Posted by AOB on June 25, 2003, at 8:57:08
In reply to Re: Zero Motivation, posted by BrittPark on June 24, 2003, at 17:14:55
> Your son seems to have a very complex mixture of disorders. It also sounds like he has problems with treatment compliance.
Yes, currently he is noncomplant. Usually he begrudgingly takes his meds. When he was younger he would have spurts of not taking meds.
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> Here's what I'd suggest. First get him seeing a psychiatrist. Psychologists can be helpful but more often than not for the seriously mentally ill they are counterproductive. By law forbidden to prescribe appropriate medications they often make a virtue of what is in fact a disadvantage.
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He is seeing a psychiatrist - # 8!. Some of those were for assessment only, some assigned during hospitalization, insurance problems led to some changes, total incompetence led to some changes. Now he is seeing a pretty competent one, in a small town so there is not a lot of choice. They BELIEVED him when he says he is OK, they BELIEVED him when he puts on a defiant, tough guy front,angry at everyone. Sure he is angry but he is also afraid and wants to have friends, fit in somewhere in this world more than anything. The current Dr. at least sees through some of that. There is availability of a psychopharmacologist in our area but not where he is living now.> In principle I agree with Linkadge's advice that simplicity in the mix of drugs that can be found that are effective is a goal. However, I think it's a subsidiary goal. The primary concern is to get your son happy and able to move on with his life. Given the broad complex of problems your son has I think it very likely that polypharmacy is going to be necessary to help him significantly.
I read somewhere that it takes an average of 7 years to get meds right. He's been on meds for over 10 years.
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> It seems as if your son needs minimally an activating AD, a psychostimulant, amphetamines, methylphenidate, or provigil, perhaps an antipsychotic and perhaps other drugs to potentiate the main drugs. I'm not a psychiatrist, obviously, so take my advice with a hefty grain of salt. I do very much think that it is important that you find an aggressive psychopharmacologist to start the search for the right combinations of medications sooner rather than later. It's also important to find a way to ensure compliance with his medications.
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> Best of Luck,
>
> BrittThanks Britt,
AOB
poster:AOB
thread:236674
URL: http://www.dr-bob.org/babble/20030624/msgs/236913.html