View Full Version : does anyone know anything about risperidone?


gunner's mom
09-17-09, 07:42 PM
my son has been taking vyvanse and it hasn't been working forhim at all, so today his doctor calles him in a rx for risperidone. i don't know anything about it, so ofcourse, i get home and look it up online. all i can find on it is that it's an anti-psychotic used to treat schizophrenia, bi-polar disorder, and autism. now i'm a bit confusedsince my son has adhd and depression. am i missing something? or is his doctor screwing up... again?

unthought
09-17-09, 07:58 PM
In severe cases with acting out and uncontrolled hyperactivity/impulsive, antipsychotics like rispiridol are sometimes prescribed to control behavior. It's a sedative/tranquilizater, personally I wouldn't let my kid take it for anything other than schizophrenia or bipolar disorder. It has some pretty dangerous side effects and it contridicts Vyvanse in that it blocks dopamine rather than stimulate it.

Has your doctor tried adding Pristiq/Effexor and/or Wellbutrin or one of the many other antidepressants that help with ADHD, in combination with Vyvanse? That's usually the next step if stimulant treatment alone isn't enough. Has he even tried exhausting all dosages with Vyvanse? You should find out more about why your doctor prescribed it and possibly seek a second opinion.

NeuroParty
09-17-09, 07:58 PM
Hi Gunner's Mom;
You're right. In any situation where you are unsure of the reason for a prescription, you should check with your doctor.

The indications you listed are correct: In the USA, RISPERDAL® (risperidone) is an atypical antipsychotic, made by Janssen, and used for the treatment of irritability associated with autistic disorder; the treatment of schizophrenia; and the treatment of acute manic or mixed episodes associated with Bipolar I Disorder.

It is important to talk with your doctor so that together you can make the best treatment choices. And it never hurts to a get a second opinion if you're feeling uncomfortable! :)

Good luck to you and Gunner.

MuscleMama
09-17-09, 08:04 PM
What type of doctor was this? I'm no expert (although I did stay at a Holiday Inn Express last night ;)), but it seems like they should go thru the more traditional, proven adhd drugs before trying something else. Below I typed out the handout the neurologist we saw gave to me and went over in detail. The top two categories (methylphenidate & amphetamines) are the most common meds which should be tried before moving on to others. FWIW this neurologist was Dr. William Singer who has over 30 years experience in this area and seems to be well-respected from what I have seen. I'm not trying to make any 'arm chair diagnosis', just want to share with you what I have learned. If others disagree, please speak up so I can learn. :)


Medications for Attention Deficit Disorder

Methylphenidate

Ritalin LA
Metadate CD
Concerta
Daytrana (patch)
Focalin XR


Amphetamines

Adderall XR
Dexedrine
Vyvanse

---------------------------------------------------------------------

Provigil

Antidepressants that have positive effects on ADHD

Imipramin/Desipramine
Wellbutrin
Strattera


Dopaminergic/Glutamate blocker

Amantadine
Memantine

gunner's mom
09-17-09, 08:10 PM
i guess i'm getting him started on a new doctor asap. this is the second doctor i've sent him to, and i seems as though none of the doctors down here know what the heck they are talking about!

NeuroParty
09-17-09, 08:14 PM
Sorry to hear it has been a struggle. Is the doctor open to your questions? Does he take the time to listen and explain?

speedo
09-17-09, 08:15 PM
There are a lot of people with strong opinions, but some of the facts are missing. Risperdal is sometimes prescribed for adhd. It is listed as a third line medication for adhd. I take it, but mostly because it helps with the ocd too. I also take tenex. I can't take stimulants because of a heart condition. I took wellbutrin for a while but it caused too much anxiety and really did very little for my adhd, so my doc took me off of it at my request.

