WTF?

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DD214_DOC

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Does this seem rational to anyone, because I cannot make sense of it. I inherited two kids (three actually) who recently moved to the area. Mom is a useless reporter and of course didn't have the records from the previous psychiatrist. