Get ready for all of this.
Axis I: ADD - Hyper/impulsivity, ADHD Combined type, Anxiety, Dysthmia (? cyclothymia because of the hyper aspect), borderline ODD and conduct disorder
He also showed strong tendencies towards Autism and Asperger's. Tho the doc thinks he is too social for these to be a big concern. we will know more after Praxis sensory integration testing gets done. We are still far down on the waiting list.
I fired the psychiatrist and our PCP has tweaked meds to something that seems to really be working. My son takes
100 mg of Neurontin, 10 mg fluoxetine, and one 20 mg Adderall XR per day for these issues. He also takes naproxen, zantac, singulair, and has an albuterol inhaler for the other stuff.
Once we are sure he is levelling out ( and he most definitely is) and we do the Praxis stuff, we are going to add family behavior therapy. the psychologist agreed to see us when we are ready b/c she knows there is no sense starting until we have a good handle on the meds.
All in all, I am much more at peace with the whole situation than I was a few weeks ago. We still have a long way to go, but it is so much easier to cope if you can see positive changes and trust your docs!!!
[QUOTE=OlderMom]Don't forget the Autism/Aspergers! [/QUOTE]
And anxiety and depression! I think the doc left out psychosis. Darn!
LOL. He did. What a blight Know that Conduct Disorder, a very serious one, is not supposed to be diagnosed until a child is 18. I'd be leery. Some autistisc kids are "too friendly" and end up getting misdiagnosed because of that. You may want to get a second opinion. Our first neuropsych really didn't get my son righit. He diagnosed him withi Bipolar NOS (not true), Cogntive Disorder NOS (well, this was t he autism that he woudn't name and he ALSO said son was too social...he was wrong, in the end) and "Autistic Tendancies" whatever that means--to me that means ASD. That a NeuroPsych would diagnose conduct disorder in a young kid makes me wonder. Check out the DSM on Conduct Disorder and you'll see that part of the criteria is being 18. Both bipolar and ASD can seem like antisocial behavior, but, hey, it's due to the disorders and can be helped. CD is pretty hopeless and I'll stick my neck out and bet your son doesn't have it. I would seriously question this. If the child is actually bipolar or ASD, I would be surprised if behavioral therapy will help much. Could be a waste of time. Yes, we tried it. Your son is also on a TON of meds. I'd also qustion a doctor that would throw a kid on so many meds. Know that allergy meds are known for kicking up mood disorders. To me, it seems like there's a med for everything and the doctor in charge of meds is not even sure what this child has, poor kid. I hope it works for you. Good luck. OlderMom38872.9209143519No, conduct disorder can be diagnosed before eighteen. It's anti-social personality, which is conduct disorder morphed into an adult behavioral disorder, that cannot be dxed before 18, and there must have been conduct disorder in childhood/adolescence for a true anti-social personality disorder dx.
http://www.mentalhealth.com/dis1/p21-ch02.html
This gives the diagnostic criteria.
lillian38872.9231944444Lillian, I'd still question it. Basically, it's a pretty hopeless diagnosis (there is no real help for it) and this Neuropsych almost diagnosed the kid with eveything under the son. Makes me think he really has no clue. Mild ODD and CD? They are on the same spectrum, so to speak. I would be very leery of this diagnosis. It's very broad and the kid is on tons of meds. I don't know...I hope it works. Frankly, if the kid is so off-the-wall that he meets the crieteria for CD, that's pretty scary. I had a kid like that who killed animals and set fires, but he'd been in foster care and was ruined. His diagnosis was severe reactive attachement disorder and he had to leave the house as he had also acted out sexually on our younger kids. The kid had no conscience at all. That's Conduct Disorder. Again, I doubt this kid is that extreme--the parent would be frantic and she's not...anyways, I wish her good luck. OlderMom38872.9258680556[QUOTE=OlderMom]Lillian, I'd still question it. Basically, it's a pretty hopeless diagnosis and this Neuropsych almost diagnosed the kid with eveything under the son. Makes me think he really has no clue. Mild ODD and CD? They are on the same spectrum, so to speak. I would be very leery of this diagnosis. It's very broad and the kid is on tons of meds. I don't know...I hope it works.[/QUOTE]
Oh, I totally agree with you. How can a child have ADHD, ODD, AND conduct disorder?
Don't forget the Autism/Aspergers! I think this guy is really just not sure WHAT the problem is. I'd like to know which tests were administered to his child. Oh, well.Have you checked the qualifications/experience of the neuro-psyche? Does this sound like your child? Have you studied the descriptions of all of these diagnoses? I am a firm believer that just because they are an "expert" doesn't mean they are right. What do your instincts say?
Also, is your primary care physician is managing the meds?
First of all... I am ok with the meds for now. I wasn't when the psychiatrist was jacking them up down and around so trust that I don't just stand for overmedicating!
My neuro psych seems to "get" my kid and quite frankly is the 1st one we have ever seen so I don't have much to compare to. Most of the strongest ( I guess you'd say) diagnoses make perfect sense. She also allowed that the dysthmia and anxiety could cause behaviors to mimick CD and ODD. I feared an ODD dx b/c his half brother was diagnosed at the same age with ODD.
Your right, I am not stressed over the ODD and CD. He isn't hurting animals of people maliciously. He is not a junior fire starter or anything like that.
As for all of the meds:
Singulair he is only on seasonally b/c he has a lot of trouble Feb thru June.
Albuterol is only really used when he already had a URI/croup and during the months above
Naproxen -- well when you kid has arthritis... let's just see what you do
Zantac - because Naproxen is rough on a stomach
Fluoxetine and neurontin are trying to stabilize his emotions rollercoaster
trazadone is to help him sleep if needed b/c for a while he was getting less than 3 hours of sleep a night and his immune system was weakened making all situations worse
I was the one having a fit about the meds and fired the psychiatrist because he had him on double doses of neurontin and x3 Adderall XR a day which didn't do what it was supposed to and I D/c on my own in short order!
In addition to neuro-psych screening, the doc also did IQ and achievement testing and had myself and the teacher fill out numerous surveys. The doc was surprised that the autism/aspergers showed up at all, but she was willing to say it needs to be looked at further and agreed that we need to have the Praxis Sensory Integration testing done to provide more info. We have been on the waiting list since March.
If you sense a bit of hostility it is because it feels as though you people all think my doc is a quack and that my son is hopelessly being drugged into a state of oblivion!
I am a single mother who has missed countless hours of work without pay to get my son the help and attention he deserves. i wouldn't be here trying to learn or get advice if I thought I knew it all of was just willing to let the doc pull the strings while I play follow the leader with them. It was actually this board that made me ? Asperger's before his testing was even complete.
ADHD and ODD are traditionally co-morbid conditions. The conduct disorder was largely addressed in the 3 surveys that were completed by myself and his teacher. Again, neuro-psych feels that other things are mimciking ODD/CD because of anxiety and b/c when his arthritis is kicking in, it often makes him aggressive and act out in ways he otherwise doesn't.
The neuro-psych stressed she thought anxiety and depression were the most prevelant with the ADHD.
No one thinks that just because we have some diagnoses on paper that our work is done. Behavior therapy might be a waste of time, but I have to give it a shot to know that we have tried everything possible to help him.
I fight my son's medical battles alone and doing the best I can and while I am largely thought to be an intelligent person, this stuff gets thrown at you and all of your intelligence sorta goes out the window for a bit!
I see the improvement in my son in the last two weeks and that is what I am going to continue to judge my decisions on.