OCD Meds, Part 2

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I'm still having problems with DS14's psychiatrist and his meds. Every time we go she maintains that he needs to be on his medicine and isn't hearing us when we say we want him off. I put a call in to the medical director who phoned me on Monday. All she did was have the doctor call me yesterday. I told her we were just there two weeks ago and we don't see why we have to make him miss another day of school to discuss what we told her then, his erratic behavior and actions. She informed me that DS has to be the one to say he wants to come off the medicine and since last time he said he wanted to continue, she could not go ahead with helping us bring him down and off the Zoloft. She says it's Pennsylvania law that since he is now 14 that it's his decision, not his parents! Wouldn't it have been nice to know this going in? She said she'd meet with us again but would not accomodate us with any closer appointment, says we have to wait like any other patient and she can't help it that she's busy. DH and I are furious! She won't accomodate us because she doesn't agree with our decision.

New behaviors since beginning meds: Cursing at administrators in school, grades dropped, total lack of interest in school, ran away once and let a neighbor believe he was abused which lead to him being taken to the hospital in an ambulance and the police coming to my house and DYFS coming, stealing, doing really random mean things like sticking a plant on someones food in school when they weren't looking, episodes of craziness, not wanting to follow rules, no fear of authority, never socializes when home, wants to be on the computer in chat rooms 24/7, doesn't dress most weekends, would prefer to stay in.

Old behaviors/reason for beginning meds: obsessing of appearance (meds worked for this), cleaning dishes and utensils before using (which still continues), some anxieties with peers.

I'm putting a call into the med. director again and letting her know I don't want this doctor anymore, she is extremely condescending, never lets me speak a complete thought, and disrespectful to myself and my husband. Looking into a new doctor closer to home also. Any other thoughts I should tell this director?

Sorry to hear you're having such a bad time.

I might just tell her "screw you, you suck," but I don't recommend that you actually do that.

Perhaps you could try a trip to the emergency ward at your local hospital. Walk in there, and tell them that your child is having a horrible, life threatening reaction to the medication that he is on, and you desperately need him to get off the medication, but you can't because that might make things worse, and your current doctor refuses to offer lower doses to help the child step down. Make sure you say things like he became increasingly violent and unpredictable after he started the medication and you fear for the safety of you and your son. You will probably find a doctor who is willing to listen to you and help your child step down his dosages, especially if you are 'overly dramatic' about the harm that the medication is doing to your child.

Finding one doctor to take you seriously and spend 2 minutes writing a prescription isn't that hard when you walk into the emergency ward and make a scene. And at this point, you may need to do it in order to get anybody to listen to you.

If I had thought about that the night he went to the ER I would totally have done that but my insurance company requires that I contact my primary doctor first and they wouldn't allow it. Primary doctor has already told me he won't help, go back to psyhiatrist, even if it's another one.

Correct me if I am wrong, but you did already contact your primary doctor. Doesn't that satisfy your insurance's requirements? And furthermore, would your insurance want your child to step down off the medication, as that would result in them paying less? If the problems are as bad as you say, then going the 'sanctioned' route may not be a good idea, especially if it just makes things worse.

it is HMO right? you can have your primary physician to give you a prescription for another more reasonable psychiatrist.
it is a horrific story though.

You have to do whatever you can to get a new doctor. That much is clear. But also I think you should start keeping a behaviour diary. When you get a new doctor (I am hoping/assuming/praying you will), you will need records of his behaviour to see if a pattern emerges, such as escalation of a particular problem. It is unlikely your current doctor is keeping accurate records of his behaviour to match what could be medication side effects. It can be so hard to sort out what's medication side effect and what's adolescence. But a written record that allows you to see a pattern- if there is one- will help. Research the known side effects of this medication so you can match them with the behaviour diary.

My daughter was on an SSRI and had a similarly disastrous escalation of problems. The medication, slowly over time, made her prone to intense mood swings, a known side effect. Luckily her doctor was open to the concept of side effects and allowed a slow stepdown along with me keeping a diary to chart changes. It took a few months but she eventually came off the medication. The diary helped because it allowed me to keep track of how much time passed between terrible episodes rather than relying on my memory.

If all else fails and you are neither allowed to get another doctor nor given assisstance in stepping down the medication because of its side effects (and you have to step it down, cold turkey is very dangerous), the behaviour diary is something your lawyer will need if you go for a malpractice suit. I am thinking an absolute worst case scenario here. The best case scenario is that you get a new doctor, who will be able to put a behaviour diary to good use. Stepping down the medication under the guidance of this doctor would be second best. Having to go the route that Tracker foresees and forcing a change via the Emergency Room is pretty bad. I hope it doesn't come to that. But no matter how things go, the behaviour diary will assist you for better (a record for a new doctor) or worse (evidence for a malpractice lawyer).

I wish you all luck. Please keep a diary. You won't regret it.

I think a diary is a great idea, my memory is terrible. We keep a diary for DS8's migraines and what happened on those days and that has helped us form a pattern for his migraines. Still no luck with a new doctor, going to call my insurance today for a list of providers they'll accept. In the meantime I have an appointment with the original b***h of a doctor on the 14th so if worse comes to worse I will at least go to that and try to get something out of her.

Has anyone heard of this law she states about 14 gets to decide if they want to take meds or not?

I haven't heard of that law but I would be weaning my child off myself in this situation. PERIOD. I would NOT go back to that unhelpful dr EVER. I'd be finding a new doctor...

I have had OCD since 12, now 42. I have also been through the wringer with doctors. May advice and its is just that as I dont know your circumstances intimately is if they dont listen dump them and find someone else. I suspect you already know this yourself but its hard finding the courage to challenge the apparent experts. Just remember no one knows your child better than you do and keep in mind you are paying these people, you are the client not the other way around!

Another resource: call the company that makes the medication and complain to them. Explain what you are experiencing and let them know your doctor isn't helping you, ask them what the protocols are for this type of behavior/dosage. (Extra drama will help you here, too.) They may do nothing, or they may - being wary of the type of lawsuit that happened with Zoloft and other meds - offer you support in getting a better response from your physician, or may refer you to a better one that works with your insurance. At any rate, I don't think it will do any harm.

Check what your state's laws regarding mental health are: some states do not allow HMOs to require a physician referral for mental health services. In that case, you can find someone better yourself.

Have you looked into the laws or maybe even consulted a lawyer to see if its true about a child of 14 being able to make his own decisions about medications?....that does not sound right to me. I thought it was 18 before you child could make his or her own decisions about medicines. Unless it is a life or death situation the parents should be able to make this decision.