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Teen on zoloft/concerta/abilify for ADHD/PDD

Posted by always_doing_laundry on June 28, 2008, at 17:08:13

Hi. I'm new here, looking for thoughts about my 16-year-old son, possibly tapering him from meds (abilify and zoloft), and when the best time (if any) would be to try it (based on other patient/parent experiences).

I apologize for length ... not sure what the guidelines are for this site.

He is dx'd with ADHD and on the PDD spectrum (originally presented at age 2 as fully autistic with echolalia, etc., but now shows more symptoms of sensory integration issues, poor social skills, repetitive habits, "odd"'ness, unusual obsessions/interests, over-responsive to some stimuli/under-responsive to others). He is high-functioning, especially on meds. He had early intervention, beginning at age 2, progressing from special education to currently only on a 504-plan.

We have a psychiatrist we trust and have worked with for the past six years, but we don't see her until school starts. I'm trying to gather experiences and opinions before deciding whether even to consider changing anything.

We are wondering whether he still needs the abilify, or if we could taper the dose; ditto with the zoloft.

I have read the horror stories about SSRI withdrawal. Additionally, he has paradoxical reactions to medications. I also know that it's easy to forget what it was like when he was crazy,...

... trying to run out the door b/c he worried there might be spiders in the shower; then afraid to go outside b/c there might be bees (first during the day, then night, then only during "bee season" then any season, lest there might be bees, then ever ... in case a bug that might actually *be* a bee in the long run comes out ... and might come near him); pooping in the urinals at school but refusing to use a toilet at home; having aggressive "fits" if something happened that didn't somehow jive with his internal system of how things should be; obsessively rubbing his hair off/pulling it out; rubbing his ears and sucking his thumb; daytime and bed-wetting; screaming at the odor of smells or switching clothes to a different season (transitioning from wearing shorts to having pants on his legs and vice versa ... ditto to wearing socks vs. sandals); etc., etc.

We easily see the difference that Concerta makes in his life, behavior, school-work, focus, etc. But I'm not so sure whether he has grown out of a lot of the other stuff ... or if it's medication keeping it at bay. The docs and OTs said that his having the experience of tolerating all those things would enable and teach him and his nervous system to manage them ... and that each new age/stage would bring growth (and new challenges).

We originally started the zoloft for anxiety (the bees, spiders, hair-pulling, etc.) And, I think, he is on the abilify as adjunctive therapy to that and for helping him overcome some of his odd ideas/beliefs about things. It has been so long, and he was started on them by a different doc, that I honestly don't remember.

We have been afraid to rock the boat and change anything, since he has been achieving in school; socializing to an extent that he just seems a bit off vs. completely standing out/weird; and because he now way outsizes me (and is stronger than my 6'4" husband), and if he decided to take off or act out irrationally, I wouldn't be able to do anything like I could when he was little.

I worry changing his cocktail could result in some kind of irreversible bad decision-making/behavior borne out of no meds/med withdrawal.

Aside from being able to save his body the pharmaceutical stimulation and save some money, he thinks he wants to enter the Air Force after high school graduation. His cousin, who also took stimulants and SSRIs, told him about having to go off of them in order to be allowed to enter. You can't be on any meds that require a script/regular meds. If that is the case, we would need to test and taper waaaayyy ahead of when he would be looking at going in.

Summer seems an OK time to try, except he works and volunteers ... and we don't want him to flip out, especially since he volunteers with children. We hate to try during school, because we don't want to negatively affect his academic performance or his school behavior. If he screws up in school, then it will affect his college eligibility (he wants to serve in the military to help finance a college education).

I know ... this is really long. Any feedback?




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