The Po Show

Pharma-Go-Round

So I picked up Matthew new prescriptions today: risperidone and more Topamax. He's weaning off the Abilify for a week, and then goes on the risperidone next week. We're adding Topamax back into the mix; it was unclear whether it was exacerbating his insomnia when he first went on Abilify, so we dropped it. We're trying again, to try and combat the probable weight gain from the risperidone (Topamax is known as the "skinny drug" in the mood stabilizer/epilepsy world). He gained 12 pounds on Seroquel, so that'll be good if the Topamax works to decrease his appetite.

It'll be ironic if the risperidone turns out to be the right drug for him. That's what the psychiatrist was going to start him on, almost a year ago. I was not at all opposed to it, though it was freaky beyond words for me that my CHILD would go on this anti-psychotic drug that I used to administer to smokers to see how it affected their smoking. I know this drug well, and know the possible side effects like the back of my hand (writing 1000 informed consent forms has a way of impressing things on your memory).

But that's not why the doctor ended up prescribing Seroquel instead. I had just read a story on the front page of the New York Times that morning (above the fold), about a teenage girl who was prescribed Risperdal as a mood stabilizer, and she ended up with all kinds of nasty adverse events. Thus, when the doctor told me, "So we're going to be starting him on Risperdal," I got this weird, out-of-body feeling, like "Am I in the Twilight Zone?" I didn't say anything right away, but eventually mentioned the article. I clearly told her that I didn't have a problem with Matthew taking the drug, just that the coincidence was a little overpowering. She immediately said, "Okay, let's go with Seroquel instead!" I told her that it was fine, if she thought Risperdal was better for him, I had no problem with it. She said that Seroquel should work for him as well, and it had a better side effect profile, with less potential weight gain. I just rode along.

I'm still just riding along. No one knows what will help him. We thought Seroquel was helping, and then it wasn't. We thought Abilify was working great for him, then, not so much. No one can look in his brain and figure out which receptors need to be tweaked the most. We just keep trying, and trying again, and the hit and miss is in my child's brain and in his future. 'Round and 'round and 'round once more.