My husband and I didn't want to try medication for Pajama Monster. We were worried about the impact on his developing brain. What if things don't develop as they otherwise would because of the meds? What if he grows to be dependant on them? We stuck it out for a year of therapy before we finally broke down and agreed to see a pediatric psychiatrist. I should note at this point how lucky I feel that there was a pediatric psychiatrist available to us. They're not nearly as common as regular psychiatrists and there are a lot of nuances that they need to know in order to effectively deal with little ones.
What changed our minds? We finally decided to try medication when we felt we'd tried everything else available to us, and when we were certain that we were trying it for Pajama Monster and not to make our own lives easier. It's one thing to use medication to help a child and quite another to use it to avoid having to work hard at consistency, praise, setting limits, rewards, etc. We finally realized that Pajama Monster was starting to be the "bad kid" in different settings, and we began to look at what this would mean for his developing sense of self. What does it do to a person to try their hardest and still always fail, and fail so spectacularly that people don't even want to be around them? How does it feel to constantly elicit negative responses from those around you for something you can't control? I can't force him to live through that, and to begin to see himself as "bad" if there is something, anything I can try to help him.
It has been quite a roller coaster so far, and the ride just goes on and on. I can't tell you how much I want off this ride. The worst part is knowing that there may not be any "off" to the ride. It may be that no med or combination will work. Each time we try a new one we not only have to wait for it to build up to level in Pajama Monster's system, but also for Pajama Monster to be at level long enough for us to see if it's the med or just another mood swing that is creating the change. Our strategy has been to always choose the med with the least side effects that looks like it might work, even if another med might be more likely to work. It makes for slow going, but reduces the risk that we'll end up with a med that is stronger than we need. We've also drawn the line at anything that seems sedating. If Pajama Monster doesn't seem like Pajama Monster anymore, we're just not going to use that med, even if it does settle the fits and mood swings. We meet with the psychiatrist every 4-6 weeks with several e-mail updates in between. It's been a long and heartbreaking ride so far.
Here's our wild medication ride to date:
Prozac: Takes weeks to get up to level in his system. High hopes, but no results. It just didn't seem to make any difference at all, so we discontinued.
Adderall: This helped. It took some tweaking to get the dose right, but at least he seems able to process instructions and consequences. He's still moody, defiant, has fits, etc, but he's a little less wild about the defiance.
Zoloft: Never showed much of a result, but broke out in a splotchy, itchy rash, so discontinued.
Celexa: This seemed like it might help for a little while, then he went absolutely bonkers. we took him off it after a 4 hour stretch in which he destroyed several toys, ripped the ivory off the piano, smeared diaper cream and saline all over the house and his sister, ransacked the diapers, removed and emptied all his dresser drawers, took and hid his sister's food, scratched up the paint on the walls, and was sitting in his room excitedly and very rapidly talking to himself about all of this. I think that's when he used his heat vent to smash holes in the drywall too. not a good fit for him.
Lamictal: This one started out OK, but rapidly seemed to push him manic as well. We stopped this one after he stabbed his sister in the back of the throat with a fork.
Depakote: This one is sitting on my counter now. We're supposed to begin it Monday and increase in about 5-7 days. It does require a blood draw, which isn't going to please the Pajama Monster, but it seems like the safest med in line that we could try next.
Wish us the best with this one. I really hope, each time that we'll have found the answer. Prayers are always welcome.
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