.

I agree, if behavioral mod was all they needed than let's chuck the medications, let's get rid of the pyshdoc's and just get ourselves really good therapists!!! Yet as we have been saying it truly is a combined approach. My family doesn't get it, they constantly question me and drive me nuts, although i have given them several books to read, the one by rosalie greene and the other by pappolos, some literature from NAMI. Yet instead of reading, they drive me insane. Their soo in denial right there with-my ex, which is fine as long as I"m alive and kicking to care for her.

I'm trying to write this while sitting next to her, as she does hw. so forgive me if i'm all over the place. I'm trying this new approach of just sitting next to her while she does it and only if she's truly stumped do i get involved.

I contacted her school today and set up a team mtg. with the pyschdoc at school, sw, her teacher and myself so that we can put things in place now just incase we wind up with a repeat of last year. She crashed hard last year. I'm still awaiting iep mtg. yet they were open to mtg. with me.

This therapist that we now have has not outlined anything, other than to say what would you like to work on, than she popped it all onto a behavior chart. I think she's using the wrong approach here. No anxiety techniques have been taught yet, no talk of really letting difficult child know what's going on with her body and mind (she's truly wondering now).

My mind is clouded today, i'm really tired and she is endlessly talking LOL!!! ah!!!!! Calgon take me away!!!

 

[Jena]

DR just called we are increasing the medication yet again. difficult child got very upset and began crying and said why do i have to take medicine, it's not normal i'm not normal, etc. etc.

 

[klmno]

Thanks again- keep in mind- I came to these "theories" after coming here and getting a lot of input and reading TEC and a couple of other things.

The therapist is clearly doing only behavior mod. and not cognitive therapy. If it were me, I'd be making some calls. Another option is to find a therapist who can help you aid your child in getting these concepts- so instead of them coaching you in rewards/punishments for your child, the therapist would be coaching you in how to teach - again think TEC here. (That is not to imply that you aren't already, just that there's something called "Therapuetic parenting" that I read about on the bpkids website and I'm trying to get a little more therapist help on that myself.)

At least psychiatrist is listening to you and sd is open for a little communication. Have a Clagon moment and hopefully, a good night's sleep tonight!

 

[Jena]

hi,

I def. will i'm now in nasty mode. I can't handle anything. i can't function like she can on only 3 hours worth of sleep, i just can't do it. She's jumping all over the place, talking a mile a minute and i'm just done.

i don't think this increase will do anything at all to be honest. it's too small. i would of went with increase of 25mg. he wants to take it slow which i guess i appreciate.

Yes I know you gained alot of what you said through being here and learning and talking, yet there is something to be said about how we all perceive the information we are given.

thanks so much!!!

 

[totoro]

Jen
Do you take any medications?
I take them with K in the morning when she is in her, "I don't want to mood"
I let her see me take my medications and tell her why I take them. She knows I have *roller coaster emotions* just like her!!! I tell her some days I don't like it either, but I have to.

 

[crazymama30]

I agree with toto, when my husband starting taking medications, difficult child took his so much easier. They do not take them together, but we are open about them. In the evenings husband will start to get "sketchy" and I will ask him if he has taken his pills. He usually looks startled, looks at the time and says oh, I should, and goes and does. I like the comparison of glasses to medications. I have to wear my glasses to see well, but I can see without them. difficult child and husband can kinda concentrate and function without their medications, but they can do it so much better and easier with them.

 

[Jena]

Toto - No, I take vitamins so what I do is I show her how big and ugly they are and she says wow I can't believe that you take those! We had the "usual" talk. I said listen some ppl's hearts don't work right or their lungs (she's very into the inner workings of the body) and they have to take pills to make their hearts and lungs work right. It doesn't make them strange in anway, actually it makes them smart for taking such good care of themselves.

I said this is just like you, you have to take your pill so that you can work well all day long and be very comfortable and sleep peacefully at night, it's not strange you are a smart, smart girl for taking such good care of yourself. That always does the trick, till the next time that is. She slurred her speech alittle tonight I noticed while we were playing a board game with her, she was a little spacey yet as the night progressed she became more focused. She's nervous about tmrw becuase she overheard me talking to boyfriend about the job interview and he has to pick her and the rest of hte kids up tomorrow so she's edgy. oh well. I said mommy has to go on this job interview, it's important to me and I know that you love me and wish me well.