kapvay and risperdol with an aspie kid causing weight gain, sleepiness, and irritability

Karen - posted on 07/11/2012 ( 19 moms have responded )

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Our son, who is now 10, was diagnosed with ADHD in 2008 and put on Concerta. A month later, he was displaying major anger and mood swings, so risperdol was added. He has been on risperdol and stimulants from grades 1-3 but in 2nd grade, after getting kicked out of school, the psychiatrist added Prozac. It seemed like the miracle combination for about a year. Last year, however, we began to see major side effects of the stimulants, such as incredible irritability, sleeplessness, anger in rebebound times after school so his medicines were changed to Kapvay, prozac and risperdol. He did well for about a month, but was experiencing continued bullying at school and irritability and about a month into the new semester, he began falling asleep in class... a lot. He takes 2 Kapvay tablets in the morning and one in the afternoon to help with anxiety, but this medicine seems to cause him to be very sleepy. However, this summer, when we tried to titrate down to only 2 pills, he began biting on his clothes terribly, and couldn't finish a task for anything. We've titrated back up this week, but now he is irritable as all get out. I've never seen him so negative! The other thing is he is now gaining tons of weight. He used to be balanced out with weight when on Concerta, but he metabolizes so quickly now, he's got a pot belly and is going to get teased about this next year if the weight isn't addressed. He rides his bike and swims, but the weight gain is substantial. Whenever we've tried to reduce the risperdol before, he's gotten moody and couldn't sleep through the night.
So, major issues - he seems so bored and depressed with life and wants to sleep whenever he's not being highly stimulated plus he's gaining a ton of weight. Help??? We got him no a gluten free, almost cassein free diet as of March and I think his medicine is absorbing much better since then, but at what cost?

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Jean - posted on 07/12/2012

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Hi,my son is 12, We have been on many different medications also. done the concerta, without much success, than they added risperdol, and also did the prozac,. My son did well on the first 2 medications for a number of years, the Prozac seemed to help at first and than when we started doing the increase, the irritability and aggression's really started.. the medication was than changed to Abilify, which was like a wonder drug, I don't know if you have looked into this or not, This medication worked well for around 5 years and now that we are starting the puberty stage, I am also experiencing what you are stating. A lot of the psycho active drugs do have the major side effect of weight gain. I am also doing the gluten free diet,
My son also began falling asleep in school due to taking tenex for his tourette's, that also created more school issues.
I would talk to your medical providers and see what the next step would be. Also another major side effect of the medications you have listed that are not FDA approved for people under 18 is the adverse reaction: being more irritable and aggressive
My son always tells me also he is bored. he also loves to swim and bike, I try to keep him on a routine schedule all summer long this is very hard. I hope this helped somewhat to know you are not alone

Linda - posted on 07/11/2012

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Hi Karen..New to this message board. My son has ASD, ADHD,and is currently taking Tenex (similar to Intuniv..a nonstimulant) to help with hyperactivity. Seems to help, but still he is very moody and is displaying alot of aggression. I think he may also have ODD and his camp counselor suggested that we have him seen by a psychiatrist. I have a feeling they will recommend risperdol. How long does it take to see results and what kind of side effects are there? He's a good sleeper now and am worried that it may affect his sleep.
Question for you also...why did the dr. prescribe prozac? Also have heard that some stimulants can cause more irritability in children (that was the case for our son anyway).

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Karen - posted on 08/29/2012

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Thank you for your advice. I feel warned, not necessarily encouraged, but warned.

Joyce - posted on 08/29/2012

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Be very careful with the prozac and the rispeidol in the long run he could become neutropenic and you will spend half your life in the ER. Get a second opinion with another psychiatrist. Kapvay is helping my child and he is not on anything else. He still has problems with his anger but not like he did when he was taking the antidepressant and the dispersal. Some of these kids get older and mature and you stop seeing a lot of these behaviors.



It is very hard to tell who your child is if they have been taking the meds since 1st grade like my son was. Due to my medical insurance I had to get a new psychiatrist and she refuse to continue with his original cocktail of depakote, risperdol and tegratol. Not saying this will work for your child but it never hurts to get a second opinion. What exactly are these medications doing to your childs developing brain.



Lord help us.

Diane - posted on 08/25/2012

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karen

Be careful of the medication treadmill, there ARE other ways. I have two boys with autism and aspergers, i know it.s hard. Get another opinion and have you tried more comprehensive diet management?Drugs are at best only effective as a short term strategie, something they don't always tell you!

Karen - posted on 08/14/2012

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Our son still has a conscience. It works differently for different people. Adderall is a completely different kind of medicine and is used mainly to treat ADHD. DAniel's main issue was not his focus. It was anxiety and mood.

