Possible brain injury from med reaction

What is the name of your state? What is the name of your state? Ohio

My son was diagnosed with ADD at age 7. He is now 12 and was taking Adderall XR for ADD, Paxil CR for depression, and Geodon (an antipsychotic) for social withdrawal and difficulty going to sleep May-Aug 2002 (11 years old). He had been on Geodon for about 4 months when he began showing symptoms of what the psychiatrist thought was Tardive Dyskinesia. The day the involuntary movements of TD started, I took him to the prescribing psychiatrist who said we could test whether we were dealing with TD by giving him Cogentin, a drug used for Parkinson's Disease patients. He was given three doses of Cogentin (2mg, 2X a day) beginning that day. His last dose of Geodon was the evening before.

Shortly after the third dose of Cogentin was given, it became clear that my son had gotten completely psychotic. He was seeing things, talking to people who weren't there, didn't recognize me or his dad. (His pupils were widely dilated for three days.) The day of the reaction the psychiatrist told me to take him from his office to the hospital ER. While there he had a CT scan which came back normal. The psychiatrist told me later that he had given my son too high a dose of Cogentin, and that is what my son had the reaction to. Within two weeks of the reaction, all signs of TD had disappeared, but the neurologist we saw for follow-up pointed out that he thinks my son has Asperger's Syndrome (a high functioning form of autism). Upon researching Aspergers, I found that the social problems, depression and attention problems are all typical of Aspergers. (The psychiatrist completely missed this diagnosis.) Some of my research has led me to the conclusion that my son went through what is called Anticholinergic Toxicity. I have also found warnings that antipsychotics and Cogentin should not be given at the same time (or too close together, because antipsychotics take a while to get out of a person's system).

6 weeks after the reaction, he began having seizures on a daily basis. This was 1 year ago, and he now has multiple seizures a day and a very bad tremor. He was on Depakote (from the same psychiatrist) to treat the seizures, it gave him some control, and the tremors almost disappeared. However, he now cannot handle ADD medications (they make him twitch and/or hear voices - this wasn't the case before). He also seems to be very sensitive to other meds he used to be able to take. It is almost like we are dealing with a different child.

Several neurologists have done EEGs and found no abnormal electrical activity. They all try to send us for psychiatric treatment with a 'pseudoseizure' diagnosis. His current neuropsychologist told me that he does not think my son is psychotic at all, and needs seizure meds, but is off of Depakote due to its side effects. His neurologist doesn't want to prescribe seizure meds even though he just had a SPECT scan showing a possible seizure focus in the left thalamus or some other abnormal functioning in the left thalamus.

I really don't want to sue the psychiatrist (or anyone else for that matter), but we are getting desperate for medical help for our son, and it looks like we will be dealing with this for a long time to come. If we were to try to take a legal route, do you think we would have a case? (We would only do this with hopes that the attorney involved would be able to put us in touch with a doctor who is more interested in helping our son than in protecting other doctors.)

Originally posted by weishouse
What is the name of your state? What is the name of your state? Ohio

My son was diagnosed with ADD at age 7. He is now 12 and was taking Adderall XR for ADD, Paxil CR for depression, and Geodon (an antipsychotic) for social withdrawal and difficulty going to sleep May-Aug 2002 (11 years old). He had been on Geodon for about 4 months when he began showing symptoms of what the psychiatrist thought was Tardive Dyskinesia. The day the involuntary movements of TD started, I took him to the prescribing psychiatrist who said we could test whether we were dealing with TD by giving him Cogentin, a drug used for Parkinson's Disease patients. He was given three doses of Cogentin (2mg, 2X a day) beginning that day. His last dose of Geodon was the evening before.

Shortly after the third dose of Cogentin was given, it became clear that my son had gotten completely psychotic. He was seeing things, talking to people who weren't there, didn't recognize me or his dad. (His pupils were widely dilated for three days.) The day of the reaction the psychiatrist told me to take him from his office to the hospital ER. While there he had a CT scan which came back normal. The psychiatrist told me later that he had given my son too high a dose of Cogentin, and that is what my son had the reaction to. Within two weeks of the reaction, all signs of TD had disappeared, but the neurologist we saw for follow-up pointed out that he thinks my son has Asperger's Syndrome (a high functioning form of autism). Upon researching Aspergers, I found that the social problems, depression and attention problems are all typical of Aspergers. (The psychiatrist completely missed this diagnosis.) Some of my research has led me to the conclusion that my son went through what is called Anticholinergic Toxicity. I have also found warnings that antipsychotics and Cogentin should not be given at the same time (or too close together, because antipsychotics take a while to get out of a person's system).

6 weeks after the reaction, he began having seizures on a daily basis. This was 1 year ago, and he now has multiple seizures a day and a very bad tremor. He was on Depakote (from the same psychiatrist) to treat the seizures, it gave him some control, and the tremors almost disappeared. However, he now cannot handle ADD medications (they make him twitch and/or hear voices - this wasn't the case before). He also seems to be very sensitive to other meds he used to be able to take. It is almost like we are dealing with a different child.

