This blog entry is long but if you have ever considered medicating your child for ADHD, OCD, Anxiety or any other behavioural symptom etc , I strongly recommend you read this blog before you do. That also goes for those of you who already DO medicate your child for these or other issue and are considering weening or removing some or all medications. For years I was an anti-Ritalin advocate. I felt and still to some degree feel that Ritalin along with other serious medications are widely over-prescribed for children with ADHD and other disorders. That said, there came a time in our son Joshua's life when we saw no other option but to consider medication as a means to help him function. We met with a new doctor and discussed the options and agreed to a trial of prescriptions. What really caught us off guard was that this doctor prescribed not one, not two but three different prescriptions at one time making a little drug cocktail. We decided to trust in this doctor because she was the expert so we introduced three new meds one at a time for varying issues with two weeks between each new added drug. Each medication had favorable results accept one which I can not even remember the name of now so many years later.What I do remember about it is that it affected Joshua in a really adverse way. He withdrew into himself and started shutting himself in his room, a total mess and ball of anxiety. This was not my boy I was seeing and hubby agreed so after the first 4 days of the 2 week trial of that medication we stopped abruptly . I decided I was never going to put that drug into my son's body and brain again. We then switched that one out to another medication . Once all three meds were successfully introduced Joshua was then on a daily regimen of Methylphenadate( otherwise known as Ritalin), Resperidone , and Clonadine for severe ADHD, anxiety and OCD and severe sleep disorder. This all happened the summer before Joshua started grade 1. He did so well that school year and made great strides. He started to learn like he never had before. Of course, a fabulous teacher and program also played an huge role but the meds were also instrumetal in bis progress.
One thing about considering meds for a special needs child is that as the child grows it is to be expected that dosages will increase and the child's needs and symptoms will change. Fast forward 4 years. Joshua is now 10 years old and over the years his medication dosages have gone up and new meds have been added. Joshua over these years had developed more severe anxiety more severe OCD and some tics and behaviors that bordered on Tourettes . Every time we went to his prescribing doctor, she would listen to our concerns and say one of two things..." it's time to increase the dose of this or that medication" or " it's time to consider adding a new medication" we tweaked and changed and switched up his drug dosages etc and sometimes with good results but they were always temporary results. More and more we as his parents were questioning if we were still doing the right thing in giving Joshua all these drugs.Until a few weeks ago Joshua was taking 5 different prescription drugs for all then original and other newer symptoms as well as some over the counter medications for those and other issues. He was a walking pharmacy . I gave him his meds on schedule like clockwork but one morning last month I forgot to give him his morning doses in the hustle and bustle of the morning. What I observed was that he had a great morning of clarity. No behaviors, no ticks, no OCD. At first I did not think anything of it until I gave him bis medications and within a half hour of those doses all his symptoms we thought we were treating returned in full force. Joshua became a complete mess of anxiety and OCD. I immediately made an appointment with his prescribing doctor to discuss what my husband and I observed .Before seeing the doctor, I tried delaying his morning dose again with the same results and discussed this at our appointment. Joshua's doctor agreed with me that at least one of his medications was giving him side effects. She suspected the methylphenadate which escentially is Ritalin. We were then instructed to take him off the drug...cold turkey. I asked if this was safe and she said the only medication she prescribed for him that should need slow weening if ever needed was the Cilexa(Citalopram) which he is also now prescribed for anxiety. That day we skipped his afternoon dose of Ritalin and he had a good afternoon , anxiety free. Day two was the same but in days that followed we found out just how hard withdrawal would be on him. We were denying Joshua's brain and body a stimulate it used for 4 years and so withdrawal produced a serious energy crash. Joshua started sleeping up to 18 hours a day. When he was awake we was alert for only brief periods and otherwise was the walking dead. Some research taught me that this was normal cold turkey withdrawal and perhaps we should have been instructed to ween him more slowly to avoid this crash. Once again I decided to hold off on his morning meds. Joshua was still a bit tired but was not falling asleep in his cereal or seeking out a nap shortly after breakfast. After this and 2 weeks of a very overly tired little boy we rushed him back to his doctor insisting she take us right away to discuss his withdrawal and the results. We confirmed that the Ritalin was the culpret for his symptoms because since