Wednesday, July 20, 2011

To Medicate, or Not To Medicate?

About three years ago, sometime during his Preschool year, Ben started a regimen of Adderall to help control his impulsivity, outbursts, and general inability to sit in a classroom without clubbing the skins off his neighboring classmates. The medication has worked really well for those things; I even blogged about trying to switch his medication right before first grade began and we quickly retreated to the Adderall because it was the most effective thing we'd tried so far.

In recent months, though, my husband (largely through his profession as a clinical psychologist) has been reading reports of serious harmful consequences arising from the long-term use of Adderall. Of course these reports come and go, and we both recognize that one or two studies do not constitute undeniable "proof" that Adderall is dangerous, but we nevertheless have been feeling concerned.

As the summer started, my husband said, "I just wish I could take two weeks off work, go away with Ben to a hotel somewhere, and wean him off the Adderall just to see what would happen." I glanced around at the hole-riddled walls, across at the outburst-scattered litter of toys on Ben's floor, down at the meltdown-induced scratches on my arms, and I said, "There is NO way, honey. This household could not survive Ben without meds."

And then a few days later, the impossible happened almost by itself. I overslept one morning, and so because I did not give Ben his meds on time, I skipped them. Since it's summer though, Ben slept in past noon anyway, and then got up and immediately logged onto his favorite computer game. He pretty much kept to himself all day, and seemed to do just fine without the medication. No screaming, yelling, or melting down of any kind. So I thought, "OK, let's try one more day." Day two without meds went pretty much like day 1--quiet as Ben kept to himself, but even when he emerged to eat or watch television, he had no major eruptions. Then we tried day 3, and day 4, and day 5, and suddenly two weeks had gone by without any serious outbursts, without any major meltdown, and without any medication.

Ben even came to me after about 10 days without medication and said, "Mom, did you ever notice how I am not getting so angry like I used to when I took that medicine?" I told him that I did notice, and that I was very proud of him.

Then we started experimenting with social activities sans medication. First was church. Granted, he had trouble sitting still in his chair for much of the meetings, but after church he reported that he had answered questions in his class and even been awarded an extra piece of candy for being very good. I'm choosing to believe this report. He's been to church several times now without meds, and unless I'm not getting the official brief, he seems to be handling the stimulation just fine.

Then we tried a movie, and he sat through the whole thing without incident. Last week we took a road trip from Utah to New Mexico and Ben announced, "Mom, THIS will be the real test of how I can do without my medicine!" Reflecting back on countless trips marked only by the blessed hours when Ben would finally fall asleep, I agreed with him. And because it's starting to seem like miracles really do happen, Ben had a calm, focused trip.

Now we face a conundrum. While 98.6% of the time Ben has been amazingly calm and well-behaved without medication this summer, we have nevertheless had a few moments of "provoked" frenzy that would really pose a dangerous situation for classmates should they occur at school. His very infrequent outbursts end up being explosions of kicking, punching, spitting, biting, screaming, and utter inability to self-soothe. Thus far these moments have only been inflicted upon family members. My husband and I are wondering if the school setting would provide enough structure and unfamiliarity that Ben would pull back from such outbursts, or if he would still lose control even among his classmates. It is an unknown for us that leaves us wondering what to do.

Off-meds-Ben is a charming, delightful, funny, wonderful boy who is not forced to endure the pharmaceutically induced highs and lows of changing brain chemistry. I absolutely do not want to place him back on Adderall, under any circumstances. But I am very anxious to see how he can perform in school without something to help him deal with provoking situations that cause him to feel mistreated.

So that's where we are: do we return to medications once school begins, or do we "give it a shot" and see how Ben can do in the classroom without any chemicals in his system? I suppose it might be a system of trial and error--but please don't let the error be too big.

No comments:

Post a Comment