How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Steve Your Own Question

Dr. Steve
Dr. Steve, Psychologist
Category: Mental Health
Satisfied Customers: 370
Experience:  19 years conducting therapy; book author; newspaper columnist; former co-host of radio show
25768173
Type Your Mental Health Question Here...
Dr. Steve is online now
A new question is answered every 9 seconds

My daughter is heaing voices. Her doctor has put her on seroguell.

Resolved Question:

My daughter is heaing voices. Her doctor has put her on seroguell. Previously she was on Concerta for ADHD and has been treated for ALL. Do you have any advice? How can I know we are on the right track for her?
Submitted: 4 years ago.
Category: Mental Health
Expert:  Dr. Steve replied 4 years ago.

Greetings:

 

Great question, but such an unfortunate situation for your daughter. Here is my impression: (and I give this with the knowledge that having active hallucinations in an eight year old is REMARKABLY uncommon)

 

The main neurotransmitter that is affected by the Concerta is called dopamine. ADHD is a general lack of Dopamine, so Concerta kick-starts the brain to make more. I have seen it happen (although this is somewhat rare as well) that a kiddo on an ADHD stimulant can actually have the dopamine levels overshoot the mark and will wind up creating some psychotic features (hallucinations, generally).

 

So here is my advice: talk to the prescribing doc and ask if your daughter can get all the way detoxed from the Concerta before her ultimate evaluation. As I mentioned, florid psychosis in eight year olds is almost unheard of - especially if there is not a family history of psychotic disorders (NOT impossible, but rarer than the side effect of stimulant meds, in my experience). That is the only way we can accurately assess what is driving the hallucinations. I assume they are a new symptom, by the way.

 

In any event, the medication prescribed to her is appropriate if she is hallucinating, but we really need to know if the symptoms are organic or if they have been created by the medication.

 

If you are satisfied with the response, please hit "Accept." That is the only way I can receive credit for my answer. Thank you-

Dr. Steve

Customer: replied 4 years ago.

 

She had been off the Concerta for four weeks when she first saw the psychiatrist. She said she still heard the voices then. He started her on 50mg of Seroquell. She says she is still hearing the voices and is on 150 mg (for three days).

I have little family history for her, she is adopted.

Expert:  Dr. Steve replied 4 years ago.

Hello again:

 

Got it. She should have been adequately detoxed by the time the physician made the medication change then. I will say this, the Seroquel will curb the hallucinations - if they are indeed just that. In children, I would work to first rule out a few other possibilities (the Concerta being the first in line). Other examples: I would also look at the potential for the reports to be manipulations - to assess this, we look at what is called "secondary gain" (i.e., what would she have to gain by virtue of falsely reporting hallucinations?). Mental capacity is also a possibility - if she is challenged in any way, she could be having a difficult time separating her internal thought processes from external stimuli (a current theory of auditory hallucinations in adults too, BTW). Finally, given that she is adopted, I would also look into the possibility of an imaginary friend being a part of her life. Often times kids under stress will "dissociate" as a means to coping with an unmanageable situation. Over time, the "friends" could transform into visceral reactions from her, again dependent upon her level of historical trauma.

 

Sorry to be so scattered in my response, but there are a few roads that could be explored when presented with this symptom. Seroquel is relatively mild with regard to side effects, but it does have to be monitored because there are a couple bad ones that could crop up if she has to take the med over a long period of time.

 

Best of luck. If you are satisfied with the response, please hit "Accept." That is the only way I can receive credit for my answer. Thanks-

Dr. Steve

Dr. Steve, Psychologist
Category: Mental Health
Satisfied Customers: 370
Experience: 19 years conducting therapy; book author; newspaper columnist; former co-host of radio show
Dr. Steve and 2 other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education