Update:
After we ditched the Prozac, we waited for just a little while, then started generic Zoloft (Sertraline). It was the lowest dose, split in half, and he's been on that for about 3 weeks. The psych was reluctant to try another SSRI, but decided to go for it. He felt with the strong reaction last time, this probably wasn't the type of drug for him.
It's definitely better than the Prozac, but I don't think it's strong enough b/c the anxiety is coming back. We're also still seeing aggressive behavior, including hitting, kicking, and throwing things. He's sleeping much better though, and there has been none of the mania or other side effects. I followed up at the 2 week mark, and he requested we make an appointment because "there is a lot to discuss". That appointment will be on Wednesday. H
I'm reluctant to totally abandon treating the anxiety, but one option would be to try the 5-HTP again, and possibly Intuniv, and hope that the 5-HTP works well enough to get us by. I'm thinking if we turn our attention back to the ADHD, maybe life will be a little easier, because right now, everything is a struggle, especially schoolwork. 5-HTP wasn't strong enough in the past, but there were no side effects, and it was better than nothing.
How bad do the side effects have to be for you to have to give up on a drug? Would the aggressiveness be a deal killer for you? I'm thinking yes, but I'm starting to wonder if we're ever going to find something that works without them.
I'm sure the psychiatrist will have his own thoughts, but I want to go in with an idea of what I want.
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I just want to brainstorm with you guys a little. I really like our psychiatrist, but I want to go in with a little more knowledge and my own opinions.
Quick summary:
-Jason is 7.5. His current diagnoses are Asperger Syndrome, ADHD, anxiety, and a medical phobia. He also has a serious cardiac condition. The Asperger's diagnosis is a newish one. His psychiatrist has mentioned it might not fit perfectly.
-Current medication-Fluoxetine, 10 mg
-We have tried numerous no-med treatments including multiple diet changes and various therapies with no success. We've also tried different supplements. The only one that made any difference was 5-HTP. We discontinued it around Thanksgiving b/c it wasn't enough, and we wanted to try an SSRI.
-We started off trying to treat the ADHD with stimulant meds (Vyvanse). He was having some side-effects that concerned us, then had one incident that scared the crap out of me, so we switched gears and decided to try to address the anxiety first. Stimulant meds have a black box warning for kids with heart defects. Although his cardiologist has OK'ed the meds, they make me a nervous wreck. At the same time, I know he can't continue to live like this. We also tried Hydroxyzine with no success.
Current major issues- Extreme hyperactivity, inattentiveness, anger, defiance. The anxiety is much better on Prozac, but after we went off the 5-HTP, it was really bad. Like, couldn't function bad.
Current side effects- The hyperactivity is more like mania at this point. I can not even describe the noise level in my house. He is doing things like lying, sneaking around and swearing, which is not typical for him. He is becoming mildly physically aggressive at times. He's not sleeping well at all. It's always been difficult to get him to sleep, but once he was out, he slept well. Now he's sleeping much less, it's almost impossible to get him to sleep b/c he is so wound up at bedtime, and he's waking up at like 6. He's probably getting 3 hours less per night. He's tired during the day, and falls asleep on short car trips. In the past, he's had some OCD tendencies, but they've been gone for a while. Now, they're starting to show up again.
My thoughts- It is obvious to me that he needs some med that will address the anxiety, and that SSRIs help. The side effects are bad though, and making the other issues seem far worse. It's hard to tease out what is causing what though, and I think we're going to be experimenting for a long time. I wonder if any combo will ever work.
I welcome any thoughts you all have.