Thanks everyone for your input and suggestions. I've been without a computer for about 10 days now so that's why I haven't responded sooner. As for the nurse practitioner, she is experienced with the different ADHD meds as she works in the behavioral counseling center we take our son to and the primary focus of her job is to counsel and prescribe for this type of thing. But that doesn't mean I am going to listen to everything she says, just as I wouldn't listen to any type of medical professional if I felt uncomfortable with what they were suggesting.
We've been on vacation at the beach in North Carolina, and we decided not to give our son any meds while we were here, just to give his system a rest, and to have his appetite back. Anyway, he has been having the time of his life playing in the ocean, making friends (with everyone!!) at the beach, swimming in the pool, and eating like a horse! Sure, it would be a little easier for us if he were on his meds, but it's just so nice to see him running around and using up so much energy during the day that he falls asleep by 7:30 each night and actually stays in his own bed all night!
I realize he needs the medicine for school, but after seeing him down here doing amazingly well without it, I know now that the risperdal and prozac is NOT for him! If our NP keeps pushing it, I will find someone else to treat our son.
That's great to hear he's having such a good time! I wonder a lot about my son and why he seems to do better in a new place. His doc told me that new places stimulate the brain more than the normal routine because there's just so much to discover and therefore much more "input" for the brain. And our kids actually function better with more stimulus to the brain. I guess that's why the stimulant medications work so well. So new and exciting places are sometimes just what the doctor ordered!The psychiatric nurse practitioner we take our son (age 6, 48 lbs) to has been pushing to add risperdal and prozac in addition to the stimulant (currently 15 mg Focalin) he takes. She suggested switching to Vyvanse from the Focalin, and then adding these other two meds. She states she has had alot of success with this combination and feels that no stimulant alone will improve his behaviors beyond a certain point. His impulsivity,anxiety, sensory issues, and inablility to transition well will continue to be a problem due to his diagnosis of being on the autistic spectrum. She feels the behaviors he exhibits are more due to that than the ADHD.
I have resisted this because the last thing I want to do is overmedicate him. He isn't doing badly on the Focalin. It's not perfect, and he has some days where his behavior could be better (don't all kids?) but he doesn't have meltdowns any longer and gets way more good behavior reports than bad. My feeling is, we went on this medicine (reluctantly) to just be able to get him through the day which is what he is doing now. His report card was excellent, he's at the top of his class academically, and he seems happy. Sure, maybe the prozac and riserdal will keep him from calling out, arguing, or leaving his seat occasionally, but I DON"T want a child who just sits and is compliant all day because he is drugged. One of our favorite things about our son is his excitement and expressiveness over the littlest things.
Our insurance is limited with whom we can see and it's not that she won't prescribe want we want, it's just upsetting to have her keep pushing this. And even though I am adamantly against it, there's a little voice in my head saying what if she is right?
So, my question is...have any of you heard of or had experience with this combination of meds? Does it seem excessive to you? Should I just continue to go with my instinct or should I listen to her and give it a try, even though it would upset me terribly. Any advice would be appreciated!
It sounds like you are happy with the results and he is happy, so why messHis teacher finds his behavior manageable I think, but I'm sure she would be happy if he were on more medication. She is a very structured person (which is good) who is very inflexible (which is bad). It just wasn't a great match this year.
Yes, I would say the medication is a success to a certain degree and maybe it could be better, but I am not sure I want to take that risk. I know medications can be stopped but after our bad experience with Tenex, I just don't want to see him go through something like that again.
Okay, I'm sure this is going to be unpopular, but don't trust this to a nurse practitioner. Nurse practitioners are great at what they are trained for, but they don't have the training a doctor or psychiatrist does, or they would BE one. Let them treat an ear infection or diagnose strep throat, or draw blood or take intake information, etc., not prescribe controlled substances for psychiatric conditions. I know insurance is an issue, but this really is a critical decision.
As far as "not perfect" goes, who wants a "perfect" kid?! The quirks and foibles that give a kid personality are no different from those in other kids. You lose all of those and you don't have your kid anymore.
Psychiatric ARNP do have training in this area. Good ones know their stuff and the medications inside and out. We work with one that is absolutely wonderful and has been working in this field for 25+ years. I wouldn't switch. Aside from knowing her stuff, she's more accessible than a doctor, appointments are schedule for hour - so if there are issue we have plenty of time to talk and she runs on time.I also wonder about a nurse practitioner. I guess it depends on how experienced she is. I didn't realize they could prescribe controlled substances. I just know what a huge difference it can make when you have someone that knows what they're doing! So you'll have to go with your gut on this one...if you trust her then stick with her. If you don't then it's time to switch. Do you think this may be one reason you don't trust her recommendation? Is it that you don't have a lot of faith in her or do you think you would feel the same no matter who recommended it? Whether you trust her or not, there's nothing wrong with getting a second opinion.
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