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a question on medicine

Submitted by an LD OnLine user on

My daughter had an appointment with a phiscologist yesterday her first one. He told me not to correct her while we talked he wanted to watch how she behaved. While there she played in ways she normally wouldn’t but I did as he asked she was told no only once when she did something that was dangerous. By the end of the half hour he suggested putting her on Imipram to stabilize her moods and help her focus. He did read reports from the school she is currently attending and the school she attended last year. My question is can anyone tell me around how long it will take to notice a change in her on this medicine and what if any changes I should expect other than the Dr. saying I should notice that she will be more focused. I am really worried about putting her on medicine at all especially one with so many known side affects and when I heard that long term use could cause heart problems.

Submitted by Anonymous on Thu, 05/08/2003 - 6:09 AM

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Hi Maxine!
Be very careful about putting your daughter on meds. Research it very, very thoroughly. Our dr. put our son on Ritalin and at school he did much better but at home his mood swings became a nightmare. And that was on the lowest dose. We took him off. Several years later I considered placing him on meds again and discussed it with a psychiatrist, since our dr. only prescribed Ritalin for ADD/ADHD. During our discussion he stated that research is now indicating that many of the meds act as catalysts for diseases to bring them to the surface much faster than they would usually cause concern, some of those being Tourettes Syndrom, mental disorders, and organ failures…which includes Heart Disease. Yes, young teenagers who have been placed on meds (usually started at 6yrs. old) have died from heart attacks and their death certificates list prolonged use of Ritalin as their cause of death. I know you stated that your dr. prescribed Imipram, but you should look into it better. We have our son on a cup of coffee a day.
Another thing they don’t tell you is that even with meds., the child still must learn to control themselves. Also, there’s a ton of learning issues and behavior issues that the meds don’t address. Behavior modification and the right teacher can make all the difference in the world.
Can you put her in ice skating or soccor, or something equally physical to help channel some of her energy? My very hyper, clumsey, argumentative gd is in ice skating and the change has been profound. It’s really helped her. My son is in baseball, football, hockey, and track….and anything else that’s active. It really helps. Good Luck!
Courtney

Submitted by Anonymous on Thu, 05/08/2003 - 10:03 AM

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Maxine,

You do NOT have to put your child on medication! Furthermore, you know your child better than a teacher or doctor who observed her once. You simply throw the prescription in the garbage. I read Courtney’s post, so I will not repeat what she said about the dangers of these drugs. Your daughter sounds young.

I don’t know what the problems are at school, but you need to find a better way to work it out. How old is she?

Submitted by Anonymous on Thu, 05/08/2003 - 10:05 AM

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Hi Maxine

I agree with the others. It sounds like you really don’t agree or want to medicate your girl. Why do you feel like you “have to” (that’s the impressions I got.) Are you intimidated by the authoriative position of the doctor and the school?

Submitted by Anonymous on Thu, 05/08/2003 - 11:24 AM

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I don’t know about the med you just described. I do know of adults who are still “kickin” who have been on ADD meds all their lives.

Medication is a personal choice. I would be concerned with a 30 min “observation” and then a decision.

My daughter struggled with global LD’s and ADD from K-2. She did much OT and tutoring (about 15,000 part time tutoring in this time period). After much frustration, observation, etc., we tried Concerta. She is a different child and we have had no adverse side effects.

She is happy, excelling in school, playing soccer, and doing all the typical things kids do. She is gaining weight, growing like a bad weed, etc.

Again, I’m NOT pro-meds always. But do believe there is a time when it has to be looked into.

Only parents can make that AGONIZING, personal choice. Only the parent has the child’s absolute best interests in mind.

Research, talk to others, be open minded and then make the decision based on your child, your knowledge and your instinct ALONE.

Submitted by Anonymous on Thu, 05/08/2003 - 1:02 PM

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Hi Maxine,

Most parents hesitate to use medication because they worry about side-effects, and often because they feel like using meds means they have failed their child in some way. Well meaning friends and family can make you doubt yourself. The fact that you want to think it over and learn more tells me that you are a cautious parent and want to protect your daughter. Good for you!

Keep in mind that whatever decision you make is not set in stone. If you aren’t ready to try medication, no one can force it on your child. On the other hand, if her school performance is suffering and she is not fitting in socially, medication might be an important part of helping her do better. It can help stop a downward slide. For a child who cannot focus, medication can make the difference between the child being “available” to learn…or not. Also, the child who gets a reputation for being difficult with teachers and peers can suffer terribly, and often doesn’t have the slightest clue as to what he or she is doing wrong or how to behave. Medication and counseling can work together to help the child find acceptance that otherwise might not come.

Depending on what brought you and your daughter to the psychologist in the first place, you might want to consider a medication trial. If the results are not satisfactory, and adjustments of meds don’t help, you can always put a stop to it. Working with a professional you trust is the most important thing you can do for your child. Best wishes JJ

Submitted by Anonymous on Thu, 05/08/2003 - 1:50 PM

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Hey JJ,

Meds seem to always spark debate! Everyone has given great advice. I struggled with med decisions for years. We have had posiive results.

