Sunday, May 20, 2007

Psych meds drove my son crazy

From Salon Magazine, part of a longer 3 page story (P1, P2, P3):

Until he was 17, my son was unique and funny and odd. He was difficult in some ways but incredibly easy in others. He washed the family's dishes precisely, went to bed at exactly the same time each night, and sorted our mail into careful piles. He did fairly well in school -- above average in math, a little below in social studies -- and spent his weekends playing tournament-level chess. He was a loner, but sweet and articulate and very close to his only brother.

Then junior year came. He met a girl, he went to a dance, he thought life was better. And for a night it was. Then the dance ended, the girl decided she was interested in someone else, and the boy became depressed.

Was this cause for alarm? I thought not. Teenage boys routinely get depressed over girls and fickle friends and school dances. It was painful, but I assumed it would blow over. When it didn't, after six months, I took him to a psychologist who recommended a psychiatrist who put him on a newfangled antidepressant she said would have the added benefit of controlling some of his obsessive tendencies, like stacking the dishes and sorting the mail.

I didn't want to control those things -- to me, these weren't symptoms, they were characteristics of my son. And I'd fought for 17 years to keep him drug-free. But the psychiatrist and the psychologist and several family members insisted: He'd become unhappy, his routines were getting in the way of his developing a social life. This pill, they said, would help him.

Instead, he gained 30 pounds and began to lose his mind.

It happened slowly, over a period of months. First his grades began to fall. There were some random episodes of violence -- nothing major, just an out-of-control moment here or there. A tendency to stand up from the dinner table, after a full meal, and walk to Arby's for a snack. Eerie giggles that seemed involuntary. A flat expression on his once-curious face.

Senior year, he started an after-school job at an auto parts factory but lost it when he couldn't keep up with even the elderly workers. He stopped speaking to his brother entirely and even hit him several times. He lost interest in music, computers and chess.

I talked all this over with his father, my ex-husband, who said, "Maybe he needs a man's attention. Let me give it a try."

So our now 18-year-old, autistic, depressed and quickly losing ground, moved across town, to live with his father in a small, quiet apartment. My ex worked odd shifts, so our son began wandering the city on foot, early in the morning and late into the night. He told his dad about how he had to fight the bad thoughts that were crowding in his head. And when he wasn't out walking, he slept a lot -- around two-thirds of his life, in fact -- despite the fact that he drank 12 to 15 cups of coffee a day.

Together, my ex-husband and I took our son to a highly respected neuropsychology clinic housed in a suburban office building. The doctors there even looked like bankers; they wore regular clothes and carried clipboards and fancy pens embossed with the names of drug companies, rather than stethoscopes.

After meeting our son twice, they conferred with the original psychiatrist (who, we discovered later, was employed by the same large healthcare conglomerate) and came up with an altogether new diagnosis. This wasn't autism at all, they told us, but "psychomotor slowing" -- a form of schizophrenia. Our son was just unlucky, they said sadly, the victim of two devastating neuro-behavioral disorders. Completely unrelated.

It was critical that we begin treating him immediately; they couldn't stress this strongly enough. We were given a prescription for a brand-new antipsychotic medication with the inspiring name Abilify that was direct-to-consumer advertised in Newsweek and Time magazine. It featured a woman gazing into an azure sky and copy promising the drug would work on the brain "like a thermostat to restore balance."

We were skeptical. But the experts were firm: He would continue to deteriorate if we didn't catch this now. Did we want our son to end up institutionalized? In jail? Sick to our stomachs and desperate, we gave him the drugs. Then he got much, much worse.

He stayed with me on weekends, and twice during the workweek he would come to my house for dinner. We would sit at the table -- my husband (his stepfather), his brother and sister and I -- but my once-reserved older son would only stand over us acting crazy. Humming, shifting foot to foot, screaming if anyone touched him or tried to move him to the side. Often, he would talk back to the people who were speaking to him inside his head, telling him to do things. He would not, however, say a word to us.

He wasn't eating meals. But he was eating -- constantly. After graduating from high school, during the period when he was still holding the voices at bay, he'd started a government job through a disability work program. I'd given him a car and helped him open a checking account during this period of lucidity. Now, he began stopping at fast food restaurants on his way home from work to consume nachos, burgers, brownies and lattes. He ate with his hands and wiped them on his clothes, which he'd quit washing. He stopped bathing altogether.

We discontinued the Abilify, tapering it off as directed. Two days after taking the final pill, he got out of bed at 2 p.m. and stood in one place for a solid hour. My husband had taken our daughter roller-skating; our younger son was at work. It was just me, alone with this 6-foot-3-inch man I'd given birth to but no longer knew. I put my hand on his back and tried to push him forward, toward his shoes. And he turned to look at me -- his eyes empty and cold -- then grabbed me by both arms and beat me until the neighbors heard me screaming and called 911.
[Fast forward through two years of hell ...]
My ex-husband -- newly married to a very understanding woman and blissful for all of about seven minutes -- never slept because he was working day and night to keep track of our son. I didn't sleep out of solidarity. Also due to worry and grief.

This turned out to be a good thing, however, because I was up all night, for many nights in a row, with nothing better to do than search online.

The first thing I found was a list of "infrequent" side effects of the very first drug, the antidepressant he'd been given nearly two years before. Among these: auditory hallucinations, narcolepsy and obesity.

The second was an obscure article about a boy who sounded exactly like my son: a high-functioning young man with Asperger's syndrome who'd suddenly become nonfunctional at the age of 17 and was diagnosed with something called autistic catatonia.

It was 3 a.m. and I was on the couch under a blanket with my dying laptop, alone in the silence of a sleeping house. That's when I Googled "autistic catatonia" and hit the mother lode. There were dozens of stories, coming from countries all over the world, and each one described in wretched detail the previous year of my son's life: the slowing, the disintegration, the delusions and insomnia and explosive anger.

In addition, they all warned -- each and every journal article, white paper and scientific treatise -- that the one thing practitioners should never do is prescribe antipsychotic medications, such as Abilify and Geodon, because they will make the symptoms of autistic catatonia much worse. And it might cause permanent damage.

The third thing I found was a Web site that described neuroleptic malignant syndrome, a slow poisoning by prescription that lasts (and this is the part that caught my attention) even after the drug is stopped.

Finally, believe it or not, we've reached the hopeful, lucky part. Only I didn't know that yet.

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