All the different kinds of drugs....

[krystaltps]

Hi all, I'm meeting with the GP on Monday to see about C getting melatonin. His paed has been very good and has written to the GP requesting he prescribe it. We've also spoken about risperidone (? is that how you spell it) or something similar to try to reduce his violent outbursts before he seriously harms one of his younger siblings. I would like to be prepared before I see the GP.... I want to be able to ask him for advice about the different kinds of drugs, as I know there are drugs other than risperidone. Trouble is I don't know the names of any of the other ones that are used for aggression, anxiety, violence, etc. What I'm looking for also is potential side-effects - it's a big decision, and one I wouldn't like to make without being fully aware of all the options. Any advice or knowledge you can share will be gratefully appreciated.... thanks

[Elanor]

Hi

 

I hope you have a useful meeting on Monday. You should be prepared for the GP saying that he can't prescribe some medications, in which case you'll have to push for a referral to someone who can - although that shouldn't stop him giving you advice. At the same time, GPs will have very little experience of prescribing something like risperidone to autistic children, and might be quite ignorant about it.

 

For information on side-effects of risperidone (brand name risperdal) try this:

http://www.nmhct.nhs.uk/Pharmacy/risperidone.htm

 

However, none of the information readily available on side-effects is really specific enough to children with autism taking very low doses of the drug. All the information you get is based on adults with psychotic disorders taking realtively high doses. Risperidone can be useful for children with AS, but this is an incidental benefit of the drug and not one that is very well understood.

 

With risperidone in particular, you need to talk to someone who is very knowlegeable about it's use in autism, and that's usually a child psychiatrist. You will also need to learn about regular checks (my son has 6 monthly blood tests).

 

Other drugs that can help include anti-depressants to treat stress and anxiety (which in turn of course can lead to agression). A lot of the anti-ds have been ruled out for children, but I believe that fluoxetine (Prozac) is still available, this might help:

http://www.nmhct.nhs.uk/pharmacy/depr2.htm

 

Best of luck

 

Elanor

[chriss]

Can Gp's prescribe melatonin?

[LizK]

Can Gp's prescribe melatonin?

 

PCTs here won't allow GPs to prescribe melatonin or atomoxetine as the first isn't licensed and the second too expensive despite being part of NICE guidelines for ADHD. Paeds or CAMHS have to prescribe melatonin and only CAMHS can prescribe atomoxetine

 

Lx

[chriss]

Thanks LizK

[krystaltps]

Hurrah!!! Am picking up melatonin from pharmacy tomorrow. Met with GP, he'd never prescribed it before, but paed had sent letter saying he was to do it (according to paed, she can't prescribe it but GP can). Tomorrow night I could be sleeping before the next day!! Am trying not to get hopes up too much though.....

Thanks all for advice. Decided not to further confuse GP by talking about risperidone, will save that for his paed next time I see her.

[chriss]

Hi Krystaltips,

 

The thing with melatonin is not to aim to high at first. The worst thing you could do is give it to him really early say 8 if he normally doesn't sleep till 12, as he will sleep at 8 and by 12 probably be awake and full of the joys of spring. Just aim to get him to sleep a little earlier than normal then hopefully he will sleep for longer. You can adjust the time you give it to him then and hopefully he will get in to better habits by himself as bedtime becomes more relaxing for him. Think I might see if I can get another prescription for my boy...

 

Good Luck and enjoy the rest and freedom this will hopefully bring you!

[krystaltps]

Hi Chriss, we didn't get it today. Went into pharmacy to pick it up, but they have to order it in as no-one else on the island uses it. We had the same problems with my younger son's Epistatus (for epilepsy). We should hopefully get it next week.

Thanks for the advive though. He usually sleeps about 1am, but he's exausted in the morning. I thought I should maybe give it to him about 10.30pm. That way he might actually get enough sleep for a change. What do you think?

[chriss]

Hi Krystaltips,

 

We were given melatonin in powder form and the only way I could give it to my son was by mixing it in yoghurt or choccy pudding. He was only 2 then (he's 7 now) and he would be sleepy within 20 minutes, if not less. The trouble is the effect wears off quickly, so whilst it is very effective at getting them to sleep it won't necessarily keep them asleep if they tend to wake in the night anyway. If you think he will stay asleep once he has taken it then 10:30 should be fine. He'll probably be asleep not long past 11.

 

The sleep clinic would only let me have melatonin for a month as the nurse insisted his sleep problems were my fault! I do bear a very big grudge for that! eventually we stopped going as she didn't help us and her advice (controlled crying and nothing but controlled crying) was making things worse. My son has since been diagnosed with Aspergers and has never been a great sleeper but is better now then he was as a tot. If he is having a particularly stressful time at school he can't sleep and lately has spoken of how much he hates lying awake at night so I am going to ask for melatonin for him again.

 

Good luck for when you do get the prescription!

 

I nearly forgot to add that the more sleep my son gets the better his behaviour is so I hope this is true for you too. I used to blame all his awful behaviour on lack of sleep when he was little!

Edited January 9, 2007 by chriss

[krystaltps]

Thanks Chriss. I used to blame many of C's episodes on lack of sleep too! We're reasonably lucky that once he is sleeping, he stays asleep, it's getting him to sleep that's the hard part. He does occasionally have night-terrors or sleep-walking episodes but is fast asleep during these, and they are getting fewer and further apart as he gets older (he's just turned 8).

I suppose it's trial and error with these things. We've been told to try him on 2ml when we get it, and work up to 6ml if it doesn't work. The highest we could go is 10ml, but this would have to be sanctioned by the paed. I will try it at 10.30 first, and if he's up during the night, I'll give it later.

Are there any side-effects? I know it's natural, so I was assuming there wouldn't be.

Thanks again for all your advice....

[chriss]

Hi again,

 

My son had no adverse side effects. Unlike when we tried vallergans syrup which left him with a kind of hangover so he was a psycho kid from hell!

 

I'm not sure why melatonin doesn't have a licence in this country yet. I think maybe not all trials are complete on it yet, or it may be because night workers have a slightly higher rate of some cancers which is thought due to their altered melatonin levels. Not to put you off though! This can't be too significant as you can buy it like aspirin in America. I'd give it to my child again without any worries, as his melatonin levels are already haywire and lack of sleep is bad for anybodys immune system.