Psycho-Babble Medication Thread 1076238

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Desperate - 9yo anger/aggression/outbursts

Posted by TM2 on February 10, 2015, at 20:42:01

Our 9 yo daughter has recently (over the past 3 months) become extremely argumentative, moody, angry, oppositional, and is having disruptive outbursts both at school and at home. She has been suspended twice this school year and can rarely make it an entire week without having to come home early. She is sometimes fine and then will suddenly change on the drop of a dime and will rage and kick and throw things. It's gotten progressively worse since November. Her teacher is stumped, as are we. She loves her class, she loves her teacher, she loves her school, but she just seems to lose all control and almost becomes irrational over minor things. Once she gets to a certain point, there is no stopping it- she gets into almost a "fight or flight" state and looks like a completely different child even. After the episode subsides, she is remorseful and devastated. She hates that she "gets like this" and begs us to help her know why she "isn't like other kids anymore." It is heartbreaking, and it is wreaking havoc on our lives at home and her life at school.

To give a bit of background: We encountered very similar problems with her 2 years ago after she became ill with a virus and then recovered only to refuse to walk on her left leg/knee for almost a month. It hurt her so badly that we took her to numerous docs and had xray and bloodwork done only to find... nothing. Nothing was wrong with her leg but maybe "growing pains." At that same time, her personality seemed to change completely. While she's always been strong-willed, she suddenly became angry and out of control. She was getting into trouble at school and I was getting calls from her teacher almost daily. She would blow up over little things that never would have bothered her before. She was moody and unpredictable and full of outbursts and rages... just like what we are going through now. We ran an ASO and arthritis panels and tests for Lymes and all kinds of bloodwork. Her only outlying result was an elevated uric acid level which was quickly dismissed by her pediatrician seeing that she "clearly does not have gout." So... basically, after about a month of not using that leg and crying constantly from the pain and acting out at school and home, it gradually just subsided. Her behavior issues lasted longer and we took her to all sorts of specialists who... came up with basically nothing. ADD was the biggest suggestion and we tried Adderall which made it WORST- it seemed to exacerbate all of the awful symptoms we were trying to fix. So we took her off Adderall and fretted and tried to sort it out. And then she pulled out of the behavior issues the same way that she pulled out of the leg/knee pain issues. It bothered me that we never figured it out, but I was just thrilled to have my kiddo back.

Fast forward to now, 2 years later. Same problems also with leg/knee pain (though not as severe this time.) She was great over Christmas break, got sick the first week of January after getting back from break and then started acting out worse than ever. We are completely at a loss.

The psychiatrist says she has DMDD or BP and wants to "try her" on Risperdal. We are SO nervous at the thought of putting our 9 yo on an antipsychotic. Particularly when this seems exactly like what we went through 2 years ago (that magically just seemed to fade away.) I feel like there is something physiological going on given the connection with the leg/knee pain both times now.

We are open to psych meds if there is absolutely no other way to help her be able to live her life again, but I wonder if we are missing something bigger or deeper. (btw, we've done counseling with her both times- moderately helpful, but not much. There are no big stressors or life changes for her- then or now- and there is no history of abuse or trauma.)

I've been looking at homeopathic medicine lately, but have no experience with it. I've considered methylation issues and have put her on methylated B vitamins in case. (I have an MTHFR defect.) I've been looking at pyroluria lately and wonder if it could possibly account for her erratic and frightening behavior.

We are at our wit's end. I spend hours every day researching and trying to find some good solutions, but I just don't know what to do any more. Maybe Risperdal is our best bet or even only hope of approximating a non-stressful life again. BUT if anybody has any thoughts or suggestions, I would totally appreciate it. Thank you in advance!!!

 

Re: Desperate - 9yo anger/aggression/outbursts

Posted by rjlockhart37 on February 10, 2015, at 21:40:06

In reply to Desperate - 9yo anger/aggression/outbursts, posted by TM2 on February 10, 2015, at 20:43:42

it would be a vary good idea to start respierdal because if the outbursts, adderall is amphetamine, it's a stimulant and it can either imrpve cognitive thinking, but it can aggrevate emotional/inner problems, in some cases i've read in articles on google... people have reported that adderall/ritilin calmed their kid down from being disruptive in class, and do the work and think normal and get along.....and others where adderall can cause manic/hyper sesitive to feelings, and that is proably what happened

respirdal, i have never personally taken it, but yea .... i think from what your wrote there's unstable mood episodes/rage that can be taken care of with mood stablizing medication, don't feel bad at all to try it, it will help, just have to work to find the correct medication to stop the mania....but also sitting down and talking things, but not all this is because of a stituation, it's i internal feelings

 

Re: Desperate - 9yo anger/aggression/outbursts

Posted by linkadge on February 11, 2015, at 10:38:22

In reply to Desperate - 9yo anger/aggression/outbursts, posted by TM2 on February 10, 2015, at 20:42:01

I would request some sort of EEC study. I would not recommend stimulants or antipsychotics.

I would inquire about an anticonvulsant or a low dose of lithium. There may be some kind of epileptic like activity, which stimulants or AAPs will not help.