Barb - posted on 08/14/2012

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Prozac is a bad drug to have anybody on takes away their conscience.Try asking about adderall with just kapavay might help you .instead give one with morning pill and one for bedtime.this was told to me by my sons pediatrican.

Karen - posted on 08/13/2012

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The prozac was added because it helps the risperidol absorb into the blood better thus allowing for better anxiety mngt. The intuniv wad not effective snug for focus but kapvsy is better. However both of those brought out irritability. Thud the balance needed from the ridprridol.

Maria Theresa - posted on 08/10/2012

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I tried Hyperbaric Oxygen theraphy...and it changed my daughter for the better by 1 million percent.................

Karen - posted on 08/08/2012

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Daniel is on "chlonodine" per the medicine Kapvay. It brings our irritability but hleps with the ADHD and anxiety. We've gone down to just two, .25mg rispeeridol pills a day and now that we're giving one in the morning and one after school, his mood has evened out. We give the kapvay (chl) 3X a day instead of in the morning (2 pills) and at night (1 pill).
We give him 1 kapvay in the morning; one after school and one at night and he's sleeping great at night without the additional risperidol. Yay! His appetite has shrunk to what is nice and normal now - by just going down on one of the risperidol pills at night.
The kapvay has a sedative in it, so he sleeps just as well if not better now than he was.

Since switching him off the 2 kapvay in the morning, he's no longer falling asleep during the day either, so praise God!
Hormones will be an issue for the next 4-5 years, I afriad, so we'll be constantly adjusting dosages, but what I can say now is that he's going to need to wean more and more off the risperidol (per his drs suggestion this past month) because it will be problematic for muscle mass here in the next few years as he's hitting puberty.
The drs recc. is to raise the amount of prozac as needed if he cannot handle the stress of school and correction, rather than to go back up on the risperidol. She listened very well when we spoke to her with our grave concerns about his weight gain. Again, we're very thankful. Thank you to each of you who posted on this thread.

Morgana - posted on 08/08/2012

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My daughter gained 40lbs in 6 months on resperidol. She was taking it for aggression and mood swings but she always looked like a balloon about to pop so we took her off of it. Unfortunately she also has tics so she cant be on any stimulants so it limits what she can take. All i can say from personal experience and also working in the field is that you are your child's best advocate and if you feel that any of the meds are causing issues raise your concerns and then put your foot down if nobody listens. Also my daughter takes chlonodine to help with her sleep, its not as harsh as the respirdol but also isn't effective with everyone but you could mention it and see what they say. You could also ask to have a sleep study done that is our next step! I wish you luck!

Maribel - posted on 07/30/2012

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My son is 15 years old and was having behavior issues at school that got him kicked out, violent at home and depressed he tried some of the above medications and I didn't really see too much difference in his behavior until another parent at a support group told me the minute her son started Abilify he completely changed. i went to my sons Psychiatrist and asked if we could change meds and take Abilify she said yes. He has been on it for 3 years now and has been great. No more behavior issues, no depression, no sleeplessness like when he was on resperidone. I highly recommend to at least ask.

Karen - posted on 07/17/2012

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What was the zyprexa for, Jean? Daniel has never had auto immune issues, but I will keep your advice in mind. Something is making Daniel incredibly tired - and we need to figure out which med or combo it is?
Could it be puberty that is tiring him out? He's sleeping till like 9am and crashing after dinner.

Jean - posted on 07/16/2012

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Hey Karen, Risperdone was causing my son to have seizures, petit mal, they happened right in the doctors office so that is why that medication was changed. As far as the Abilify, it is always a good idea with any of these meds that your health care provider be checking their blood counts at least every 6 months. My son has always had auto immune issues since he suffered a very rare reaction to his last mmr shot. so his doctors monitor him very closely. after going in monthly for 4 months he white blood count had just totally bottomed out, not sure why,
Prozac caused and adverse reaction in my son Parker, he was threatening everybody and anybody around him, he would snap for no reason, it was to the point where a cross crisis plan was put in place.
The puberty stage which usually starts about this time or can even go on into the early 20's with people with disabilities can drive you crazy really fast,lol
My son just started on ZYprexa and in the past 48 hours he has been awake about 8. I am contacting his provider tomorrow,

Karen - posted on 07/16/2012

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Why do you feel your son is a Zombie now, Jean? I'm just wondering. I feel like the Kapvay makes Daniel zoned out.
You became aware that your son had a low white blood cell count? Whoa... what triggered that alert?

