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5757880 tn?1395578022

Possible Change of Diagnosis / Medication

Hello!
So we went for the 2nd part of the evaluation regarding my son. He is eight years old and is currently diagnosed with ADHD, anxiety issues and possible PDD. She is currently still evaluating him regarding the PDD because she does not want to underdiagnose him or overdiagnose him.
I understand that, that's fine and we have another appointment with her in one month.

However, she did give me a list of the medication children with PDD would normally take, so I can research it. The names are Risperdal, Latuda and Fanapt. When I briefly looked at these meds today, I noticed they are prescribed for bipolar disorder. So now I'm confused.... She never mentioned my son was bipolar. Also, I thought PDD was a part of the Autism Spectrum and usually children with Autism don't receive medication regarding their disorder???

Any information or advice regarding these meds or what I need to look for with PDD?
14 Responses
189897 tn?1441126518
COMMUNITY LEADER
   These are all very potent antipsychotic medications.  You can look two of them up here  :
    http://www.crazymeds.us/pmwiki/Meds/Risperdal
    http://www.crazymeds.us/pmwiki/Meds/Latuda
        google for fanapt
  I happen to like the above website because it gives the info to you in pretty straight, understandable talk.  Ignore their ads.
  
    You never really mentioned what your sons symptoms were other then the ADHD.  He must have some very strong co-disorders.  These are not lite weight medications.  This site does mention how or why they would be used for autism - http://www.webmd.com/brain/autism/medications-for-autism.   Essentially it says, "They may help decrease problem behaviors that can occur with autism."  So its not the autism she is treating its the behaviors that might also occur with autism.
    There are some anti-anxiety meds that are fairly lite weight that I certainly would look into first before trying these.  But here again, I don't know his symptoms.

    This kind of makes me wonder if he was on any other meds when the the Vyvannse wasn't working for him.  There are meds that can effect how these stimulant meds work.  And it sounded like he was being either over dosed or the med had worn off.  I generally am not in favor of doctors just switching around from one med to the next with out first trying different doses.
    Is he now on Plain Methylphenidate 15mg (3 times daily?  and how is that working?
5757880 tn?1395578022
Hey There :)

My son is still finishing up the Concerta 54mg and the doctor asked us to make the switch either this weekend or next weekend. She wants us to time it out so it's ready for school. The doctor asked me to only try the 10mg first and then if he needs the extra 5mg, then add it into the mix.

My son has had symptoms here and there but nothing definitive and that is why it's hard for the doctor to diagnose the PDD. He has a lack of social skills, very analytical / business like, throws tantrums or has emotional outbursts (though those have lessen), he has a deep oral fixation we cannot seem to break through, impulsive, hyperactive, poor motor skills, sensory issues, not touchy-feely, inappropriate social interactions, constantly making noises, hand-flapping, etc.

The doctor thinks it's ADHD and anxiety, she just isn't a 100% on PDD.
189897 tn?1441126518
COMMUNITY LEADER
I am going to send you some stuff on Sensory Processing Disorder.  Have you heard of or looked into that?
  What kind of a doctor are you seeing for your son?
5757880 tn?1395578022
I haven't heard much of SPD, no and I don't think the doctor/therapist thought of that or they haven't voiced it. I'm waiting for the final report from the OT evaluation we had done last week.

The doctor doing the diagnosis is an MD with Oaklawn in Indiana.
189897 tn?1441126518
COMMUNITY LEADER
     The reason I asked is that sensory often gets mistaken for ADHD.  And it is possible (I think) to have both.  Sensory is diagnosed and treated by an OT so it is good that you saw one.  Sensory is usually not treated by medication.
     We have a sensory forum on medhelp that is run by a mother whose own son has sensory processing disorder. Your son seems to have many of the same symptoms as her son.   She is very knowledgeable in how it is treated etc.  That forum is here - http://www.medhelp.org/forums/Sensory-Integration-Disorder-SID/show/1396
    And here is a site with lots of information on sensory.
            http://www.sensory-processing-disorder.com/
5757880 tn?1395578022
Okay, I have researched the meds given and... well, I'm a bit uncomfortable about giving these types of meds to an 8 year old. I understand that they "use" them to lessen the behaviors caused by PDD, but isn't that a bit dangerous seeing how these drugs have been approved by the FDA for a completely different use?