Linkadge

 

Re: Desperate - 9yo anger/aggression/outbursts

Posted by hello123 on February 11, 2015, at 13:29:10

In reply to Desperate - 9yo anger/aggression/outbursts, posted by TM2 on February 10, 2015, at 20:42:01

i saw you had blood tests done, but what about a brain scan?

 

Re: Desperate - 9yo anger/aggression/outbursts

Posted by Hugh on February 11, 2015, at 14:37:13

In reply to Desperate - 9yo anger/aggression/outbursts, posted by TM2 on February 10, 2015, at 20:42:01

I think linkadge meant EEG. I agree. Perhaps a qEEG. Since your daughter is only nine, I'd suggest trying neurofeedback before resorting to Risperdal.

 

Re: Desperate - 9yo anger/aggression/outbursts

Posted by Phillipa on February 11, 2015, at 15:37:55

In reply to Re: Desperate - 9yo anger/aggression/outbursts, posted by Hugh on February 11, 2015, at 14:37:13

I suggest having the lyme's titer rechecked ANA as lots of times people who have or had lymes test negative. The ANA would rule out other autoimmune illnesses. Also agree with the thought of some sort of seizures. So frightening for you and Daughter. My heart goes out to you. Phillipa

 

Re: Desperate - 9yo anger/aggression/outbursts

Posted by Linkadge on February 11, 2015, at 19:04:47

In reply to Re: Desperate - 9yo anger/aggression/outbursts, posted by Hugh on February 11, 2015, at 14:37:13

Yes. Typo. Thanks

Linkadge

 

Re: Desperate - 9yo anger/aggression/outbursts

Posted by ed_uk2010 on February 11, 2015, at 20:11:32

In reply to Desperate - 9yo anger/aggression/outbursts, posted by TM2 on February 10, 2015, at 20:42:01

Hi there,

Sorry to hear you're going through such a rough time. May I ask, is there any family history of mental health problems such as severe depression, bipolar disorder, schizophrenia or suicide? Also, was your daughters health and development normal up until the recent episodes of illness? Any problems at her birth or during the pregnancy?

>Our 9 yo daughter has recently (over the past 3 months) become extremely argumentative, moody, angry, oppositional, and is having disruptive outbursts both at school and at home.

What is her behavior like between the episodes? I understand she feels remorseful, but is her mood otherwise normal?

>will rage and kick and throw things.

What type of issue initiates a temper tantrum?

>elevated uric acid level which was quickly dismissed by her pediatrician seeing that she "clearly does not have gout."

So, what explanation was given for the elevated uric acid level? Do you know whether it was only marginally elevated or substantially so? It does seem plausible that this finding was related to her joint pain, although it might not have been. I think it would be worth having this simple test repeated and examined further if it is still abnormal.

Does your daughter have any diagnosed medical problems and does she take any medication? Some medications can cause behavioral disturbances. Also, is she overweight? - I only ask because elevated uric acid is much more common in children who are overweight. Otherwise, there are a variety of causes of high uric acid in children. It often increases during acute infections, for example.

>ADD was the biggest suggestion

It doesn't sound typical of ADD. Temper outbursts are common in ADD but the problems with attention and hyperactivity are ongoing. Her problems appear episodic and the pattern of becoming mental unwell, getting better, and then getting worse again is not usual in ADD.

>The psychiatrist says she has DMDD or BP and wants to "try her" on Risperdal.

The diagnosis of bipolar disorder is very difficult to establish in childhood. As for DMDD, she is clearly having episodes of disruptive behavior but the diagnosis of DMDD doesn't explain why the symptoms appeared, disappeared and appeared again.

>We are SO nervous at the thought of putting our 9 yo on an antipsychotic.

I can understand that for sure. Of course, it wouldn't necessarily be long-term. It could be a very low dose used on a temporary basis. Hopefully, things would improve as they did before and the medication could be stopped.

Risperdal is known to decrease aggressive behavior in children with a variety of conditions.

The others mentioned an EEG study. Have you had this done? Does your daughter appear confused during the episodes and does she remember the events afterwards? A characteristic of certain types of partial seizure is severe episodes of abnormal confused behavior which are not remembered properly afterwards. This does not sound quite like what's happening, however. It is true that some forms of episodic aggressive outbursts respond to specific anti-epileptics though, even when they are not epilepsy. Meds used in children for this purpose include valproate and Tegretol.


>I've been looking at homeopathic medicine lately, but have no experience with it.

I wouldn't, to be honest. By their very nature, homeopathic medicines are so diluted that they don't contain anything. They are placebos. Safe, but ineffective.

>I've been looking at pyroluria lately and wonder if it could possibly account for her erratic and frightening behavior.

Well, pyroluria is not a recognised medical condition. I don't think it's the answer.

Anyway, the vitamins you're giving sound like a good idea. Omega-3 fish oil supplements may potentially improve behavior and development in children. So that could be something to consider.

