Starting the first of January, we were forced to change health insurance providers. We were moved from an open system to a closed network provider. This meant that we had to change doctors. This also meant my son had to change doctors. It took a few weeks to get "plugged in" to the new network so we continued with the Remeron (45mg) and I arbitrarily decided to tail off the Neurotin (as many as 3 x 600mg). Neither drug appeared to to much but make my son sleepy. The Remeron alone accomplished that. So much of the month was spent listening to my son perseverate. Nothing much else happened. He didn't get better and he didn't get worse. When he finally found himself asleep, I felt respite as well as he did (I assume) for he finally stopped repeating the oft-said phrases. Usually, the moment he awoke, it all started again. Sometimes, I overheard him muttering as he drifted off to sleep.
Last week, we met with the new psychiatrist. After hearing our story and even seeing my son in action (he attacked my wife and then me during the appointment), she decided to try Haldol. She too believes in the go low and slow approach. He started at 1mg once a day while keeping the Remeron as is and adding Cogentin because of reaction he had to Abilify.
Haldol, being an old anti-psychotic, fell out of favor because it could compromise liver function. It is still used but usually teamed with occasional blood tests. So it is with us.
After the first day on Haldol, my son came home from school quiet and agitated. He marched into his room and had a tantrum. His babysitter called me in a panic. I told her to lock him in his room and let him work it out. I called the psychiatrist fearful that he was having a reaction to the Haldol similar to what we had seen before with other drugs. The psychiatrist called the babysitter and got more detail and decided it may just been an unrelated mood thing.
So we kept on. We started to see slight differences. He began to speak to us more. He began to ask if he was sick. He started to ask some the same old questions of a few months ago. ("Am I going to die?", "Will I have a heart attack?") and some new ones ("Where has Oprah gone?", "I used to ride my bike a lot, didn't I?").
After about 4 days at 1mg, the doctor got back to us to see how things were going and because there was some change, she suggested going to 2 mg. We have seen my son pick up the phone and talk to people (something he has not done for several months). We have seen him try to color a little. He still perseverates. He is still anxious and depressed. He still has some OCD-like behaviors but he is more communicative.
We'll have to see where this goes...
