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Dr. Kaushik only please...
What can I do for my 9 year old child who has been diagnosed with a clear Disruptive Mood Dysregulation disorder (DMDD) DSM-5 - 2013 Currently, my child is on Abilify 4mg and Lamictal 100mg daily. There have not been any signs of improvement yet.
She is still exploding daily and is in a foul mood 90% of the time. She cries and yells regularly over things that trigger her, such as noises, asking her to do something that she does not want to do, such as homework, getting off the computer, washing, brushing teeth and getting to bed on time. When she is not in her negative mood, she is sweet, loving and affectionate. My child often makes art for me that says I love you on the pages.
She just can’t seem to regulate her mood and gets triggered by so many things which causes irritability, agitation and anger.
I don’t think these meds are working yet. She started the Lamictal at 25mg and moves up another 25mg every 2 weeks.
She has recurrent temper outbursts manifested verbally such as verbal rages and behaviorally with physical aggression toward people that are grossly out of proportion in intensity or duration to the situation or provocation. They happen 3-5 times a day every day and are observable by parents, teachers, friends and family.
This has been going on for 4-5 years. I have had to hospitalize her 4 times. She completely gets in her own way in this world. She has had numerous therapies with and without peers to learn coping skills and social cues and boundries and dealing with anger and being impulsive. She explains it as being a person who is triggered by numerous things and feeling like a rocketship that does not have enough space between to stop think and utilize coping skills. Its just like blast off. My voice and tone and our dogs licking and all rules and request set this kid off.
She is totally defiant but completely remorseful after all the bad behaviors. She says she just can't control these episodes and sensitivity to triggers.
We tried: prozac made her very depressed and wanting to jump out of her own skin and not be around. paxil risperdone geodon eyes rolled up in her head and lots of tics ritilan ok but became more explosive as it comes out of her concerta daytranna tenex no improvement saphris no improvement trileptal no improvement abilify She has only been able to tolerate Abilify at 2-4mg which helps her about 35%. Without any medicine she is 100% out of control and in a rotten bad mood all the time. With Abilify she has some good nice sweet moments and can function somewhat. When we increase Abilify over 4mg she gets worse. When we decrease she gets worse. The 4mg is not doing the trick to make her a balanced liked person in this world.
All SSRI's and Stimulants activate and stimulate her nervous system in a horrible and negative way.
Very frustrated kid with no friends. She has obvious inattentiveness and some OCD components as well. Please share your thoughts on this situation and the suggested meds. It is impossible for this kid to function.
Please help... When should the Lamictal begin working or since it has not yet at 100mg dose that mean its not right for her? She weighs 100lbs.
I am waiting for her Lamictal blood levels to come back and show me how they are metabolized. At 50mg they were sub therapeutic levels.
So far no mood lift at all from the Lamictal... Always grumpy!