Hello, from a medical perspective, many, many "knee jerk' reactions by psychiatric and other prescribing persons is to medicate away. Not a good idead. First, before any psychotropic medication intervention is even considered and pondered, he should be referred to a neurologist for a comprehensive neurological work-up to ensure that the behaviors he is displaying are not those of some type of neurological deficit or seizure disorder. Even if a neurologist completes an EEG (electroencephlagram) and these turn out to be normal, these are not diagnositic in themselves. Even with the normal EEG, he still may have some type of seizure disorder that can comonly mimic a psychiatric disorder such as ADHD.
I have seen this many, many times in my practice, children referred to me for what is thought to be a psychiatric phenomena; however, it turns out that the symptoms and presentation of the young person are derivatives of some type of neurological disorder, such as a seizure disorder. So, misdiagnosis is well and alive. I would recommend that besides the EEG, he have other comprehensive testing, not limited to but including the following: CBC with differential, Complete metabolic panel (CMP), SERUM LEAD and Cadium levels, Comprehensive thyroid testing TSH, T3, Free T4, and total T4. The TSH is a screening test and the others, in the aforementionded, need to be done in unison to ensure that there are not any hidden thyroid conditions. Further, another essential test I would insist on is a Hemoglobin A1c which is a test that gives the average glucose or blood sugar levels over the last six to eight week period and a gluetin test is not a bad idea. an EEG of the heart is essential too as if he is started on medicaton, you need to know the baseline cardiac function to ensure that the heart can tolerate such intervention. Then, if the child is started on any medication, routine EKG's should be conducted to measure the progress of the heart and ensure it is tolerating the medication without problems. I know that this is a long, litany of recommendations but the last would be make sure and ask your child's provider for EMLA cream or ointment which is topically applied to the area or areas where it is thought the blood would be retrieved, and should be applied one hour to the veinipuncture procedure. It truly works, numbs the area that the veinipuncture occurs, and is much, much less traumatic than without. Again, I sound like a loud mouth that will not shut up, but make sure all medical implications are ruled out before conidering any medication intervention. Medications, I have see, can be very, very beneficial; my approach is to start low and go slow, no matter what the medication is. Best Regards, Cindy
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