OCD Medication Question

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There are definitely dangers in stepping down by yourself, without a doctor's supervision. But so too are there dangers in staying on a med that isn't working. Are these pills extended-release?

That is a quite significant dose. I haven't heard of anyone taking more than 50mg. That is the recommended dose for OCD and Depression. Stepping down is going to be quite difficult and take a long time. I also think you need to find a doctor to supervise this-I don't think a pharmacist is going to help.

Only reason I asked for the medicine for him was because I felt like he was exhausting himself everyday. He was so bad at one point that he wasn't able to touch his own food. He did work himself out of that with therapy even before the medicine. There were other things like waking up 2 hours before he had to leavel for school to do his hair, washing every dish and utensil before he uses them. It was sad to watch but he never cared about it, it didn't bother him. It did make life difficult for him though and as I said, exhausting.

The behaviors now have been extreme. He tried to run away several times during his crazed episodes. He's been extremely uncaring of his grades, again, very uncharacteristic of him. Doing everything to break the rules including stealing, cheating, defiance and disrespect to teachers. He seems like he's trying to get out of his own skin at times. Again, the only variable I can change since I can't change puberty or his school at this point is the medicine. I've done some reading up on it and it sounds like there are others with this history although there is not a lot out there regarding the effects on children. I can only assume that they are more severe in children then in adults. Hormones are a definite factor, there is also a possible identity crisis going on. I don't want to ever change who he is, he's a great, loving boy, but what i wouldn't do to turn back time about 8 months.

He says I keep trying to change him and it breaks my heart. I was only trying to help him cope and have an easier time of it, not change him.

Sounds like you have a serious problem. Take a wild guess what it is.

If he is saying that then you are probably trying to control aspects of him that he feels are innate to himself and an integral part of his personality, or at the very least, not something that warrants medication. One also has to take into account that on occasions, there are some OCD related things that people with OCD do that they really don't want to be bothered about. For example, Howie Mandel doesn't want to shake people's hands. Ok. This probably an aspect of his OCD that is fairly constant,yet not really all that life impacting. What if he were a child though, and his parents found it entirely unacceptable that he wouldn't shake people's hands? Then it's made into a major issue and he feels like he's being micromanaged.

I would make a list of things your son does that frustrates you. I would think carefully about what issues are actually reasonable to attempt to address, and what issues are negative and might make life difficult, but are otherwise normal for teenagers, and eliminate them from the list.

For example:
Arguing frequently: Fairly normal.
Stealing: Not acceptable.

Then I'd group those issues into two groups, one for OCD and one for behavior.

Then take a look at those lists. OCD management has to be done with the patient 100% on board. It's a very internal and personal thing and the person has to feel ready to tackle these issues. Even with CBT, its the person who chooses which aspects of OCD they feel ready to tackle. They are not forced into it, that almost never works.

I don't know that I would show him the list of OCD stuff because he might feel threatened by that and become defensive. I would just tell him you were using the medication to try to help control the OCD, and didn't mean to make it seem like you were trying to control him and you are sorry.

As to the other list, with the bad behaviors, I would probably just flat out ask him what the issue was, concerning the cheating, stealing, and being rude to the teachers (note being rude to teachers isn't all that uncommon but still shouldn't be ignored). I would tell him it's really these things you have a problem with. I'd probably take him out to lunch first and have this talk when he's in a fairly good mood. I'd probably also tell him if there is something in life that he's having a hard time with, there are better, more positive ways to deal with it that might actually help solve the problem, than just create more problems.

Mind you this is just what I would do personally if I had a child (which I don't) who was acting this way.

I'd be willing to bet a lot of this bad behavior has a reason behind it.

If he does have AS you might have to go down a list of questions to get to the heart of the problem.

For example, to get an answer to the question of "Why did you cheat?" You might have to ask.
"Do you know it's wrong to cheat?"
"Do you think it's fair to the other students?"
"Do the other students cheat?"

It might actually be that the other students do cheat, and don't get caught, and he may have come to the conclusion that, in light of this, being honest light he was told was the right thing to do, really just put him at a big disadvantage and made things unfair for him.

That's just one of many reasons a child with AS might start breaking rules....inconsistent enforcement of them, or having been chastized and socially pressured when they follow rules others consider to be insignificant, such as not jay walking.

You've got some excellent advice here. From the way you describe his OCD, I can see why it would have compelled you to talk to a professional, and then further to take their advice about meds, however when I compare it to the OCD my 7.5 year old is exhibiting, I can see that the OCD you describe may have been perfectly tolerable for your son. My son is at the stage not only of struggling to touch his own food, but anything that has touched something that has touched something that has touched the food. It is definitely at the point where we will need too seek counselling. It sounds like your son may have been able to deal with the hard-core OCD through counselling (as you said he did), but still had residual OCD that wasn't really bothering him.

I recently heard Liane Holliday Willey speak (she has Aspergers and is an extremely succesful keynote speaker, author, and college prof.) - she has OCD too, but it manifests as the need to do things like ride her bike precisely 15 miles a day. If she goes over, she has to walk back the number of miles she went over, carrying her bike; if she goes under, she has to ride in circles in her yard until she reaches the magic number. Doesn't affect her ability to live her life, so she's not too worried about it.

Have you considered CBT? He is definitely old enough to benefit from it. If you decide to step him down, or even if you don't, I would definitely pursue that.

And PS: I am painfully neurotypical and spent 2 hours doing my hair every morning before school as a teen too. Many boys are no different

He's been in therapy for years to help him cope with the bullying that came with the AS. I had him with his current therapist for a year before we started medicine, I guess I'm not sure exactly what CBT involves but there were things she would do with him that I believe were exposure kind of things that would be considered CBT, right? He never really wanted any help, it didn't bother him until it came to the point where he couldn't touch his food, then people were starting to ask him questions in school.

Funny about the hair thing though, I'm sure a big part of it is normal teenage with some OCD mixed in. These are such tough years. Praying we make it through. That's what his doctor keeps telling me, that many of these behaviors are normal teenage things~so if that's the case, why is she pushing that he stay on this medication when I'm telling her he's having other adverse effects.

Find another doctor.