Published Jan 9, 2003
lynn1967
30 Posts
Okay. update on my daughter. The psych. started her on Adderall. She was on it for about 5 days and it made her WILD!!Even more than she already is. She was totally out of control. So we stopped that on Sunday.
About three nights ago she was supposed to be going to bed and she was complaining of hearing noises, monsters,etc. so she came out to me and we started talking and she told me that she was hearing voices in her head that were telling her to kill herself. She adamantly denied that she would ever hurt herself and told me that she would tell me if she ever had those feelings (I believe her) But she said that the voices started when she began taking the Adderall. She has been off of the Adderall since Monday and she said she hasn't heard anymore voices.
Today the psych. wants to start her on Resperidol. I have seen this drug given at the LTC where I work and it just scared me. Have you heard of it being given to a 9 year old before? Some thoughts on this??
fab4fan
1,173 Posts
I would get a second opinion; Risperdol is a pretty heavy duty anti-psychotic. Is it even FDA approved for someone that age, or is he just treating her "off-lable"?
sanakruz, ADN
735 Posts
Dont go for it.
She had psychosis induced by the stimulant adderal.
I am not an MD but i'm telling you to do as fab4 suggests
It's spelled RISPERDAL (risperidone)
http://www.us.janssen.com
RNFROG3, BSN, RN
143 Posts
totally 2 nd opinion all the way!
memphispanda, RN
810 Posts
My 12 year old has been on Risperdal for at least 3 years. He has asperger's syndrome with symptoms that include ADHD, OCD, anxiety, and paranoia. It has helped him tremendously, but I want him off it anyway. It has been connected with gynecomastia in boys, and I don't want him to have another nail in his social coffin. We have not been able to succesfully take him off this drug though. When we attempt to taper off, his paranoia is totally uncontrolable. I wouldn't use Risperdal unless and until you had tried other options. If Adderall is the only stimulant you have tried, go for another one. Ritalin, Concerta, Dexedrine...they are all similar but can affect a child in very different ways. My son was violent on dexedrine, but not on concerta or adderall. Anyway, hope some of this information helps you in some way...I tend to be verbose.
You are right nonetheless memphispanda.
Risperdal is a "atypical" antipsychotic and as a result many think it's superior to haldol, mellaril, stelazine et al.
It can cause extra pyramidal symptoms including tardive dyskinesia, and neurolypitc malignant syndrome.
These are worse case scenarios, yes.
Clients I work with (adults all) have experienced gallactorrhea, dystonia, and paradoxal reactions.
I do not like this particular med.
There is a depo available also but not in the US
And no studies available as to efficacy and safety in peds
maureeno
221 Posts
Aderrall is amphetamine. I concur with the posts above and would only add run away from that prescriber.
researchrabbit
603 Posts
We did a research study on risperdal in kids with conduct disorders. Worked (sort of) for some...but they all gained weight. Most gained A LOT of weight. The kids complained of being hungry all the time.
I concur that the voices your child was hearing could have been a side effect of the adderall. It is telling that they are gone now that the drug has been stopped.
Seems funny to me that the prescriber hasn't taken this into account. I agree, get a second opinion.
Carol, has Seroquel been tried with your child? I haven't seen any child studies, but I can say that I only had 2 adult patients who had weight gain with that one. (although stuffy nose seemed to affect most everyone...some had sedation but it improved within 2 weeks for most).
OH goodness! Weight gain? My child could do with some of that. He is one of the oldest in 6th grade, and one of the smallest...heightwise and widthwise. He is flat puny.
We haven't tried Seroquel. Does that tend to work well for paranoia? That is the major issue the Risperdal helps with.
adrienurse, LPN
1,275 Posts
I think people have developped a false sense of security about risperidol. Sure it is a lot better than the older antipsychotics, but it is not without side-effects. Please approach the situation with caution and make sure she is not getting more than she needs. I have seen people develop severe tardive dyskinesia from this drug (which is of course a permanent condition).
Seroquel works pretty well for paranoia in adults (have not seen it in kids -- so don't know). I did have an 18 year old who was so paranoid he took to carrying around a hammer -- just in case. He was well enough on the seroquel that he got a job and then an apartment (a miracle for this guy).