The thing you have to watch for with risperdal is tardic dyskenesia. It mostly happens to people who are on the VERY high doses they give for schzophrenia or bipolar for a long time. The dose they give for adhd is small , so it is a lot less likely to happen... but it is still a good idea to watch out for tardic dyskenesia anyway. It's fairly rare, but you need to be careful of it. If you get TD, you stop taking the risperdal right away. The worst side effect that you can typically expect is weight gain. It's pretty common. I gained 30 pounds in 6 months when I started taking risperdal almost 4 years ago. Some people experience extreme , rapid weight gain , so you definitely need to watch out for that.


Me :D

NeuroParty
09-17-09, 08:31 PM
Hi again, Gunner's Mom,
If you'd like to check out the full FDA-aproved U.S. prescribing information for risperidone, you can download it at:
http://www.risperdal.com/risperdal/prescribing.html

Retromancer
09-17-09, 08:35 PM
I would like to have our more medically savvy members explain the doctors logic here. To my mind these two drugs are polar opposites. That the would be prescribed to the same person is boggling.

Having worked at the front desk of a downtown subsidized building I am no stranger to Risperidone. Personally I would not take it -- or many of the other anti-psychotics willingly. We are talking heavy-duty sh*t here...

my son has been taking vyvanse and it hasn't been working forhim at all, so today his doctor calles him in a rx for risperidone. i don't know anything about it, so ofcourse, i get home and look it up online. all i can find on it is that it's an anti-psychotic used to treat schizophrenia, bi-polar disorder, and autism. now i'm a bit confusedsince my son has adhd and depression. am i missing something? or is his doctor screwing up... again?

MuscleMama
09-17-09, 08:56 PM
Just fyi, from gunnersmom's other thread, her son is 5 y/o and just tried Vyvanse, his first adhd med (at a very high dose), with lots of problems.

FrazzleDazzle
09-17-09, 08:59 PM
Gunner's mom, I'd run to the nearest second opinion. IMHO.

gunner's mom
09-17-09, 09:07 PM
thank you everyone! from what i read, i don't believe i'll be giving it to him in the morning. i just wish i understood why he prescribed this

Lady Lark
09-17-09, 09:10 PM
Ask. Maybe there is a good reason for it. If you're not comfortable giving it, then by all means don't. I just think it's a good idea to find out why before completely dismissing the idea. You can always get a second opinion later.

gunner's mom
09-17-09, 09:15 PM
yes, you're right lady lark. i plan on calling his doctor first thing in the morning to find out what's going on. i never actually talked to the doctor today. he had his nurse call me and it was right at 5:00. i didn't even realize what the rx was until i got home with it and looked it up which was a little bit later

Trooper Keith
09-17-09, 09:17 PM
I am now doing some serious research on this subject for you. I have seen lots of stimulants prescribed alongside antipsychotics in the juvenile psych hospital where I work. I am also personally prescribed Adderall XR and Geodon.

EDIT: I forgot what drugs we were talking about while making my post, and started thinking it was methylphenidate and Risperdal which is a combination I've seen a lot more frequently (though I have seen Vyvanse along with a neuroleptic before).

There's something really basic that I'm missing but I have no idea what it is. I'll keep looking.

FrazzleDazzle
09-17-09, 09:25 PM
Isn't risperadone something that would come a little later in the trail period though? If the doc tried (a high) dose of Vyvanse, wouldn't the next logical step be a smaller dose of one of the other stims? Or, could he be going by the unusual reaction that Gunner had from the Vyvanse and totally switch gears? It just seems like such a drastic step to take at the point Gunner is at right now with his treatment trials.

Retromancer
09-17-09, 09:29 PM
From my layman's perspective it does look like the doctors priority here is the child's behavior. On Risperidone he is sure to calm right down...

With the population I am most familiar with the priority is "stabilization" -- so what if the patient is walking around in a haze due to a laundry list of medications?

(Please understand I am not one of the "anti-medication" advocates that periodically surface on this forum. It's just the medication itself and the age of the patient that is bothersome.)

Just fyi, from gunnersmom's other thread, her son is 5 y/o and just tried Vyvanse, his first adhd med (at a very high dose), with lots of problems.

