Lisa,
I am a Child and Adolescent Psychiatrist practicing in Arizona. Having read all of the comments, my first advice is to not stop "all medications" without a doctor's supervision. It sounds like your psychiatrist is trying reasonable approaches. OCD symptoms seen with Asperger's can be very debilitating for a child and Prozac (fluoxetine) is a reasonable, FDA-approved treatment. Unfortunately, your son had a reaction which can happen to ANY person treated with an antidepressant- this reaction can include suicidal thoughts and "elevated" or "irritable" behavior (sometimes referred to as "manic" behavior). Along with this reaction, a person can have increased interest in sex or inappropriate behaviors- sexual or otherwise). First of all, I recomend sticking with your psychiatrist or another psychiatrist or behavioral pediatrician experienced in treated children with Asperger's. I believe you WILL get your son back. You can expect the Prozac to be out of his system over the next week or so. The changes caused by Prozac may take up to another month to subside. The risperidone is a reasonable medication for now to treat his symptoms and also help some with OCD symptoms. He's on a low dose which is safe. I would only continue having a patient of mine take this medication for long periods if he had significant benefit from the medication- for example improved social interaction, decreased OCD or improved mood stability.
Now, the most important thing I have to say is that, it is quite likely that the Prozac brought out some symptoms that may have occurred to a lesser extent around this time anyway. He is 13- he's starting puberty and his hormones and brain are changing rapidly. A child with autistic-spectrum disorder is at risk of developing behavioral and even mood stability problems at times of change- be that physiologic change or external stresses. I have so much more I could say, but get as much help as you can from local resources- therapists, counselors and educators. I am not against alternative treatments if they don't risk harming your child. There are many more "traditional" therapies to take advantage of as well. Good luck to you!
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Lisa,
July 20, 2009 - 1:43pmI am a Child and Adolescent Psychiatrist practicing in Arizona. Having read all of the comments, my first advice is to not stop "all medications" without a doctor's supervision. It sounds like your psychiatrist is trying reasonable approaches. OCD symptoms seen with Asperger's can be very debilitating for a child and Prozac (fluoxetine) is a reasonable, FDA-approved treatment. Unfortunately, your son had a reaction which can happen to ANY person treated with an antidepressant- this reaction can include suicidal thoughts and "elevated" or "irritable" behavior (sometimes referred to as "manic" behavior). Along with this reaction, a person can have increased interest in sex or inappropriate behaviors- sexual or otherwise). First of all, I recomend sticking with your psychiatrist or another psychiatrist or behavioral pediatrician experienced in treated children with Asperger's. I believe you WILL get your son back. You can expect the Prozac to be out of his system over the next week or so. The changes caused by Prozac may take up to another month to subside. The risperidone is a reasonable medication for now to treat his symptoms and also help some with OCD symptoms. He's on a low dose which is safe. I would only continue having a patient of mine take this medication for long periods if he had significant benefit from the medication- for example improved social interaction, decreased OCD or improved mood stability.
Now, the most important thing I have to say is that, it is quite likely that the Prozac brought out some symptoms that may have occurred to a lesser extent around this time anyway. He is 13- he's starting puberty and his hormones and brain are changing rapidly. A child with autistic-spectrum disorder is at risk of developing behavioral and even mood stability problems at times of change- be that physiologic change or external stresses. I have so much more I could say, but get as much help as you can from local resources- therapists, counselors and educators. I am not against alternative treatments if they don't risk harming your child. There are many more "traditional" therapies to take advantage of as well. Good luck to you!
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