Several neurologists have done EEGs and found no abnormal electrical activity. They all try to send us for psychiatric treatment with a 'pseudoseizure' diagnosis. His current neuropsychologist told me that he does not think my son is psychotic at all, and needs seizure meds, but is off of Depakote due to its side effects. His neurologist doesn't want to prescribe seizure meds even though he just had a SPECT scan showing a possible seizure focus in the left thalamus or some other abnormal functioning in the left thalamus.

I really don't want to sue the psychiatrist (or anyone else for that matter), but we are getting desperate for medical help for our son, and it looks like we will be dealing with this for a long time to come. If we were to try to take a legal route, do you think we would have a case? (We would only do this with hopes that the attorney involved would be able to put us in touch with a doctor who is more interested in helping our son than in protecting other doctors.)

One problem I have answering your question is that you do not clearly identify the several psychiatrists you have taken your child to.
Your child is not doubt a victim of too many prescriptions of mind altering drugs. Many psychiatrists are poor prescribers and know little about the medicines they have ordered. A child of 7 should not be suffering "depression". ADD is hugely over diagnosed.
My suggestion is that you take your problems to two different specialists.
First: gather all your prescriptions together (I hope you have the bottles or better-- copies of the prescriptions) and take them to a pharmacoloigst at a University Medical Center. Pay him for an evaluation. He may wish to see your son, but probably not.
Second: Find a good clinical psychologist, not psychiatrist. You may find one at a major Children's Hospital.
Before you do these two things re-write your question. Be careful to date everything. Identify each doctor (no need to name them, just say who they are and what is their specialty). Type the question on one page, delete all extraneous matter.
Follow the advice you get, but be wary nonetheless. You may find that you should see a malpractice lawyer after a few weeks of re-evaluation of your child.
Your son needs to be weaned off some of this stuff, and a pharmacologist can help you here. The clinical psychologist (a PhD and a pediatric psychologist if possible) will help you in any future medical care your son needs.
You will learn that many differences exist between psychiatrists and psychologists. As you work with new doctors be selective and listen carefully to all the doctors. Look for signs of good everyday common sense and a real interest in your child.

Sorry this story was confusing. Let me clarify: when I mention psychiatrist throughout the note, I am speaking of 1 doctor, not several different doctors.

My son is currently seeing a neuropsychologist and is not on any of his past medications. He currently takes Clonidine to assist his sleep, and Valium in small doses when his seizures will not stop.

Thanks for the advice.

Good.
Now see a lawyer.

[ellencee]

weishouse
I doubt you have claim of malpractice for failure to diagnose or improper medication as regards the diagnosis of autism. Missed diagnosis, misdiagnosis, and failure to diagnose do not apply to situations where a definitive method of diagnosis is not available and where diagnosis is based on what works and what doesn't or necessary progression of symptoms.

Yours is a good example of what is going on with treatment of children, today. Your child was treated for being too social, and then to not be so withdrawn from social activity, and for depression! All of this began when he was 7 years old. No wonder his problems compounded. However, even though my professional opinion on the medication control of childhood behavior is as I have stated, this is acceptable treatment and in and of itself is not improper or malpractice.

Some psychotropic medications must be given with Cogentin in order to prevent the permanent development of certain conditions such as TD. If there is an area of your situation that I would want to explore, it would be the overdose of Cogentin. Depending on the significance of the damages to your son (which includes any treatment to manage the overdose), I suggest that you pursue the matter further. If it is found that the seizures are a direct result of the overdosage, then you (more likely than not) have a valid claim of malpractice.

If you have not changed treating pyschiatrist or obtained a second opinion, then I suggest that you do the latter and seek a second opinion. In a medmal claim, when the client continues to seek care from the professional who is being accused of malpractice, the medmal claim is weakened if not eliminated.

Best wishes,
EC

[pele]

For a related story, published on 10/26/03, go to the following link to the Honolulu Star Bulletin

[url]http://starbulletin.com/2003/10/26/news/index1.html[/url]

[ellencee]

pele
Good article. It reinforces the obsession of the American public with wanting a pill to cure anything considered abnormal or undesirable instead of working hard to overcome the problem(s).

There is a TV ad for a pill to give women back their desire for sex. The woman in the commercial says that after working all day, taking care of three kids, making the meals, doing the housework, and the laundry, etc., she was too tired for sex. But now, she has pill X and she's got her sex life back. That woman doesn't need a pill! She either needs to quit her job and be a mom, or get some help from Dad and the kids. Then, she wouldn't be so exhausted she had no desire for one more task before sleep; it might even seem like fun instead of work!

I think your article should be mentioned in the family law section of this forum, too. So many of the children being discussed in the child custody section are being medicated to keep them still and quiet.

Thanks,
EC

[pele]

Ellencee, Touchdown! You hit the nail right on the head.

I have posted the article in the family law section.

Pele