I think they are suggesting that 200 mg is the effective dose range, but some of our patients were on considerably higher doses (800-1000) with no ill effects other than the transient drowsiness.
rebelwaclause, ASN, RN
354 Posts
>>>Medscape DrugInfo.com
RISPERDAL ORAL
Patient Handout
RISPERIDONE - ORAL
The following information is intended to supplement, not substitute for, the expertise and judgment of your physician, pharmacist or other healthcare professional. It should not be construed to indicate that use of the drug is safe, appropriate, or effective for you. Consult your healthcare professional before using this drug.
Common Brand Name(s):
Risperdal
Uses
This medication is used in the treatment of psychotic or mental conditions.
How to Take this Medication
Take this medication exactly as prescribed. During the first few days your doctor may gradually increase your dose to allow your body to adjust to the medication. Do not take this more often or increase your dose without consulting your doctor. Your condition will not improve any faster but the risk of serious side effects will be increased. Do not stop taking this drug without your doctor's approval.
Side Effects
Dizziness, drowsiness, nausea, increased dreaming, nervousness, loss of appetite, dry mouth or fatigue may occur the first several days as your body adjusts to the medication. Weight gain, vision changes, decreased sexual desire and insomnia have also been reported. If any of these effects continue or become bothersome, inform your doctor. Notify your doctor if you develop: rapid/pounding/irregular heartbeat, skin rash, itching, difficulty moving, muscle stiffness, muscle spasms or twitching, sweating, involuntary movements (especially about the face or tongue), drooling, tremors, trouble swallowing, mental confusion, seizures. Tell your doctor immediately if any of these unlikely but very serious side effects occur: one-sided weakness, numbness in the face/arms/legs, vision problems, slurred speech, confusion. Males - in the unlikely event you have a painful, prolonged erection, stop using this drug and seek immediate medical attention or permanent problems could occur. If you notice other effects not listed above, contact your doctor or pharmacist.
Precautions
Tell your doctor your medical history, especially of: kidney disease, liver disease, heart disease (including heart failure, history of heart attacks or ischemia, conduction abnormalities), strokes (cerebrovascular disease), dehydration (too little body water), seizures, blood disorders, breast cancer, swallowing difficulty, allergies (especially drug allergies). Because this medication may cause drowsiness or dizziness, use caution operating machinery or engaging in activities requiring alertness such as driving. Dizziness on standing may occur. To avoid dizziness or lightheadedness when rising from a seated or lying position, get up slowly. This medication may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, or sunlamps. Use a sunscreen and wear protective clothing when outdoors. Caution is advised when using this drug in the elderly because they may be more sensitive to the effects of the drug. This medication should be used only if clearly needed during pregnancy. Discuss the risks and benefits with your doctor. This drug is excreted into breast milk. Breast-feeding is not recommended while using this drug.
Interactions
Tell your doctor of any over-the-counter or prescription medication you may take, especially of: sedatives, narcotic pain relievers (e.g., codeine), anti-anxiety agents, antidepressants, muscle relaxers, medication for seizures. It is recommended you avoid consuming alcohol while taking this medication. Do not start or stop any medicine without doctor or pharmacist approval.
Overdose
If overdose is suspected, contact your local poison control center or emergency room immediately. Symptoms of overdose may include unusual drowsiness; rapid pulse; fainting; unusual muscle movement or rigidity of the face, neck, or limbs; tremor; seizures; and loss of consciousness.
Notes
Laboratory tests may be done periodically while taking this medication to monitor the effects. See your doctor regularly.
Missed Dose
Try to take each dose at the scheduled time. If you miss a dose, take it as soon as remembered; do not take it if it is near the time for the next dose, instead, skip the missed dose and resume your usual dosing schedule. Do not"double-up" the dose to catch up.
Storage
Store this medication at room temperature between 59 and 86 degrees F (between 15 and 30 degrees C) away from heat and light. Do not store in the bathroom. Keep this and all medications out of the reach of children.