Trooper Keith
09-17-09, 09:40 PM
Also, five years old is awfully young to be on Vyvanse and/or Risperdal. Risperdal would be almost ok if it was a small dose (.5mg bid or something) and if there were psychotic symptoms, but...

I never say this, but I'd probably see another doctor.

My doctor has a tendency to question why other doctors are allowed to practice medicine, and this is one case where I'm sure he would.

speedo
09-17-09, 09:43 PM
The doc might be suspecting ODD. It's not unusual to add an atypical antipsychotic like risperdal to treat ADHD+ODD

Me :D

gunner's mom
09-17-09, 09:44 PM
he did prescribe .5 mg

what is ODD?

SuzzanneX
09-17-09, 09:49 PM
http://www.google.com/search?sourceid=navclient&ie=UTF-8&rls=GGLG,GGLG:2007-30,GGLG:en&q=risperidone


try them?

speedo
09-17-09, 09:53 PM
0.5mg twice a day would be a little big. More like 0.25mg once a day would be more like it.

The thing is, it all depends on what the doctor is thinking. If the doc is treating bipolar, the dose will be a lot higher than for ODD or agression

Me :D


Also, five years old is awfully young to be on Vyvanse and/or Risperdal. Risperdal would be almost ok if it was a small dose (.5mg bid or something) and if there were psychotic symptoms, but...

I never say this, but I'd probably see another doctor.

My doctor has a tendency to question why other doctors are allowed to practice medicine, and this is one case where I'm sure he would.

speedo
09-17-09, 09:59 PM
0.5mg a day sounds a lot better than twice a day :)

Myself, I take 0.25mg in the morning and 0.5mg in the evening (to reduce rebound).

ODD is oppositional defiant disorder. It can result in some pretty extreme behavior in some kids.

Me :D

Retromancer
09-17-09, 10:09 PM
How extreme? I was regular head-banger -- rather like your avatar. I am actually thankful now I was born earlier and my family lacked medical coverage when I was a young child...

Prescribing Risperidone to a five year old. I simply can't wrap my head around it...

0.5mg a day sounds a lot better than twice a day :)

ODD is oppositional defiant disorder. It can result in some pretty extreme behavior in some kids.

Me :D

gunner's mom
09-17-09, 10:11 PM
i can't either!

speedo
09-17-09, 10:20 PM
I see that wikipedia cites the chocrain library as saying that risperdal is not effective for adhd. I'm not going to cite the old quote about risperdal being a third line med for adhd anymore. It's obviously wrong.

I don't see a problem with putting a kid on risperdal. People put their kids on stimulants too. Just be informed as to the risks and the benefits. If in doubt, talk to your doctor.

Me :D

Retromancer
09-17-09, 10:26 PM
All I know is that once you've watched someone "fly catching" you never forget it...

speedo
09-17-09, 10:40 PM
I've seen it. I worked in a psychiatric hospital back in the 70's. You used to see a lot of it in the schizophrenic patients... no doubt due to the use of thorzine and stelazine.

The atypical antipsychotics are a lot less prone to cause tardic dyskenesia than the old drugs, but they can still do it, particularly at large doses... in the case of risperdal I recall that a dose for schizophrenia might run 6-8 mg/day or more.


I've been at 0.75 mg for almost 4 years with no problems other than I gained a bunch of weight initially. I was at 1.5 mg/day for a while but I reduced that as it was more than I needed to treat my ocd.

I don't see where this drug is the awful thing that some people portray it to be.

Me :D

Trooper Keith
09-17-09, 10:43 PM
It's a great drug, no question, and .5mg is a reasonable dose for a 5 year old, but I think we're generally suspicious of prescribing it to a 5 year old to begin with unless there were behaviors that obviously warranted it. Especially after a biffed Vyvanse trial.

It bears asking: is the doctor a psychiatrist or just a pediatrician playing like he knows the brain?

speedo
09-17-09, 10:51 PM
YES, that is the important question to raise IMHO. Does the behavior warrant the drug?.....