removing this drug from his regimen, his symptoms we were trying to treat have mostly disappeared . Because of the extreme fatigue we also stopped giving Joshua his Clonadine and Melatonin for sleep disorder. I just could not justify drugging him to sleep when he was soooo fatigued already. Aside from one tablet of Melatonin , Joshua has successfully fallen asleep right away without those meds since we removed the Ritalin whereas before he was unable to fall asleep at all without at least the clonadine and sometimes also the Melatonin . This was a happy surprise. Our biggest concern was the never ending fatigue...excessive fatigue. I shared our observations with the doctor and right away she felt his Resperidone was compounding the fatigue he was experiencing from the Ritalin withdrawal. Since his anxiety , OCD and ticks had dramatically decreased anyway she suggested that we ween ( yes ween) him from the Resperidone slowly. Hmmmm , why was weening not suggested for the Ritalin? That one still puzzles me. I did not give Joshua his afternoon dose and low and behold , he did not fall asleep in his dinner that night. For the next three days up until now I have skipped the morning dose of Resperidone as per instructions and Joshua has been alert, mostly anxiety free and more focussed. He has started reading his books ( actually reading them instead of looking at the pictures and pretending to read ). He has been playing with toys... something he rarely if ever did before, and he has been sitting still through entire T.V. programs...something he NEVER did. In the next day we will cut his afternoon dose of this medication by half and then eventually drop it completely. This will be three serious medications dropped from Joshua's daily drug regimen with so far great results. We could not be happier at this time the only prescription medications ( besides the Resperidone which we are weening and eliminating )Joshua takes are Citalopram (otherwise known as Cilexa ) and Lamotrigine. The Lamotrigine is for absent seizures and I will add that his neurologist wants us to consider a trial without that one next year. Our son also takes some over the counter meds for severe bowel issues that required serious surgeries . These we have to continue with at this time to prevent relapses in his condition and we are fine with that but our goal as agreed upon with his doctor is that we eventually hope to have Joshua taking only the Cilexa as prescribed by her and possibly still the Lamotrigine as prescribed by his neurologist as well as the over the counter bowel meds. When he gets older and can more sufficiently control and regulate his diet, we hope he can forego the bowel meds too. time will tell. This has been a journey and a huge learning experience for us. Do we regret using the Ritalin and other medications????? Nope..not in the least. That said, we offer advice to any parent considering medicating their special needs child for these or other conditions. First to you I say educate yourself. Do the research. Do not just rely on what the doctor tells you about the drugs he or she is prescribing. Ask other parents who have used these meds for their children about their experiences. The next thing I suggest is that you journal everything ...EVERYTHING...you observe in your child, and I mean everything. Any little change. Do not give a medication first thing in the morning if at all possible. Wait a half hour and note the before and after results and differences in your child from the drug he or she is given. Next I suggest if your child takes more than one medication is to stagger the meds. Do not give two or more meds at once if it can be avoided and in most cases do not ween two or more meds at the same time. This will help you to know which medication is having what effect and if there is an adverse affect to a medication, you will more easily be able to pin point which drug is responsible. Before seeing the prescribing doctor write down all questions you have because I guaranty the doctor will be over booked and therefore rushed to get you in and out and you will forget to ask something important. Last I says write everything down and follow your gut as a parent. I also suggest you ask your child's teachers and / or Educational assistants to do the same a document what they observe when working with your child with each new medication and dosage change. You know your child better than anyone . Yes doctors have expensive degrees and training but they do not spend the time your child that you do . This blog entry is not meant to deter anyone from considering medication for their child for ADHD or anxiety etc. Many children truly need these drugs and Joshua was at one time one of them . I still believe that. He still needs some of his meds.Even Temple Grandin, a respected professional and speaker with autism will tell you that though she is against the over use of drugs in autistic children, she takes and needs a low dose of anti-depressants to function. Some kids just need the help. What I am saying though is to listen to your instincts. If something seems wrong down the road with a medication, it probably is. Ask lots of questions, wait and listen for the answer. Research and ask those with first hand experience what to expect both for intraducing a new medication and for weening an old one... and what ever you do, make your child's doctor listen to you. If they don't then find a doctor who will.
