Anonymous wrote:OP here--I am exceedingly grateful for all of this. I'm tracking even if I'm not responding. The discussion of antipsychotics is really intriguing. We had tried seroquel, but it left him unable to function during the day. Maybe it's worth trying another.
One additional question--has anyone tried the NoVa CR2 (crisis response) program? We're thinking of giving it a go before the next step.

We tried NoVa CR2 after an incident that required calling the cops to our home. CR2 came to the home every day and like everything else, it helped for a little while. Definitely try it. You may want to call first and see if you can pre-register---- so that they have your family history when crisis arrives. Ultimately, DS was sent to Barry Robinson in Hampton Roads for 5 months. He had previously been inpatient at Dominion, PIW and Children's- all crisis response with little long-term gain. The other disadvantage of crisis response/inpatient vice residential is every inpatient stay changed the meds based on a short amount of time with DS. Felt like we kep starting over. Then when he would come home and meet with his psychiatrist and go back to school, we would find that he couldn't function on the high level of meds that were prescribed at inpatient.

Recommend starting with your insurance company. Finding out what they will cover and if those facilities are suitable and have space is important. Finding space is hard and every insurance plan is different.

OP - I just want to strongly recommend the Genomind genetic test so you can see your kid's potential reaction to different meds. It was really helpful to mine and found a med for him after he had a horrible reaction to an SSRI. It is an easy swab and really was informative. Results came quickly.

Just writing to say you are not alone. We may be in the shadows but we are here. I hear the suffering and understand the agony of this. I have 2 children with significant anxiety and depression. They are both on Abilify and have been since very young. It is not a "big gun", just because it isn't as 'socially acceptable" as lexapro. What is important is that you find something that works. I am with you, in spirit, though I dont know you, to keep up the effort. I am sorry I dont know about the programs individually.

On meds: Abilify is available in generic form (aripriprazole, or something like that) now. My DD takes a low dose daily, in addition to an SSRI. The combo has been helpful in smoothing out mood swings and volatility. No side effects at all.

On treatment options: your insurance company may well have a database of in-network providers for residential treatment. Ours (United) does, and while the pickings are pretty damn slim, it's a place to start. And your DC's psychiatrist should be able to provide you with some leads as well. Push for that!

Hugs to you, OP. Sending you kind thoughts and good wishes.

I'm thinking of you too, OP. Hugs.

How are you, OP? I'm thinking of you and your family.

No advice on meds or facilities but I wish you the best OP on your quest to get help.

Ability is really expensive but there is usually a coupon just fyi

Seroquel is more of a downer than
Abilify. Also, seroquel should be taken more than 12 hours before getting up. It has that prolonged sedative effect on some people. On the other hand maybe it will be good for your son to sleep things off. His brain is on fire and he desperately needs some down time.

Best wishes OP.

OP here--I am exceedingly grateful for all of this. I'm tracking even if I'm not responding. The discussion of antipsychotics is really intriguing. We had tried seroquel, but it left him unable to function during the day. Maybe it's worth trying another.
One additional question--has anyone tried the NoVa CR2 (crisis response) program? We're thinking of giving it a go before the next step.

Anonymous wrote:

Anonymous wrote:To begin this process there are two possibilities - either your insurance or the school district, through an IEP. Start both processes and see which goes faster! Different states do this different ways, also. I know Pennsylvania is much different than either MD or VA, for instance.

Are you saying you can use an IEP to get long term inpatient hospitalization or residential treatment? If so, can you explai more how that works?

I always thought just that the IEP could be changed to support continued education during treatment.

For info related to the above, read #5 at this link:

http://www.williamdikel.com/mental-health-related-services-on-ieps.html

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. The psychiatrist has a long term plan (a 2-3 year plan), but nothing seems to be getting better, and these rages are destroying our other kids (and us, but whatever). They pop up at random times and there is no stopping them until they run their course. And in the meantime, he's not going to school and is not functioning in society. And we have less than a year until he's 18 and we lose some levers to get him care. I'm just at a loss.

I am concerned that the doctor cannot control the outbursts with meds. This alone is a good reason to hospitalize and tweek meds under 24 hour supervision. Have you seeked a second opinion?

OP here. This is his fourth psychiatrist, although the first since he had a real breakdown in his ability to deal with anxiety at all. The biggest problem is his lack of sleep. The doc keeps tinkering with his meds, but nothing seems to enable him to sleep at night and function during the day (the meds that make him sleep render him totally nonfunctional).

I am not sure what kind of anxiety is happening here, but my daughter has a significant Generalize Anxiety Disorder and Social Anxiety Disorder. It was severe enough that she didn't go to school for months. A daily dose of Inderal (only 10 mg) was a huge game changer.

We had really good luck with abilify plus Prozac for my very aggressive OCD/ASD child.

thinking about you, Op

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. The psychiatrist has a long term plan (a 2-3 year plan), but nothing seems to be getting better, and these rages are destroying our other kids (and us, but whatever). They pop up at random times and there is no stopping them until they run their course. And in the meantime, he's not going to school and is not functioning in society. And we have less than a year until he's 18 and we lose some levers to get him care. I'm just at a loss.

I am concerned that the doctor cannot control the outbursts with meds. This alone is a good reason to hospitalize and tweek meds under 24 hour supervision. Have you seeked a second opinion?

OP here. This is his fourth psychiatrist, although the first since he had a real breakdown in his ability to deal with anxiety at all. The biggest problem is his lack of sleep. The doc keeps tinkering with his meds, but nothing seems to enable him to sleep at night and function during the day (the meds that make him sleep render him totally nonfunctional).

Have you talked to the doc about the big guns, like Abilify? Have you done a genetic test for med absorbtion (genesight)?

Was going to suggest something similar. My DD had SSRI-resistant anxiety and was put on Zyprexa, an anti-psychotic. While I am not a fan of this class of drugs (and have written here before about that, extreme caution is required), Zyprexa has helped a lot and she is now on a quite low dose doing fine. Her anxiety attacks were terrible and very destructive. Not rage exactly but she would scream hateful things and would systematically and almost robotically trash everything around her as though she were in a trance.

Hmm...this is really interesting and helpful.

I was just going to recommend the same thing. We recently discovered that my daughter has a double mutation related to the methylation cycle and has started taking Deplin. It seems to be helping. She also was found to be an ultra-rapid metabolizer of 2/3 of all medications and all psychiatric ones, so she needs higher than expected doses for a therapeutic response. Best to you and your family.