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Hi. I am considering adopting a 13 yo girl who I have been told has adjustment disorder, depressed mood and ADHD. She's on Risperadol, Tenex and Concerta. Does this drug regime make sense given her diagnosis? She's currently in a residential care facility and I'm told she has no "acute diagnosis". Thanks!
Ask them who perscribed the drugs and for what perpose. I would guess she has serious anger outbursts given the meds she's on.
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If she is in a residential care facility, she had/has some SIGNIFICANT issues. I agree with Lucyjoy that she likely has serious anger outbursts. 'Adjustment disorder' is sometimes code for RAD. 'No acute diagnosis' might mean that her issues are chronic but she is not currently suicidal/homicidal.
I would ask them several questions
1. How many pysch hospitalizations has she had?
2. How many stays in RTCs?
3. What were the trigger events for the above? suicide attempts? homicide attempts?
4. Has she ever set or attempted to set a fire?
5. Has she ever sexually acted out? What were the circumstances -- boy/girl older/younger forcr/no force?
6. Has she ever hurt or killed an animal?
7. Has she ever urinated/defecated outside of the toilet?
8. Did she suffer severe neglect or sexual abuse prior to the age of 5? at any time?
9. Was she exposed to drugs or alcohol in utero?
10. Has she ever made false allegations against anyone?
#7-8-9 are the trifecta for predicting significant issues in teens
#4-5-6 are huge red flags for severe mental illness with accompanying violence
If, after hearing their responses and reading her file, you wish to move forward with placement, I strongly suggest that you go very slowly. Start with visits at the RTC, the start participating in family therapy with her with the RTC's tdoc, etc. Once she is in your home, take your time finalizing and be sure that your subsidy agreement addresses funding for any future RTC stay that may be needed. Respite will be another key part of your subsidy.
Best of lyck in your decision.
Please, please make sure your state adoption will provide for future residential treatment care if needed! Can not emphasis this enough, as well as respite. My daughter is 13 and I have her since she was 16 months. In then last. 6 months she has had 6 psych hospitalizations. Never saw this coming. We were concerned about possible neglect in foster care in first 16 moths, now it seems pretty certain. Due to moving from adoption state I've had to give state custody in order to get her help! Things are a nightmare right now! Looking at borderline personality disorder, although too young to be diagnosed with that yet. Make sure you are able to get the help you will need including adoption subsidy. Ask many questions before you move forward, leave no rock unturned so you can help her all she needs. This is taking a huge toll on our family! Bless you and best wishes as you move forward!!
Tenex & Concerta are ADD/ADHD meds. I would ask why they are both being given.
The Risperdol is an antipsychotic med - typically used for BiPolar Disorder. I have also seen it used for Severe PTSD or PTSD with Psychotic Features. Remember - these diagnosis are not precise, particularly in a child. THe same child can get different diagnosis from different psychiatrists in the same month - just depends on how they present at the time and what features that particular Dr thinks is important.
I agree with the questions suggested by the prior posters.
I would also ask:
1. What is the family history of mental illness (both maternal and paternal).
2. How old was the child when first removed from parent's care?
3. How many times removed?
4. How many foster care placements?
5. Any bio siblings? If yes - where are they?
Good luck.
Tenex is a non-stimulant; it's possible she has some anxiety/PTSD which a stimulant would amp up. Concerta could be for focus/impulsivity.
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