Expert: Ivan Goldberg, M.D. - 6/27/2010

Question
My son was diagnosed 2yr ago, and it has been quite a "ride down a road in the dark w/out headlights", to put it mildly.  He was hospitalized back in April for 7days, because he was suicidal, and when he was released his meds were cut down from abilify, prozac, respirdal, to just taking seroquel 100mg in the evening.  Since then he has been spiriling downward, his psych dr. has increase the seroquel to 100 mg at 8am, 3pm, and 300 mg at bedtime.  This was working wonderful, but after 5 day, he developed a mouth tic, so now he is taking the same am and pm dose, and just 200mg at bedtime, plus citalpram 10mg in the am.  Now he is torturing his 10yr old bro, who has autism, I have caught him w/sewing needles sticking repeatedly his brother, he has become more aggressive towards everyone in the house.  I am a single parent who works 12 hours M-F, so not working, homeschooling is out of the question.  Just trying to cope and figure out my next move......

Answer
Hi . . .

The situation you describe is not only heartbreaking but also technically difficult.

It seems to me that your son should be treated by a child psychiatrist at one of the better psychiatric hospitals in the country. That does not necessarily mean that he must be an in-patient, but that he should be treated by a child psychiatrist with much better than average skills. You may find a list of the best psychiatric hospitals at:

http://health.usnews.com/best-hospitals/rankings/psychiatry

Best regards . . .

Ivan
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