If it is a pediatritian, I'd ask for a referral to a psychiatrist to treat the child, I think.

For myself, I have a psychiatrist who treats my adhd and ocd and I would definitely not like to be treated by a general practitioner because I feel that a psychiatrist has a greater depth of knowledge in psycopharmacology than a GP does. It is just better quality care imo.

Me :D

gunner's mom
09-17-09, 11:00 PM
yes, it is a psychiatrist

and no, i don't believe the behavior warrants the drug

speedo
09-17-09, 11:04 PM
You might want to ask the doctor why this drug is needed.

Me :D

unthought
09-17-09, 11:29 PM
There's something really basic that I'm missing but I have no idea what it is. I'll keep looking.Not really, there is no theraputic benefit to antipsychotics for ADHD, at all. They're used to sedate and control only. They act by blocking dopamine recepters in the brain, which prevents activity from being passed on from one neuron to the next. Stimulants force the release of dopamine into the synaps and also inhibit the reuptake of dopamine, leaving it available in the synaps. Rispiridol and other antipsychotics work by blocking messages that use that very same dopamine from ever going through. They're contradictory to one another. Antipsychotics are very serious drugs with very severe risks that one should not take unless they have no other choice. The damange they cause is very harmful and long lasting and can cause all sorts of health problems, including reduced lifespan. From living in a hospital for four years, and being around mental health patients, I've observed that the side effects are quite a bit more common that the drug companies and doctors would like you to think, and most of them aren't even properly documented or passed onto the user. Most people don't even notice they have it, and the signs won't show themselves until discontinuation of the medication that caused it.

Tardive dyskinesia is characterized by repetitive, involuntary, purposeless movements. Features of the disorder may include grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips, and rapid eye blinking. Rapid movements of the extremities may also occur. Impaired movements of the fingers may also appear. For comparison, patients with Parkinson's disease have difficulty moving, while patients with tardive dyskinesia have difficulty not moving.

Other closely related neurological disorders have been recognized as variants of tardive dyskinesia. Tardive dystonia is similar to standard dystonia but permanent. Tardive akathisia involves painful feelings of inner tension and anxiety and a compulsive drive to move the body. In the extreme, the individual undergoes internal torture and can no longer sit still. Tardive tourettism is a tic disorder that can closely mimic Tourette Syndrome, sometimes to the point where the two can only be distinguished by the details of their onsets. Tardive myoclonus, a rare disorder, presents as brief jerks of muscles in the face, neck, trunk, and extremities. "Author: James Robert Brasic, MD, MPH, Research Associate, Division of Nuclear Medicine, Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine Coauthor(s): Brian Bronson, MD, Staff Physician, Department of Psychiatry, New York University Medical Center; Tristen T Chun, BS, Division of Nuclear Medicine, Russell H Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine Contributor Information and Disclosures"...

Article goes on. http://en.wikipedia.org/wiki/Tardive_dyskinesia

Trooper Keith
09-18-09, 01:21 AM
Not really, there is no theraputic benefit to antipsychotics for ADHD, at all.

I never said there was. Antipsychotics aren't used to treat ADHD symptoms, though they are occasionally used to manage the violent behavioral issues in children with comorbid ODD or CD. The question was why a D2 receptor antagonist would not block a stimulant from working - because it doesn't, and it reasonably should, except that I'm clearly missing something.

They're used to sedate and control only.

They're used to reduce hallucinations and delusions, and to stabilize against mania, and to treat treatment resistant depression, and to stabilize mood, and to control anger in PTSD victims, and all kinds of neat ****, but they aren't used as chemical restraints anymore.

Chemical restraints are illegal many places in the US. Antipsychotic drugs are not used as chemical restraints in 2009 by any standard mental health provider.

They act by blocking dopamine recepters in the brain, which prevents activity from being passed on from one neuron to the next.

