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drug worries-which one is best

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  • drug worries-which one is best

    We have just had our Epilepsy and Seizure test at Sick Kids. We were in for 2 days. It is definite that my son does not have Epilepsy or seizures,they agree with the TS and OCD that the Tourettes clinic diagnosed. It is really taking me a long time to accept the medications. I was on the band wagon of never giving my son Risperdal, yet it has worked for him in certain ways. And I am all for increasing the dose from 3 mg a day to 4 mg. Now I am on the Prozac wagon. When this was suggested for his OCD, I think I was in shock. When a drug is suggested, I go on the internet and research it. Then I wish I hadn't, the side effects just worry me more. However I do agree that if the medicine works, then the side effects should come second. But how do you accept this. How do you know what drug is the best? If it wasn't from the Tourettes Clinic that suggested Prozac, I think I would have gone to another dr for a second opinion. Has anyone else felt this way?

  • #2
    drug worries-which one is best

    Rose,

    It's good to hear from you again! You should be commended for your caution in not mindlessly accepting a therapy until you become fully informed. Being a partner in one's health care is prudent and wise.

    Modifying the dose of a medication is a normal method used by physicians to fine tune medication treatment for their patients. Every person's body or brain chemistry responds differently to any given medication, so the skilled clinician makes the necessary changes based on his/her training and clinical experience.

    The internet can be a frightening a nd daunting place to research medications because in addition to legitimate and reputable scientifically based information, there exists a great deal of hyperbole coming from individuals promoting their own agendas.

    A search for any medication name will result in thousands of hits to sites with little more to offer than make claims based on misunderstood facts or anecdotal reports.

    The TSFC Forum does not promote or recommend medications, because this is decision you must make with your physician based on information you gather and your combined assessment of benefits vs risks.

    However, when researching a medication, it is recommended that you search for scientifically based information sites. Each medication has a product monograph which describes the manufacturer's data approved by the regulatory body in the country involved.

    In Canada, the Health Protection Branch approves drug company submissions.

    Monographs have to be read keeping in mind they report every reported adverse effect experienced during trials, plus the incidence of adverse effects has to be taken in the context of the incidence on these same side effects with placebo, and the long term duration of these adverse effects.

    No medication is side effect free, but on the other hand medications do provide therapeutic effects.

    This is where the benefits vs risk assessment is made. If the side effects are worse than the condition being treated, then it may not be worth it.

    OTOH Prozac belongs to the class of medications known as Selective Seretonin Re-uptake Inhibitors (SSRI) which are used extensively to treat depression, anxiety as well as some which are used to treat obsessive compulsive disorder.

    Have you discussed your concerns with your son;s physician and what are your concerns about the medications your son's physician is recommending?
    Steve

    Dum spiro spero....While I breathe, I hope

    Tourette Canada Homepage
    If you enjoy the TC Forum, please consider a Tourette Canada membership
    Please visit our sister Forum: Psychlinks Psychology and Mental Health Support Forum

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    • #3
      side effects

      I haven't talked yet to the dr. We go back in Feb to see them. I am 52 years old. I remember Prozac jokes. Now they think it will help my son with something I never took seriously. I am just aghast as to where to go with this. I remember the saying " what's wrong with you-born in a test tube". Well guess what if it wasn't for that test tube my triplets wouldn't be here today. I was never a hippie, but I think some of my youth is haunting me. I have to talk to the dr about the side effects. My son isn't sexually active now, he is only 16. But will these effects bother him in the future. He has already said that he won't date until he is better. He is already constipated. If I talk to him about other side effects, what if he then gets depressed. He isn't now and seems to be handling things. What is bothering him now is the voices, his tics, his acne has increased, and the constipation. The only thing that he feels so special about is he passed his driving test. (Now I need a med lol) Maybe it is me but I will have to ask dr how to talk to him about this or wait until my son brings it up. If a specialist in TS and OCD recommend a drug, then I should give it an honest try. I have to think of my son. Thanks Steve for letting me sound off with my age.
      Rose

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      • #4
        drug worries-which one is best

        Rose,

        In order to deal with your son;s therapy which might involve the prescription of psychotropic medications, ie medications that affect brain chemistry, it will be necessary to separate yourself from the jokes and derogatory remarks associated with mental illness.

        Not that Tourette is a psychiatric disorder, but some of the pharmacological treatments involve medications used in psychiatry.

        Psychiatric and neurological disorders are illnesses like any physiological illness such as diabetes.

