How Much Psychiatric Medication is Too Much for a Child?

This week, I encountered yet another insurance / psychiatric medication prescription snafu. Bob's old Seroquel prescription had run through its refills and I submitted a new prescription for his bipolar medication from his psychiatrist. Blue Cross Blue Shield refused to pay for it. Why? Because their monthly limit is 102 tablets. Bob's prescription for his psychiatric medication was written for 105.

Yes--splitting hairs over Three. Pills.
While I went through all available channels to get this mess fixed again, Bob got to go to school without his usual dose of Seroquel. The school nurse had a limited supply, and thankfully provided his morning and afternoon psychiatric medication doses--but that still left him 200mg per day short.

Psychiatric Medications: Overmedicating A Child with Mental Illness

This week has been less than stellar, and I'm sure that's partially attributable to the sudden drop in his Seroquel dose, but I've also been questioning the effectiveness of his current medications for several months. He's been much angrier lately, and demonstrating the feral behaviors we hadn't seen for some time.

I called his psychiatrist. She increased his Seroquel (which was finally available Thursday evening) to 400mg per day and asked us to return in two weeks for reevaluation.

400mg/day of Seroquel is a lot. For an almost-10-year-old boy who barely weighs 65 pounds, it's a helluva lot. And that's not all he takes--he's also on lithium and carbamazepine for his bipolar diagnosis, and Focalin for ADHD. All at high doses that keep increasing.

This "logic" doesn't gel with me. If I have a headache and two ibuprofen don't make it go away, the answer isn't necessarily to take six. When a person develops an infection resistant to one antibiotic, a different antibiotic is prescribed--not increasingly higher doses of the ineffective one.

How much of this stuff am I willing to force down my son before I put my foot down and say "enough is enough"?

Most Parents Are Not Experts in Psychiatric Medications

If you're shaking your head and pitying my poor, over-medicated child, you're in good company. What you don't understand is that parents of mentally ill children are in the unenviable position of being caught between the psychiatrist--whose weapon of choice seems to be "drug roulette"--and Everyone Else, who would like our children to "Please Stop Acting Like That, Thank You."

As frightening as it is to take the prescription and go, it's gut-wrenching to watch a child struggle through a childhood that's anything but normal. It takes weeks (or months) to get into a new psychiatrist. This one got lucky before--shouldn't we stick with her and keep trying?

Yes, we should. Although I have started the quest for another psychiatrist, preferably specializing in mood disorders. In the meantime, I give Bob his medications as prescribed.

What else could I do?