Daniel laughs a lot and can be very happy. And when we tried to reduce the prozac a week ago, he was irritable as all get out. So, it seems that the prozac is not what causes the irritability. However, when we tried to titrate down on the Kapvay, he was so flightly and impulsive and biting up all his shirts, we knew it wasn't enough of a dosage that would help him overcome the ADHD stuff.
The dr. we work with is very good but she doesn't want him going down on the risperdone. She said that she was glad that the gluten free diet seemed to be helping him absorb the current medications better this past 5 mos. and suggested we try going down on both the Kapvay and the prozac to see if the sleepiness subsided. Unfortunately, the decreased Kapvay resulted in the things I just shared above and the decreased prozac resulted in anger rising up again.

I don't know that abilify was all that bad but it semeed to make him incredibly weepy and tired. He was an equetro when he took it though, and this better psych. didn't trust Ability as it was just approved for kids under 18. Prozac has been FDA approved for children for many years and is tested, tried and true.

Hormones are really messing with things though and I dont' know what dangers to his liver these things could eventually cause. We had his liver tested last fall and all was clear.

Jean - posted on 07/15/2012

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Karen, I know some people have different reactions to different meds, The biggest issue during the time my son took Abilify was his white count. the reason he was taken off the med was because it was destroying his bone marrow. It had totally taken away all the aggressions, etc. I never heard him complain about being bored and he actually laughed.. He doesnt do much of that these days.
Everyday is a struggle. Once again I am working with his med providers, counselors to try to find the right combination of medications that work well. I don't want my son drugged to the point of being a zombie . I want him to be a happy child
Please check out and do alot of reasearch on different medications.
I am fortunate to work with Adults with Disabilities and on of my responsibilities is med management, I also do peer counseling for parents who have austistic children trying to help them in anyway I can. I have hit so many bricks walls along this journey that as I go along I want to try to give back and help

Karen - posted on 07/15/2012

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Shucks, Linda - I didn't answer a couple of your questions... I'm sorry. If I remember correctly, we saw positive effects of risperdol within a week, maybe two max. It helped him sleep at night, but the only side effect that came on during the transition on it was that he was a little sleepy during the daytime when we added an afternoon dose. The dr. suggested we use the .25 mg pills instead of the .5 mg tablets because we could give him a .25 mg tablet in the afternoon without it making him so sleepy. It worked.

Giving the two, .25 pills at night has been wonderful for his sleep.

Karen - posted on 07/15/2012

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Jean, as you can see in my response to Linda, Daniel was taken off the prozac and the risperdol and put on Abilify. It was most certainly NOT a miracle drug for Daniel. When we went to see the counselor while he was on it, she was shocked that he was put on abilfy. She warned of the moodiness and the strength of that particular medication.

We haven't seen any of the negative effects of the prozac - only the positive. Kapvay tends to make this child tired and much of Daniel's irritability seems to be associated with being tired or bored. He chooses to be bored when not entertained... so I structure summer a lot so he has to self-entertain with lots of the basics fun things to do around the house. Otherwise, this kid would be a video gaming junkie and/or a tv addict, whining when he had too much screen time and had to get off. This whole puberty thing is totally throwing us for a loop. The moodiness and rebelliousness is really kicking in. Eeks.

Karen - posted on 07/15/2012

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HI Linda. Thanks for posting. It sounds like you're headed down the same bumpy road we've been on. Daniel was put on the risperdol to even out the irritability that came with the stimulant. It helped a lot and we didn't see weight gain till this year when we encouraged the dr. to try and switch him to a non-stimulant. He has gained 10 lbs in a semester, so now the weight is a big concern. The risperdol works, however. That's the double edge sword.
Both the psy. in Georgia and the psy. here in Houston wanted Daniel on prozac because it multiplies the effects of risperdol and helps with the depression that comes with being an aspie kid who doesn't deal well with ongoing stressors. The prozac was the thing that helped Daniel over his biggest hump back in 2009 and so we have not wanted to have him go without it since. A dr. took him off of prozac and risperdol last fall and put him on Abilify and Equetro and it was an absolute nightmare! Daniel was so lethargic and moody and he was raging almost every day. So... after getting away from the pill pushing dr. we were with, we found another good psychiatrist here in Houston and she wanted him back on the risperdol and prozac.
Overall, they have really worked for him.
The stimulants do tend to bring out irritability in a lot of people - they certainly do for Daniel. However, when the dr. tried to take Daniel off all stimulants in the fall of 2009, the poor child was biting up his shirts, his school desk, every pencil/pen, you name it and he couldn't sit still and focus for anything for 6 weeks. It destroyed his self estreem with regard to school and he was manic. So... we knew that he requires something to help him focus, not have the biting and we've seen it when we reduce the amount of Kapvay as well. Our child just needs something to help with this side of his aspergers. It's a shame that Kapvay isn't all that and a bag of chips, but no medication is. Does this help?

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