Update on DS

[ArizonaGirl]

After many meetings, evaluations, screenings, etc. the child psychiatrist has finally settled on a diagnosis of ADHD for my DS.

We have decided to hold off on meds right now in favor of continuing behavioral therapy and will revisit meds later, but he did offer several medication options.

The child psychiatrist had said that stimulant meds are not an option right now because of his age, but that we would look at the non-stimulants like guanfacine (Intuniv), clonidine, or Straterra. For the aggressive behavior he would suggest a low level dose of Risperidal.

Does anyone have any experience with any of these medications particularly in a very young child.

TIA

[Gena]

DS has been on a low dose of Risperidal in the past. It was prescribed for what the medical community calls "irritability of autism". I really hate this term because it makes it sound like you are medicating the child for being somewhat cranky. In reality, "irritability of autism" includes severe mood swings, aggressiveness, self-injury, and other behaviors that inhibit the individual's ability to function.

We started Risperidal a couple of months before DS turned 5. It was one of the hardest decisions I ever made. (And I say "I ever made" because DH was totally against it.) At that time DS was having a lot of aggressive acting out. It had gotten to the point that we were afraid to take him places because we never knew if he would end up hurting someone. After he knocked me into a brick wall and gave me a concussion, we realized that we needed to do something before he caused serious injury to another child.

The dose started very low and was gradually ramped-up a little. Even at his full dose it was still considered low. We saw a change in his behavior within the first week. The medication didn't completely eliminate his behavior. But it took the edge off his emotions enough that we were able to use behavioral therapy techniques to teach him other ways of coping with his frustrations, anxiety, and fears.

When DS had been on Risperidal a little over a year, we decided to wean him off and see how his behavior was without the medication. To our relief, his aggressive behaviors did not return. DS recently turned 9. We still continue to work on appropriate ways to react to frustration and anxiety. But DS's teachers were shocked when we mentioned that he had once been medicated for aggressive behavior.

We know other families in our autism group who have used Risperidal for longer terms of several years. Some of those families started their children on the medication quite young. Some of those kids have been able to come off the medication; others continue to need it. It differs so much for each child.

I don't have any experience with the other medications you mentioned. DS has ADHD-like symptoms as part of his autism (his doctors don't agree on whether or not he qualifies for a diagnosis of co-morbid ADHD). The topic of medication comes up at times and may be something we decide to do in the future.

[ArizonaGirl]

Thanks Gena,

We are very torn about the idea of medicating him because he just seems so young to be considering medication. However, he seems to struggle so much some days to just cope and I think that his behavior and "quirks" are starting to effect him socially amongst his peers.

His lack of impulse control and fits of aggressive behavior are leading to serious discussions regarding medication.

I am heartened to hear that your DS was able to wean from the Risperdal and the aggressive behavior did not return.

Thank you all so much for your help and support

[o_mom]

Pm-ing you!