Antipsychotics are strong D2 and 5-HT2A antagonists that also have affinities for several other 5-HT receptors as well as 1 and 2 adrenergic receptors and moderate affinities for H1.

I'm beginning to really wish I hadn't edited out the parts of my previous post where I ramble about how MPH and risperidone work.

And that's just the old ones. The "next generation" of antipsychotics have arrived with the development of Abilify! New antipsychotics will almost certainly follow its lead in being selective partial dopamine agonists. Much cooler with a much lower side effect profile.

Stimulants force the release of dopamine into the synaps and also inhibit the reuptake of dopamine, leaving it available in the synaps.

In a nutshell. They also act on NE.

Rispiridol and other antipsychotics work by blocking messages that use that very same dopamine from ever going through.

See above.

They're contradictory to one another.

See, that's what I'm grappling with. It seems, intuitively, that they should be. Still, it's entirely possible to take an antipsychotic for mania or schizophrenia, and a stimulant for ADHD, and see symptom remission for both.

I know it's just a case series, but

Julia W. Tossell, Deanna K. Greenstein, Anna L. Davidson, Susan B. Job, Peter Gochman, Marge Lenane, Thomas F. Nugent III, Nitin Gogtay, Alexandra L. Sporn, Judith L. Rapoport. Journal of Child and Adolescent Psychopharmacology. Fall 2004, 14(3): 448-454. doi:10.1089/cap.2004.14.448. (http://www.liebertonline.com/doi/abs/10.1089/cap.2004.14.448)

Antipsychotics are very serious drugs with very severe risks that one should not take unless they have no other choice.

Any psychoactive medications are serious drugs that should only be taken when warranted.

The damange they cause is very harmful and long lasting and can cause all sorts of health problems, including reduced lifespan.

[citation needed]

From living in a hospital for four years, and being around mental health patients, I've observed that the side effects are quite a bit more common that the drug companies and doctors would like you to think, and most of them aren't even properly documented or passed onto the user.

Why were you living in a hospital? I don't mean to pry, but you're making a rather outlandish claim.

For what it's worth, I work in a psychiatric hospital. I've observed quite a few patients on antipsychotics. None of them have developed TD or really any noticeable side effects. In fact none of them that I can think of have even demonstrated even mild EPS.

Most people don't even notice they have it, and the signs won't show themselves until discontinuation of the medication that caused it.

Such as?

Tardive dyskinesia is characterized by repetitive, involuntary, purposeless movements. Features of the disorder may include grimacing, tongue protrusion, lip smacking, puckering and pursing of the lips, and rapid eye blinking. Rapid movements of the extremities may also occur. Impaired movements of the fingers may also appear. For comparison, patients with Parkinson's disease have difficulty moving, while patients with tardive dyskinesia have difficulty not moving. ... Article goes on. http://en.wikipedia.org/wiki/Tardive_dyskinesia

Yes? Again, and? Extrapyramidal symptoms happen with antipsychotics. Everyone knows that. They also tend to happen very quickly once treatment is started and TD very, very rarely becomes permanent after discontinuation of the medication. It's not even the worst of the potential side effects. If you're trying to scare people off of antipsychotics, maybe try neuroleptic malignant syndrome, or something?

Antipsychotics are quickly overtaking antidepressants as the most prescribed class of medication. Especially since the release of Abilify, antipsychotics are being used to treat a wide range of psychiatric conditions from their originally intended purposes (psychotic and manic symptoms) to all kinds of new uses (treatment resistant depression, intermittent explosive disorder, anger control issues associated with juvenile psychiatric disorders, etc.).

Their safety and efficacy has been well established. Low doses of atypical antipsychotics are one of the safest things you can be put on. The biggest complaint of most users of antipsychotics? Drowsiness. And that's just because they're potent antihistamines, like Benadryl. Going to spare myself the citation game because it's 1:10AM and post my own link:

http://scholar.google.com/scholar?q=antipsychotics+safety&hl=en&btnG=Search

There's plenty there.