        Risperidone ( Risperdal ) is a medication frequently prescribed in treating TS. Read about the medication by clicking HERE

        The Canadian product monograph is available as a pdf file from Ortho Janssen HERE

        If your physician is considering prescribing Prozac (fluoxetine), have a conversation with the doctor about the potential for drug/drug interaction with these two medications, according to the product monograph for Risperdal Page 54.

        You may also care to read about Prozac (fluoxetine) at Mayo Clinic.com.

        While there, you may wish to read about their description of Risperdal. Take note of the inclusion of Prozac in the drug interaction list.

        In your discussion with the doctor, mention your son is experiencing constipation perhaps caused by the Risperdal, one of the listed side effects.

        Your doctor should be able to control constipation by altering the dose or by altering his diet.

        According to published reports, the incidence of decreased libido caused by Prozac is less than 10%. It should not be a major concern at this time, as the dose to treat OCD would be less than to treat major depressive disorder, lessening the chance for bothersome side effects.
        Steve

        Dum spiro spero....While I breathe, I hope

        Tourette Canada Homepage
        If you enjoy the TC Forum, please consider a Tourette Canada membership
        Please visit our sister Forum: Psychlinks Psychology and Mental Health Support Forum

        Comment


        • #5
          drug worries-which one is best

          Rose:

          It is good that you are past the question stage of the diagnosis and you are now in the next stage that we all share.

          Communicating your concerns with your Doctor about medications. If you have questions and concerns as listed above you can try to call into the Doctor's office to leave a msg for him to call. Granted he may not, but his nurse usually will. Someone will take the time to call you back with the medications your son takes.

          I do this from time to time especially after I have spoken to the pharmacist about my concerns first. They usually provide a pretty solid over view to my questions and advise me how to approach the Doctor and which questions I should be focused on.

          Usually if there are concerns about blending two or more medications your pharmacist will have the answers and call the Doctor for you.

          After doing some surfing with the links provided above, you can print the information that you are questioning for your Doctor visit.

          If I ever find FDA notices or MFG notices about medications my son takes I print them and show my Doctor. He then decides if they are relevant to my son's case and explains his position at that time.

          I did this with one medication my son has been on recently because my son was experiencing some side effects. He appreciated me informing him and responded quickly to my concerns.


          In connection with the constipation, we know this one too.

          After speaking to your Doctor, you will find there are many options to make it better. It is important that you speak to him about this because you do not want to alter the way your son's medications are absorbed by giving him something over the counter without asking first.

          I have increased my son's water intake and that has helped him a lot. He drinks 6 to 8 bottles a day and he likes apple juice.

          I hope you frequently visit the forum and keep us posted on your progress. It is good to see you back.

          Warm regards,
          PJK

          Comment


          • #6
            drug worries-which one is best

            There's no way to tell which is the best med, unfortunately, because each med affects each person differently.

            If you want to wait on the meds and his OC symptoms aren't dire, Cognitive Behavioral Therapy has been determined to have GREAT success in dealing with OCD. Tamar Chansky wrote a great book along these lines: Freeing Your Child from Obsessive-Compulsive Disorder:
            A Powerful Program For Parents Of Children And Adolescents
            . There's a review of it here http://www.ocfoundation.org/ocf1500a.htm, about halfway down the page. I haven't read it, but Imp of the Mind is another book I've heard good things about.. it's reviewed on that page above, too.

            I was on Prozac for a bit over a year. It DID significantly reduce my OC symptoms and helped with my depression (which is what I actually got it for).... but I gained 35 pounds. Blech! ;) Like Steve said, it's a benefit/risk thing. [/u]

            Comment


            • #7
              drug worries-which one is best

              Prozac had NO affect on me. None. It was spooky.

              I have taken about 22 different medications. I've stopped taking 19 of them for various reasons, some better than others. One time I had a fight with a doctor about a med. that she wanted me to stop taking - I loved it. I wanted to keep my brain, damn the side effects.

              I've taken anti-psychotics (no laughing), anti-depressants, blood pressure medication, neuroleptics, ssri's, tri-cyclics, stimulants, and everything in between.

              The one thing I know about TS+ and medication is: no one else can tell you what is a good or a bad medication. Ritalin was awesome, except for the tic problems. Prozac = placebo for me. Wellbutrin was awesome, except for the bathroom trips. Luvox and Effexor were, well, um, they prevented me from, well, you know, uh, I'm not sure how to put it with kids around. Clonadine was pretty good at keeping me focused on... <zzzzzzzz> Oh, sorry, fell asleep there.

