The last several weeks have been rough. A little over a month ago Pajama Monster's blood draw showed that his Depakote levels had suddenly skyrocketed for no apparent reason. He was suddenly well above the therapeutic range. Naturally we reduced the dose and our doctor ordered another blood draw to see if the Depakote levels had dropped and to check on liver function. Two weeks later his Depakote was still high and his liver tests were showing overly high scores too. After more tests and reductions it became apparent that Pajama Monster's liver was just not going to keep playing nicely with the Depakote, so the Depakote had to go.
Our psychiatrist recommended Risperdal again and again we refused. Perhaps it would fix all the behavior problems we're having, but it would also make him feel a little sedated and increase his lifetime risk of tardive dyskinesia and diabetes. He's only six. He can't be sedated through his childhood. How will he learn and grow as he's supposed to? No. Just no.
The next and safest option appears to be Lithium. Now we had to decide when to start it. It took about a week and a half to wean Pajama Monster off the Depakote. We were given the green light to start the Lithium increase while we were doing the Depakote decrease, but I didn't want to do that. Pajama Monster has been medicated for a long time. Deep in my heart I kept hoping "What if he doesn't need the meds as much any more.? What it he's matured and can handle things better?" I wanted so much for that to be true. I felt that I owed it to Pajama Monster to at least see how things are off everything. I notified the school so that Pajama Monster's behavior wouldn't be held against him. As we tapered the Depakote his behavior kept getting worse. I kept hoping that we'd hit rock bottom, but that didn't seem to happen till about 1-2 days after we stopped the Depakote completely. We also stopped the Adderall right after the Depakote stopped so that we could start with a clean slate. Surprisingly, his appetite came back as we stopped the Depakote, not the Adderall. I kept hoping that maybe we just wouldn't start any new medication and he's be ok with just behavioral intervetions. By last Monday, a day before we finished the Depakote, we pulled Pajama Monster out of school. He was becoming increasingly violent, hitting teachers, having screaming meltdowns, and usually had to be removed from the class for the entire day starting at 9:15. School starts at 9:00.
I think we've finally hit rock bottom. We started the Lithium 2 days ago. Pajama Monster has been poking holes in his wall and scratching up his bed. He pooed on the floor and the urinated on his bed to make a "yellow Easter egg" stain while I was on my hands and knees scrubbing up the poo. He's urinated down his heat vent, urinated into various containers, even taken the plastic 3 ring sheet protectors out of his art binder to fill them with urine. He threatens to kill me and hits me. He steals and has started removing the pins from door hinges. He has screaming tantrums and can't calm or listen to reasoning or warnings. Much like before "Pajama Monster, please don't do that. No! Do not do that! You will lose your computer time. *Parent moving to stop him* Stop now!" has no impact whatsoever and he's surprised and furious when, after he does whatever it was we were telling him to stop, completely ignoring all directions, he then loses his computer time, or has whatever consequence he's been warned about. He has all the problems he did when we started the medication last time. I didn't want to medicate, but I don't see how he can have any kind of life like this. He can't go to play dates because of his violence. He can't function at school. I just pray this medication is the right choice. I don't know if anyone is out there reading this, or if it's just a place for me to vent, but if you do happen across this blog, and you're willing, prayers for my litle Pajama Monster would be truly welcome.