On a personal note, I am alive today because of antipsychotic medications. Were it not for my treatment with antipsychotics, I'd be either completely stark raving mad again, or six feet underground. That's not an exaggeration. And that's the case for many, many people who take antipsychotic drugs.

Abilify made my eye tic. Risperidone raised my prolactin levels. Geodon made my finger twitch for about three days when I was an inpatient first starting on it. These are the bulk of the "horrible side effects" that antipsychotic drugs will cause most people. It's worth noting that I've been on Geodon for months and the worst side effect has been a loss of appetite. Big deal.

You people make me feel like a drug company shill. Maybe I should be a phamaceutical rep.

Retromancer
09-18-09, 03:10 AM
Point(s) taken. On the street the biggest issue is hands-down non-compliance. Whatever the side-effects of these drugs, the consequences of "going off meds" are as a rule far worse. Been there [as a witness], got the police report...

But we are talking about adults here, not 5 year old boys -- how ever badly they misbehave!

The re-marketing of these 'atypical' anti-psychotics --especially to children -- is a troubling development. I would encourage anyone that is interested in this subject to check out fellow Seattle-ite Philip Dawdy's blog Furious Seasons. He has been doing yeoman work in this area. (If you like what you see kick some hard currency his way. Even journalists need to eat...)

gunner's mom
09-18-09, 10:15 AM
to clarify-the doc is not wanting gunner on the vyvanse and the risperidone together. just the risperidone. my son is not crazy, he doesn't exhibit extreme behavior. yes, i'm sure this is a good drug for people who NEED it, but i have no doubt in my mind, after reading everything in this thread, that he does not need this drug at all. i think that all these psychiatrists are just trying to over medicate my baby and it's really starting to tick me off!! why do they just wanna throw meds at him and see if they work? i read somewhere in this thread, i think maybe it was speedo?? anyway, they said they were taking .25 mg in the morning and .5 mg at night. and also that they are taking it for ocd. how old are you? how much do you weigh? my son is 5!! he only weighs 40 pounds and is steadily losing weight! they want him to take .5 mg in the morning and another .5 mg at night! i think this is completely ridiculous.

Vickie
09-18-09, 12:46 PM
I would really talk to the doc about his reasoning for this med. He needs to give you a lot more info if you are going to be a partner in your son's treatment. If the doc is more of a "paternalistic-do what I say because I know best" kind of doc, maybe you should explore another doc. It is best if you have a doc that can work with you as a team for best treatment of your son. There will be alot of changes as he grows older that will need to be adapted to, so make sure you can work with this doc or work on making a change to another doc.

My youngest was on risperdal for a while when she was 8.

At the time she was having severe anxiety that was being expressed as violence and was endangering herself and others. The med worked really well (used at a much lower dose than when used for psychosis). We started low at .25mg for a week before adding a second dose of .25mg. As we got other issues sorted out, we were able to drop the risperdal.

For background, she was first on a stimulant which helped but due to weight we could not go up to a high enough dose and she had pre-existing anxiety that we were worried about. Next the doc added guanfacine to augment the stimulant and help with anxiety. There was a particularly bad set of circumstances at school (teachers can be more cruel than kids-and it is more covert) and the anxiety was getting worse so the doc added low dose risperdal. Another consideration was that risperdal might add weight for this skinny child and would not cause additional weight loss. We say great results and as we got the school issues under control we were able to drop the risperdal. It is in our arsenal should we ever need it again.

Our doc went through each step in detail with me as to why we should work with each med, what side effects to watch for, and how to know if we were seeing benefit. I also looked up articles on the use of risperdal (risperdone) for ODD and conduct disorder and its safety in kids. The doc was a great guide through this. Because of his extra care, explanations (including other options) and the fact that he is up on current research on these meds, I trust his judgment.

