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Child Behavior (Expert Forum)
Tantrums? ODD? and the use of Mellaril for my 3 year old daughter?
Answered by
Kevin Kennedy, Ph.D. - Child and Adolescent Psychotherapy, Family Therapy, Crisis Intervention
Harvard Vanguard Medical Associates
This forum is for questions and support regarding child behavior issues such: Child Discipline (behavior management), Normal Child Development, Parent-Child Communications, Social Development
Tantrums? ODD? and the use of Mellaril for my 3 year old daughter?
by Laura, Nov 03, 2000 12:00AM
My daughter just turned 3. She is very smart, extremely articulate in her speaking, very advanced in vocabluary and in physical coordination. However, she has horrific tantrums when she is not "in control" of a situation. Although this is a simplistic way of summarizing this situation, I could go on for pages with details. After many conversations with our pediatrician (and him experiencing the tantrums first hand) he referred us to a neurologist - said the behaviours are caused by the stimulations and synapses - beginning with the neurological system. Anyway, we visited the pediatric neurologist, and after much evaluation and attempts at interaction, and finally purposely causing her to have a tantrum, determined she is probably a child demonstrating Oppositional Defiant Disorder - ODD. After behavioural direction - i.e. how to parent a child who wants to control everything, and to remain being the parent in charge - we have been recommended by our pediatrician to use Mellaril to "modify" the behaviours/tantrums/outrages. We have been hesitant and have not started using this drug yet. At this time, she no longer has 4-8 tantrums (10-40 minutes in lengh, as she did 6-8 months ago). However, we are limited in the activities we can do .... cannot get a babysitter; cannot drop her in Sunday School; cannot take her to the doctor; cannot take her to get a haircut; cannot take her to places she is not totally familiar and in control (even Sea World!!) without a totally out of control tantrum. Our pediatrician only sees her having these tantrums, as she won't get weighed, measured, eyes or ears looked at, etc. without completely getting out of total control and both of us having to hold her to get examined....it's exhausting. He (our pediatrician) has recommended - after previously just suggesting we consider - putting her on Mellaril. He says this will curb her tantrums - she may want to do or participate in some things, just gets overtaken by the control and rage...or something to that effect. Please give me any feedback on the use of Mellaril on ODD children; on children with tantrums; on this situation and other appropriate avenues to explore....on any direction, support groups, reading material, or web sites which could help us manage our life and help our daughter continue to develop and enjoy life. I realize this is a quick snapshot summary and question - any response or feedback is greatly appreciated - I can use ANY assistance and help at this time - please....Tired Mommy - Laura :)
Doctor's Answer
by Kevin Kennedy, Ph.D., Nov 04, 2000 12:00AM
, Nov 04, 2000 12:00AM
Dear Laura,
Before I mention anything else, I'd recommend you read The Explosive Child, by Ross Greene, a Boston psychologist. You will see your daughter described on those pages, particularly in regard to the relative ease with which she becomes frustrated and angry and then her disproportionate response to the anger.
Another thing I would recommend is an evaluation by a child psychiatrist, particularly before you commence any medication. You have done some very sensible things, having your daughter evaluated by her pediatrician and by neurologists. But it will be important to have the input of a child psychiatrist, in whose domain belongs, chiefly anyway, the prescribing of such potent medications as major tranquilizers/antipsychotics (like Mellaril), antidepressants, mood stabilizers, etc. The recommendation to employ Mellaril is not by any means unreasonable, but I would not proceed before you've allowed a child psychiatrist to review the options with you, and there are options. The child psychiatrist can help clarify the diagnosis (and Oppositional Defiant Disorder, a type of Disruptive Behavior Disorder, is certainly a likely possibility). But, the sorts of behavior your daughter demonstrates can cut across diagnostic categories. Ultimately, it's not the diagnosis that's treated, it's the symptoms, but it's important to have as clear a picture as possible about the diagnosis.
Before I mention anything else, I'd recommend you read The Explosive Child, by Ross Greene, a Boston psychologist. You will see your daughter described on those pages, particularly in regard to the relative ease with which she becomes frustrated and angry and then her disproportionate response to the anger.
Another thing I would recommend is an evaluation by a child psychiatrist, particularly before you commence any medication. You have done some very sensible things, having your daughter evaluated by her pediatrician and by neurologists. But it will be important to have the input of a child psychiatrist, in whose domain belongs, chiefly anyway, the prescribing of such potent medications as major tranquilizers/antipsychotics (like Mellaril), antidepressants, mood stabilizers, etc. The recommendation to employ Mellaril is not by any means unreasonable, but I would not proceed before you've allowed a child psychiatrist to review the options with you, and there are options. The child psychiatrist can help clarify the diagnosis (and Oppositional Defiant Disorder, a type of Disruptive Behavior Disorder, is certainly a likely possibility). But, the sorts of behavior your daughter demonstrates can cut across diagnostic categories. Ultimately, it's not the diagnosis that's treated, it's the symptoms, but it's important to have as clear a picture as possible about the diagnosis.
My 6 yr old son started having tantrums when he was 4 1/2 and he was out of control and we couldn't go anywhere, do anything either. After much research I started him on essential fatty acids and after only two weeks his behavior did a 180. He still takes them and as far as I am concerned he will take them as long as I am breathing as we now have a life, we can take him anywhere and do everything we want to do. He is cooperative, obeys, and is doing well in school. Please read "The LCP Solution" by Jacqueline Stordy and Malcolm Nicholl. This books discusses the scientific studies that show that essential fatty acids improve behavior and also help with problems such as dyslexia and dyspraxia.