gcvmom
Here we go again!
I think the meeting went well. difficult child 2 was able to articulate what's going on with him -- both the good and bad. We've decided he is one of these rare people who metabolize drugs ultra rapidly. psychiatrist has about 30 to 40 patients on Seroquel XR and no one blows through it like difficult child 2. No one. But he accepts that and believes it and so the plan is to increase the p.m. dose to 700mg and the afternoon dose to 400mg in hopes that it will help his impulse control, attention, focus, organization -- all the stuff he's still struggling with. psychiatrist agrees that the 5mg Daytrana patch is plenty, especially since we already see a wee bit of irritability and lability in the late afternoon and early evening. He sees it as being mainly a tool to offset the sedation from the Seroquel XR. So we'll see. Clearly this kid's brain has changed and mood disorder is the dominant problem now, even though it looks like severe ADHD. His brain doesn't respond to ADHD medications and that's really what is so telling.
We talked about difficult child 1 as well and the fact that he struggles with classwork (F's and D's), but does fine on tests and quizzes (A's and B's). difficult child 1 says his mind sort of goes blank sometimes and he just doesn't know what to do in class -- like the doe in the headlights syndrome. psychiatrist feels this is a slightly different type of anxiety from the phobic type -- more of a panic type (which runs very strongly on my side). So rather than make drastic changes in medications, we're adding a low-dose beta blocker (propranolol) in the mornings for a few weeks to see if that helps.
After I excused the boys, I also gave him an update on husband and his Paxil wean (which I learned was husband's idea), which he was glad to hear and encouraged me to be up front with husband about what I'm observing and to keep him (psychiatrist) in the loop. That way if things continue to slide, he'll be able to address it with husband and explain to him why might need to go back on the Paxil.
He also gave me some coupons for FREE Seroquel XR -- so heads up to anyone taking that -- ask your psychiatrists if they have those coupons as they expire 12/31/08 -- it gets you up to 11,200mg (total for the whole prescription) and if you have more than one coupon, you can use one every two weeks.
So fingers crossed these new changes for the boys help with their school issues! I am hopeful...
We talked about difficult child 1 as well and the fact that he struggles with classwork (F's and D's), but does fine on tests and quizzes (A's and B's). difficult child 1 says his mind sort of goes blank sometimes and he just doesn't know what to do in class -- like the doe in the headlights syndrome. psychiatrist feels this is a slightly different type of anxiety from the phobic type -- more of a panic type (which runs very strongly on my side). So rather than make drastic changes in medications, we're adding a low-dose beta blocker (propranolol) in the mornings for a few weeks to see if that helps.
After I excused the boys, I also gave him an update on husband and his Paxil wean (which I learned was husband's idea), which he was glad to hear and encouraged me to be up front with husband about what I'm observing and to keep him (psychiatrist) in the loop. That way if things continue to slide, he'll be able to address it with husband and explain to him why might need to go back on the Paxil.
He also gave me some coupons for FREE Seroquel XR -- so heads up to anyone taking that -- ask your psychiatrists if they have those coupons as they expire 12/31/08 -- it gets you up to 11,200mg (total for the whole prescription) and if you have more than one coupon, you can use one every two weeks.
So fingers crossed these new changes for the boys help with their school issues! I am hopeful...