MGDAD
09-18-09, 02:47 PM
Run, dont walk away from this doctor. He is not listening to you. He is not being careful with his prescriptions. He is doing an "off-lable" prescription for a strong medication for a 5 year old that does not have severe behaviors after only trying one stimulant. That is not proper procedure for a psychiatrist treating a 5 year old. When we get right down to it a stimulant for a 5 year old is an "off-lable" prescription.

Im going to say it one more time as clearly as I can. The doctor is being very careless in his prescriptions for your son. And remember, I am one who is generally pro medication and has a daughter that has taken this combination of meds successfully.

There are other medicine choices for your son that should be tried before moving on to atypical antipsychotics. MPH (ritalin), or the "pure" MPH which is Focalin. Based on your sons experiences your doctor should be trying very small doses of short acting stimulants. That would be the cautious road to take. No, Im not a doctor, but the path for finding proper meds for a child is pretty common sense.

NeuroParty
09-18-09, 02:59 PM
Hi Gunner's Mom,
Just wondering if you got to talk to the doc yet. Off-label prescribing is very common in psychiatry and especially pediatric psychiatry. You may have noticed that some of the drugs on MuscleMama's list from her doctor are also off-label for ADHD. The problem with off-label prescribing of course is that it is based on weaker research into how well the drugs work and how safe they are. The positive side is that doctors prescribe using their best judgement. You're a great mom to dig for more information and find out all you can. Keep us posted!

Trooper Keith
09-18-09, 03:40 PM
Im going to say it one more time as clearly as I can. The doctor is being very careless in his prescriptions for your son. And remember, I am one who is generally pro medication and has a daughter that has taken this combination of meds successfully.


I'm going to absolutely second this. I am probably one of the more outspokenly pro-medication people on these forums, and I frequently tell people to listen to their doctors because their doctors almost always know better. I even started into this thread looking to reassure you about why your doctor might be doing this (comorbid ODD symptoms or violent behaviors) but in this case it's absolutely clear that your psychiatrist is being reckless and downright irresponsible with your son's case and prescribing medication which simply doesn't make sense for your child.

Find another psychiatrist - preferably one who specializes in juveniles.

MuscleMama
09-18-09, 05:01 PM
How do you guys feel about neurologists vs psychiatrists? We had a very good experience with a neurologist who works with lots of adhd kids. I believe gunnersmom is on her second psychiatrist and her pediatrician isn't helpful either. Here is her quote from her other thread about vyvanse:

ok, so the doctor did finally call me back today. after i told him everything that's been going on, he said to DOUBLE THE DOSE! i was like whaaaat? no way. i told him i know i'm not the doctor but it seems like to me that he's already got too much in his system, why the heck would we double it? and then he said "oh... well maybe we should cut the dose in half" he told me to open the capsule every morning and only give him half of the medication.

so, this doctor saying double the dose one minute and cut the dose in half the next minute really makes me think he doesn't know what he's talking about. but then again.. i'm new at this. i mean, there's a big difference in 60mg and 15mg! he's only 5!

i was thinking about changing doctors again. this is the second doctor we've seen. the first one told me that my son is mentally retarded and needs to be put on disability which is hilarious considering he is really smart! the only problem is getting him to sit down and pay attention.

Trooper Keith
09-18-09, 05:07 PM
I don't think neurologists have the training to properly diagnose and treat DSM disorders - their training is in neurology and deficits of the brain caused by physical malfunctions of the hardware, so to speak, whereas psychiatrists are trained in mental disorders regardless of their etiology. There are certainly neurologists who know what they are doing, but then, there are pediatricians who know what they are doing, too.

MGDAD
09-18-09, 06:11 PM
I think there can be good doctors for ADHDers that are simply Pediatricians who specialize in treating mental dissorders, or pediatric psychologists, or neurologists or neurospychiatrists that specialize in treating pediatric mental dissorders. Some doctors sometimes get a degree in something, then decide to specialize in a area that they did not first think about. There are plenty of ways for doctors to learn enough to be good enough to properly treat ADHD through continuing education.