I did tell my doctor and doctor's nurse today that I'm uncomfortable with these choices of drugs at this time and if there is no proof that these meds assist and have been designed to assist with PDD, I don't think I was to go this route.
189897 tn?1441126518
COMMUNITY LEADER
   I felt the same way when I first saw the drugs.  Although there are cases where it probably is useful.  But I would say only a pediatric psychiatrist should make that call.  You said your doctor was an MD.  Is she a pediatrician and not a psychiatrist?  
   And I would certainly wait till you hear back from the OT.
Avatar universal
Medicines for treating the three core symptoms of autism – communication difficulties, social challenges and repetitive behavior – have long represented a huge area of unmet need. Unfortunately, few drugs on the market today effectively relieve these symptoms and none of the options most often prescribed by practitioners work well for every individual.
5757880 tn?1395578022
I did speak with the evaluating physcian and she informed me that only the O/T person will be able to state if my Zane has SPD. It's been two weeks, as of today, and if I don't hear anything, I'm going to call the O/T tomorrow.
(I need the report by Monday for a Wraparound Meeting)

The evaluating doctor is not a pediatrician, she is listed as a pyschiatrist and stated she can only diagnose the "mental" part of my son's evaluation. When I mentioned I was uncomfortable with the medications she mentioned, she asked me to contact my primary physican and get her opinion to possibly ease my worry.
5757880 tn?1395578022
My son has (2) of the (3) core symptoms; however, he also has sensory issues, hypteractivity, implusiviness, unfocused, lacks concentration, etc.

They are working on an evaluation regarding PDD, yet they want to take their time, especially since the insurance company will cease all assistance if he has been diagnosed with PDD and the mental health facility assisting us now under a state grant would have to terminate assisting us under the grant. They currently have him listed as "Rule Out PDD"; diagnosed with ADHD and Anxiety Issues.

189897 tn?1441126518
COMMUNITY LEADER
   Interesting, because a psyc is going to typically know more about those meds then a physician.  I am guessing that she feels you trust your own doctor more?   What I am curious about is you said, "she can only diagnose the "mental" part of my son's evaluation."   Was she the one that did the evaluation or is she just interpreting the evaluation?   And, more importantly, how was the evaluation done?
5757880 tn?1395578022
When I meant the mental, she meant she couldn't diagnose the issues going on with his sensory problems. That would have to come from the O/T evaluation.

The evaluation done regarding the ADHD and rule out PDD is in her office, she will sit with Zane, ask us questions, ask him questions, have him interaction with different objects in the room.

As for trusting my own physican, ehh... :) we might be changing primary physicans in the future due to things that had happened (IE: I got a dog bite, she told me to call her if it got infected. I called her after hours and let her know it was infected a week after it happened. She told me to pour hydrogren perixode on it. I ended up going to the ER just to get the antibotics I needed).
189897 tn?1441126518
COMMUNITY LEADER
   Ok, that makes sense.  That definitely is the role of the OT.
   a little surprised that the psyc did not send out a questionnaire to your son's teachers.
   Ohhh, hear you about your own primary doctor.  And in a way, was kind of surprised when your psyc suggested you talk to your doctor.  Most docs don't have a lot of experience with the meds your psyc suggested.
5757880 tn?1395578022
I spoke with the primary and she basically stated that I need to consider all that the pysch wants to do. I asked for her expierence in the meds and she stated she has young patients on Risperdal and as long as the dosage is correct then it's fine.
However, my Aunt did her own research and spoke with a friend of hers who also has worked with these meds and she said she wouldn't put her kids on it. :)

Very much a catch-22
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