UPDATE-Can anyone help me figure out meds issues?

[JTsMom]

The psych said to take him off the Prozac, then report back by the end of the week. Now he's going to be a wreck for Christmas. Sigh.

[egoldber]

I'm so sorry Lori.

I have to say this time of year is always always always oldest DD's worst time. The combo of the darkness and the ever present sweets and holiday madness make this a really hard time for kids who don't regulate their emotions well.

[Pepper]

I thought of Intuniv for you, too. DS1 took it for ~8 months, after we had a terrible time on ritalin. It worked fairly well for him for impulsivity but it also made him sleepy, to the point where he'd fall asleep in class and snooze while they carried him to the nurses office. We changed the time of day of the dose to mid-afternoon, and that helped him to fall asleep at bedtime (6 hours after he'd taken the Intuniv). We just had to stop that drug though ebcause it wasnt working for him as well and we couldn't increase his dose anymore (he was at 2 mg; DS1 is 6).

The thing that REALLY helped us with sleeping was melatonin (1 mg taken at bedtime. We had to try a few different brands b/c DS didn't like the tasste of some of the tablets). DS1 used to sleep really well too, but was having nightmares and increased night waking for ~3 years. All of that stopped within a week of starting melatonin (I was shocked, because NOTHING we try ever works so well). He was on it for a few months and then his psych said that he had to take a break from it, so now we give him 25 mg of beadryl at bedtime. He sometimes takes a little while to settle down to sleep but thankfully the nightmares and night waking have not returned.

And as for the coloring himself - maybe this will make you feel better. My typical 3-year-old DS2 drew all over his arms, leg, feet and face with a magic marker because he couldn't find his Ben 10 ultimatrix - so he drew himself a new one, and then drew himself to look like an alien, too.

[inmypjs]

So sorry you're going through this. I don't have any great advice but wondered what is he like without meds at all? Not in any way suggesting that is the way to go, just wondered how what you are currently seeing differs from when he wasn't on anything. The thing that struck me the most about your post was that now he is doing things that you never saw him do before. I would ask for a change for that reason.

[JTsMom]

bumping for update in OP.

[egoldber]

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.

This is the opposite of what DD's psych said after our disastrous sertraline attempt. I was discouraged and she said there were many SSRIs to try before giving up.

The aggressiveness would be an issue for us because DD is in school and they have basically zero tolerance for aggression. Have you considered going up in dosage? His dosage may simply not be high enough. I was reluctant to move older DD up in dosage, but it wasn't until we went from 10 to 15 to 20 in about 2 months that we saw the most benefit. I would try that before moving on to something else.

Can you also add in Intuniv though? Does it have to be one or the other?

[JTsMom]

Going up was the original plan, but I figured that would make the side effects worse. Not necessarily? We can add the Intuniv, but wanted to try one thing at a time so that we could watch for side effects. It is really dragging though.

At this point, I'm starting to doubts self about everything. For example, what if the aggression was originally a SE of the Prozac, but then became behavioral? He has never been aggressive though. He did go through a hitting phase as a toddler, but it was mild, and only directed at us.

I think the reason he was wary of another sari was bc of the mania specifically. It freaked me out pretty badly.

[JTsMom]

Switching to Intuniv, and may add in 5-HTP after I watch the Intuniv for a week or so. It's supposed to help some with mood, so I'm hoping it makes the transition easier. The anxiety seems worse at night, so the sleepiness it could cause may work in our favor.

[pinkmomagain]

Hope you find some success with the Intuniv. It's been helpful for DD2s ADHD-inattentive type. She takes it in the am and it doesn't make her sleepy, but I believe it can lower BP and dd's BP is already low so it can make her sluggish if she is not well-hydrated.

As far as the SSRI manic effects, I think I've read that that people who are more vulnerable to this are those who may be bipolar. Don't remember where I read it or even if that comes into play in your particular scenario but thought I'd put it out there in case it's something you'd want to ask the dr about. Otherwise, like egoldberg mentioned we found success actually increasing prozac and waiting a couple of months for full effect (and I was very hesitant to increase but took a leap of faith with a new dr and we've been very pleased with the results). Although aggression was never something we saw, in fact, we have seen no ill effects from prozac at all.

[egoldber]

I hope the Intuniv works for you guys.

We did see some aggression with the sertraline/Zoloft.