 

Re: Desperate - 9yo anger/aggression/outbursts

Posted by Bill82 on February 11, 2015, at 21:45:09

In reply to Re: Desperate - 9yo anger/aggression/outbursts, posted by ed_uk2010 on February 11, 2015, at 20:11:32

Rage and aggression in a waxing and waning manner has been known to be caused by certain bacterial infections. Problem is they are very hard to test for as the tests are inaccurate, and the medical field is split upon wether or not they are the cause, one side being trigger happy in prescribing antibiotics the others saying it's bad medicine. Bartonella hensalae has been said to possibly cause what it called bartonella rage, that comes and goes. It can often be co infected with other things, such as lyme(borellia) babesiosis( a protozoan) and mycoplasma strains. I am in the middle on this issue as I think the "lyme literate" doctors are too biased that these things cause everything, but at the same time it is usually an environmental cause if people suddenly chane and do not gradually develop symptoms. Did she get sick at all before all this began? Other types of pediatric psych symptoms can prevent overnight from certain infections, look up PANDAS for more info. It commonly is onset after an infection and waxes and wanes with the course of being exposed to the virus(common one is strep) symptoms include ocd, Tourette's like symptoms, food obsessions, declines in handwriting ability drawing etc, rages. Course of treatment is to try a course of antibiotics for a month or so, can often cause dramtic results. Blood titters for common infections can also be drawn in terms of igg levels present, however these can at times be inaccurate. Was the walking on leg possibly an anxiety based fear of some consequence? Or was it because it hurt. Anyways just some thoughts

 

Re: Desperate - 9yo anger/aggression/outbursts

Posted by elbee on February 12, 2015, at 0:18:34

In reply to Desperate - 9yo anger/aggression/outbursts, posted by TM2 on February 10, 2015, at 20:42:01

Hi,

I'm so sorry you're going through this. It sounds like such a difficult struggle and I'm glad your daughter has you as an advocate!

I can't say that I have anything to add that will help. As an adult taking antipsychotics it has taken some trial and error to get the right one and they each have different side effects. If the antipsychotic route seems best (and I have no idea if it is), give it some time to see if the given medication works but if there are side effects that make it intolerable, go to the next one--until you find one that she tolerates. Risperadal made me drool and people who interacted with me easily got the impression that I was medicated in some way. Zyprexa worked for me and Seroquel worked OK too but is a little sedating. I will be thinking of you and hoping that they solve this distressing challenge you and your family are faced with.

-L

 

Re: Does she have strep? elbee

Posted by linkadge on February 14, 2015, at 9:25:12

In reply to Re: Desperate - 9yo anger/aggression/outbursts, posted by elbee on February 12, 2015, at 0:18:34

Saw an article today on children exhibiting sudden changes in mood / aggression as well as certain tics. It appears (anecdotally) to be associated with an infection with strep.

Linkadge

 

Re: Does she have strep? linkadge

Posted by ed_uk2010 on February 14, 2015, at 11:05:39

In reply to Re: Does she have strep? elbee, posted by linkadge on February 14, 2015, at 9:25:12

> Saw an article today on children exhibiting sudden changes in mood / aggression as well as certain tics. It appears (anecdotally) to be associated with an infection with strep.

It doesn't look like it. She had the ASO blood test.

 

Re: Does she have strep?

Posted by linkadge on February 14, 2015, at 18:21:23

In reply to Re: Does she have strep? linkadge, posted by ed_uk2010 on February 14, 2015, at 11:05:39

Sorry. I skimmed.

 

Re: Desperate - 9yo anger/aggression/outbursts

Posted by linkadge on February 14, 2015, at 18:24:19

In reply to Desperate - 9yo anger/aggression/outbursts, posted by TM2 on February 10, 2015, at 20:42:01

Could the leg pain be associated with some sort of hormonal surge? Growing pains might be associated with changes in hormone levels.

(sorry...a long shot).

Linkadge

 

Re: Desperate - 9yo anger/aggression/outbursts TM2

Posted by phidippus on March 2, 2015, at 13:16:06

In reply to Desperate - 9yo anger/aggression/outbursts, posted by TM2 on February 10, 2015, at 20:42:01

What is medically wrong with her knee?

Before putting her on Risperdal I would seriously consider putting her on Lithium before anything else.

Lithium has been used as a mood stabilizer and has been used to treat bipolar disorder and augment antidepressants in the treatment of depression. Lithium has also been used to control the violent outbursts of IED-intermittent explosive disoder-and TBI-traumatic brain injury.

Lithium works best in a range, which means blood testing is necessary (.6 to 1.2 is the blood level lithium is most effective at). If you have too much lithium in your blood, you can become toxic, however it is difficult to become toxic enough that you experience damaging effects. I have had a level of 4.8 and was very sick but no permanent damage was done.

If your daughter experienced brain damage because of the virus she was infected with, it may have affect her pre-frontal cortex which controls things like anger outburts. If your daughter is bipolar, she will have deficits in her PFC, which result in the same kind of behavior. I am bipolar and as a child had many angry outbursts as a child.

Lithium, I think, is the most logical choice for you.

Have you seen a neurologist?

Eric


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