              Medication is still an art form. Every person with TS+ reacts differently to every medication. My recommendation is: a competent, kind doctor. And get 2nd opinions, but NOT from the Internet. And don't read the Physician's Desk Reference (PDR) without a chaperone. They are required to put EVERY POSSIBLE side effect in there. Go look up aspirin (acetylsalicylic acid) and you'll see the longest side effect list of all. Go figure.
              Darin M. Bush, The Tourette Tiger, author of "Tiger Trails"
              http://www.facebook.com/tourettetiger

              Comment


              • #8
                drug worries-which one is best

                Thanks for your insight. My point is I am taking these drugs seriously despite what I grew up with. I have heard alot of CBT lately and I am looking into that, but for the time being I will follow my Dr. advice as coming from a Tourettes Clinic and not just a pediatrician, I feel they have more experience. Yes the Prozac is for his OCD. Mainly the voices, if it wasn't for this, he probably wouldn't need meds. My main goal is to keep him as close to his brothers as possible in friends activities, dating, anything to help him not be as different as they are. I just don't want him to become depressed with his condition as he gets older. It hurts to hear him say "who would date me like this". If the drug works, then the side effects come second, but I just can't tell him all of the side effects until I know it is helping him. He is just at that age where he likes girls,going out with his friends (which he only has 3 that put up with his Habits), no one wants to have him as a partner in a class project because "he says they think he acts weird". Are your tears coming yet because mine are. Being a teenager is hard enough, he has to put up with acne, constipation and he is afraid of the weight gain which at the moment is good for him. I know everyone has been through this, so I am sorry about sounding off. But you wouldn't believe the relief of finally knowing what is wrong with your child, well yes you do. Bear with me, I know it gets better. And thank you for your personal comments.
                Rose

                Comment


                • #9
                  drug worries-which one is best

                  Rose:

                  It sounds like you have handling the situation very well and you are doing a great job.

                  I do not tell my son about side effects but I do ask him to let me know if he feels off or does not feel well (ex: chest pains, etc...)

                  My son use to say, Mom just "fix me". With the proper med's and dose this is better now.

                  My son has felt as the odd one out in the past and we are preparing to reintroduce him into a school setting again, holding our breath and hoping that the experience is better then in the past.

                  We have told my son that being different can be good and that he is his own person. He is building interests that make others interested in him and don't make him seem "odd". (Ex: Building a website, forum moderator for a major game played on the net.)

                  I hope that things improve for your son now and he needs to learn how to thicken his skin a bit and keep plowing through life. There will be other teenagers that are just cruel he would have liked to hang around but when they behave this way it shows they have their own insecurities and nothing he says will change that.

                  Has the school considered a in-service worker to come in and speak about TS or other disorders?

                  You know the saying "actions speak louder then words"? This is what we are making an effort to teach our son to help him through the process.

                  The good (open minded) teenagers will be drawn to him in time and the others will continue to snicker behind his back. Give it time and I am sure with all the support you have provided at home it will get better.

                  My son's therapist told him Friday that it is alright if my son can not relate to some of the other students. They can not relate to him since he has gone through so much and runs at a different pace in life, but in time the right ones will come along that he can enjoy hanging around with. Don't get discouraged.

                  I wish you all the best and I hope you realize you are doing a great job with your son. My hat is off to you!
                  PJK

                  Comment


                  • #10
                    drug worries-which one is best

                    Hi Rose:

                    I think you are great to be so open to whatever will improve your son's quality of life. PJK just summed it up with
                    in time the right ones will come along that he can enjoy hanging around with
                    My son is 14 (on Thursday the Th) and he has been going through the increased acne and "teenage" type issues they all face. When my son was diagnosed we had to make a decision with our Dr around what was best for his QOL so we made the choice to introduce meds. I do not advocate for med or no meds... I advocate for what will give your child the best possible chance at having a fun and full life.

                    My son has benefited from meds and Like PJK I did not share the side affects, I too asked him how he felt and encouraged open dialog around how they made him feel. Because we have created this type of openness for him, he was able to come to me about 3 weeks ago and share that he was feeling overdosed ie less like himself once he took his late afternoon dose of Ritalin. I was so impressed that he was able to recognize this and that he suggested reducing his meds for a month to see how he felt. He no longer takes that extra dose (which he has been taking for about two years) anymore because he feels more like himself without it.

                    my point is that you need to trust yourself as a mother... you know him best and then keep the communication open and over time he will get to a point when he can tell you what he needs.

                    I wish you all the best as you work through this stage of managing a child with Tourette. I hope you continue to visit and vent with us. Please don't every feel like you have to apologize for unloading here... that's what this forum is all about. I'd struggle finding a mother who hasn't felt the way you do right now. Support is a wonderful therapy.
                    Janet

                    TSFC Homepage

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