My childs doctor is simply a pediatrician, but he only treats kids with mental dissorders. He has plenty of certificates and experience working at and even teaching at teaching hospitals for pediatric psychiatric conditions. He is teaching a class at Berkeley next semester about pediatric psychiatric medications for the psychology department. Yet he does not specifically have a degree in pediatric psychology.

(sorry Kmiller, I dont mean to dissagree, just have a different opinion, but of course it is only my opinion)

Trooper Keith
09-18-09, 06:23 PM
We're not disagreeing. Like I said, there are neurologists who know their stuff, pediatricians who know their stuff, family care doctors who know their stuff. The residency doesn't mean the doctor doesn't know anything except what he specialized in - it just means he's only demonstrated expertise in his field, fresh out of medschool.

Pediatrics and ADHD are so intimately related that I wouldn't write off a pediatrician diagnosing ADHD whatsoever. Unless, of course, they started treating the kid with Risperdal. That was the reason why I asked who was seeing the kid in the first place.

Either way, all I'm saying is, if I'm looking through a phone book for somebody to treat ADHD, I'm going to flip to "psychiatrists," not "neurologists." If I'm looking for someone to treat my concussion, on the other hand...

gunner's mom
09-18-09, 06:42 PM
i talked to his doctor today and he said that he believes this is the right route to take and i should trust his judgement. he actually seemed kinda ticked that i went and did research on the medication before giving it to gunner. and i've been at work all day and hardly had time to call the doc in the first place, much less go searching for a new one. so first thing monday morning i'm gonna make him an appointment with someone else

Trooper Keith
09-18-09, 06:59 PM
That pretty much proves it. There is a reason I trust my doctor, literally, with my life: he has always been able to justify his treatment decisions to me, they have always made sense, and they have always been based on modern research.

At the same time, he's terribly arrogant and has a tendency to question why other doctors are allowed to practice medicine. I love him for his arrogance. When I was an inpatient, he made a call during a session with me and told his secretary to cancel his work with a local hospital. He told me his case load was too big. I said "well it probably is, there's what, 6 psychiatrists in the area?" He responded "as far as I'm concerned, there's just one."

I love my doctor. I really hate the fact that someday I'll move and stop seeing him.

Your doctor, however, is a jerk and a reckless practitioner. Good for you finding another.

FrazzleDazzle
09-18-09, 08:39 PM
Whatever this doc's reason for prescribing these meds for Gunner, he should take or find the time to talk with you about your concerns and answer your questions, or point you in the direction to find out more, not leave you feeling like you ticked him off. I always ask the doctors certain things about the meds my son has been prescribed; then I ask the same questions to the pharmacist and I stand there and keep asking until I'm done, then I come on here and ask some more questions. But I usually won't fill a script or give it to my son until I have a good amount of knowledge in hand, first. I have left doctors that would not take the time with me and my son to talk with us. There are plenty out there who will.

I don't think credential soup at the end of a doctor's name makes much difference in how they relate to patients, the particular knowledge base or special interest they may have in practice, or how much influence pharm companies have in how they practice and prescribe. :p

NeuroParty
09-20-09, 04:00 PM
That sounds like a really good idea.

MGDAD
09-22-09, 01:17 PM
It was good you went back and asked him one more chance to explain himself. Based on his pathetic answer it lets you know that you have to find another doctor. If you dont feel comfortable with the medication, and the doctor can not clearly describe why he thinks it is the right one, he is not a good doctor. Especially for an off lable prescription. Good luck.

MuscleMama
09-24-09, 04:30 PM
Any updates? :)

Debacle
10-15-09, 12:40 PM
I came in late on this but for whatever it's worth, my 13 yo son (who does NOT have add/adhd), who is severely autistic, has been on risperdal for about 5 years. It's worked well for his behaviors and he's had no side effects. We have his blood sugar monitored, though. Not sure why your doctor prescribed it for add though.

Trooper Keith
10-15-09, 02:43 PM
Any chance we can get an update on this?