Listen closely to everything! No med need be permanant. Get a second opinion.

This is a tough time for any MOM.

Hang in there!

LIZ

Submitted by Anonymous on Thu, 05/08/2003 - 2:34 PM

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Liz,

That was really nice to read. Not judgemental, just supportive.

You are right. This is your decision Maxine. Read all you can. Try to stick to the facts as much as possible. Read the bad and the good and then go with your gut. I have read alot of emotional stuff on both sides of this debate.

It is your decision either way.

Hang in there.

Linda

Submitted by Anonymous on Thu, 05/08/2003 - 4:49 PM

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Hi Maxine,

Of course, it is your decision either way. But if you go in the direction of meds, you might want to ask the psychologist why he is recommending iniprimine and not a stimulant, which is usually the 1st choice of medication for ADHD.

If he feels an antidepressant is additionally warranted, you might want to ask him about welbutrin, which is used for both adhd and depression or a combination of a stimulant and antidepressant such as one of the SSRIs. Usually, tricyclics, such as iniprimine are not the 1st choice in prescribing meds.

But the psychologist may be have a perfectly good reason for recommending it. However, I would want to know what it was in light of what I just mentioned.

Just so you know, I am not a medical professional but an adult with LD/ADHD who has been there and done that. So keep that in mind as you read my post.

PT

Submitted by Anonymous on Thu, 05/08/2003 - 6:07 PM

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Very well said, Leah — I’m an extremely ‘meds conservative’ type, but I agree with you wholeheartedly…consider my neck to be right out with yours!

Maxine, you need to do some research — there are no easy answers, but you will find the best path if you ‘do your homework, then use your gut’ as someone said in an earlier thread.

If you can, post some facts about your child’s age, difficulties, etc. at home, school, and play — you will get replies from others that may help you in your search.
Best wishes to you and your daughter!

Submitted by Anonymous on Thu, 05/08/2003 - 11:46 PM

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Courtney wrote: “During our discussion he stated that research is now indicating that many of the meds act as catalysts for diseases to bring them to the surface much faster than they would usually cause concern, some of those being Tourettes Syndrom, mental disorders, and organ failures…which includes Heart Disease. Yes, young teenagers who have been placed on meds (usually started at 6yrs. old) have died from heart attacks and their death certificates list prolonged use of Ritalin as their cause of death.”

I certainly agree that it is improper for schools to manhandle parents into medicating their children, and I also agree that the long-term benefits and risks of stimulant medications need further study. Whether to medicate is a difficult question on which reasonable minds can differ and parents need to make the choices they are most comfortable with. To do this though, they need good information. Toward that end, I wanted to further develop the information Courtney posted. Courtney is correct that stimulants may unmask Tourette’s Syndrome. Stimulants do not cause the disorder but merely uncover what already exists in the child. Many children with Tourette’s do take stimulants and control their tics with other medications. Transient tic disorder of childhood is relatively common and is also not necessarily an indicator that a child should not take stimulants. It depends on the child. Some children with tics will actually improve on stimulants, as did my son, for example.

Second, I think the “mental disorder” Courtney may be referring to is bipolar disorder. Again, stimulants do not cause a child to develop bipolar disorder. Instead, they may unmask a disorder the child already has by inducing manic behavior. Bipolar children may exhibit symptoms that look like ADHD, rather than the classic manic and depressive stages that we see in adults. Bipolar children should not take stimulants. They probably should not take antidepressants like imipramine either, unless they are also taking mood stabilizers.

Third, the only “organ failure” associated with stimulants that I am aware of is a few rare cases in which children who were taking ritalin and clonidine developed heart symptoms. It has not been conclusively shown that these medications, separately or in combination actually caused the symptoms. It is hard to say for sure because the occurence is so extremely rare.

Finally, stimulants are not the only choice for a parent to consider. Strattera is a new, non-stimulant (it is actually an antidepressant) that has proved effective for some people. Few doctors would start a child on imipramine over Strattera.

Andrea

Submitted by Anonymous on Fri, 05/09/2003 - 1:47 AM

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My daughter will be eight in two weeks. She is rated by the school as mr the Dr.after reading the reports from the schools she has attended and the therapist she saw where we use to live said he would like to try her on this before he does other testing. I went to him because I am trying to find a way to help my child and am open minded to all sugestions. I have also checked into theraputic horseback riding and am waiting to see if she will be accepted into the program. The problems we discussed at the appointment were: bedwetting-social issues-behavior-problems sleeping through the night-accedemic issues-hurting herself when upset or bored-comprehension-activity level-ectra.. The Dr. stated that Imipram would help her with the bedwetting and with focusing. I guess I have always felt that whats the use of going to the Dr. if you aren’t going to do as he says. I felt like we were rushed in our appointment and was disappointed. Also adding to my frustration was the fact that her advocate was suspose to attend the meeting and failed to show up. I have yet to hear from him as to why.

Submitted by Anonymous on Fri, 05/09/2003 - 11:55 AM

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I have heard of imipramine being used to treat bed-wetting. There is another thread, perhaps on this board, that discusses bed-wetting. You might take a look at the conversations there to get some ideas. FYI, therapeutic riding is wonderful! My son started a therapeutic riding program three years ago after I heard from a parent on this board about their good experiences with it. My son loves it and it has really helped him.

Andrea

Submitted by Anonymous on Fri, 05/09/2003 - 1:17 PM

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What is therapeutic horse back riding and what has it done for your son?

Beth

Submitted by Anonymous on Fri, 05/09/2003 - 3:37 PM

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As a person with some serious medical conditions, I am unfortunately a connoisseur of doctors and certain kinds of medications.

Doctors are human too, despite what many of us and them have been taught. They have normal human limitations — they can’t know everything, any more than the rest of us can know everything.

Doctors have pet theories and pet medications, just as many of the resto of us have favourite ways of doing things. This is not necessarily bad; better for a doctor to prescribe a medication he knows well than to try random experiments with something whose side effects he’s unsure of.

There are good doctors and bad doctors, wonderful doctors and flaming incompetents. There are doctors with a lot of knowledge and weak people skills, and there are doctors (like a lot of really damaging teachers I’ve met) with wonderful bedside manners — people that everybody loves — who make dreadful mistakes that ruin other people’s lives.

Medications are not magic bullets. At best you’ll always get some side effects. It is *always* a question of weighing the benefits against the problems.

Considering all this, I usually go for the doctor with the lousy bedside manner but the deep knowledge of the disease and medicine. And I always try to talk for at least a little time about the details of the drug — what it is supposed to do, what are the potential side effects, how common and how bad they are. Also be *super* careful about interactions with any other medications and health conditions — this is a life-or-death question.
I also because of my problems have to read the Physician’s Desk Reference (PDR) and get the straight dope about the medication, all the details. This thing is something else to read but it is the horse’s mouth. All doctors and pharmacists have a copy. Also, the same info is on a long, long sheet of paper inside the pharmacist’s big bottle of the medication — he can let you read it. Don’t let it scare you — when side effects are mentioned, as they will be, look at both danger (should be low) and frequency (should be very very low).

You have to become an informed and responsible patient. Read up *reputable* reports on a medication — be careful not to get into scare sites on the internet. Read up about your child’s problems and the various treatments used. Talk to the doctor a bit more — try going in when his office is less busy if possible. It is sometimes a good idea to get a second opinion from another doctor if that is possible.

If you think your doctor is belittling your concerns or treating you as if you’re too stupid to understand, time to get another doctor.

Once you are really informed and know what the goals are, and what the other options are, then you can make the best decision possible.

Submitted by Anonymous on Fri, 05/09/2003 - 5:50 PM

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There are different types of therapeutic riding. One type is essentially OT on a horse and focuses on exercises that help with motor issues but does not actually teach riding. The kind of therapeutic riding my son does actually teaches riding skills in an OT-focused way. If you’ve ever ridden a horse, you know that they bounce and sway. This gives lots of feedback to kids with motor issues and helps with balance and trunk strength. If you want to make the horse start, stop or go in a particular direction, it takes more than just tugging on the reins. You’ve got to use your whole body, sometimes in very subtle ways. A therapeutic riding instructor helps the child to use his body to control the horse and in the process helps the child to better control his own body. Riding exercises also require following directions, sometimes in a pretty long sequence. This can help children who have difficulty in this area.

My son has shown tremendous improvement in his balance and trunk strength since beginning his lessons a few years ago. He is also developing into a fine rider. You can’t imagine what a boost it is for a kid who has trouble controlling his own body to suddenly be in charge of a gigantic animal. My son is a true nature-lover and a gentle, intuitive kid. All kinds of horses love him and respond to him. It is a gigantic self-confidence booster.

The biggest problem with therapeutic riding is the waiting lists. My son’s instructor has something like 80 kids on her list. We were very lucky to find an open spot.

Andrea

Submitted by Anonymous on Fri, 05/09/2003 - 6:42 PM

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Thanks for the information. It sounds like a win-win situation to me. I had heard of it but didn’t understand what it was. I will ask around here.

Beth

Submitted by Anonymous on Fri, 05/09/2003 - 10:43 PM

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Thank you all for your comments I will do some research and mabe get a second oppion before starting her on the medicine. I do agree with you Victoria Drs. are very human, and there are good and bad in the mix. I don’t dislike the Dr. I find him to be very informative. And found out today that he has already contacted the school and made arrangment for an observer from his office to go to the school a couple times next week, plus has set up appointments with the speech, ocupational therapist. I guess he want more information before he sees her again. The school wasn’t very happy that I didn’t call them and warn them that he would be contacting them.

Submitted by Anonymous on Sat, 05/10/2003 - 7:22 AM

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It sounds like your doctor is *exceptionally* involved! Most of mine can’t remember your name without the file to remind them. In general this is very good. However, you still have a right to disagree with him if your gut tells you so.

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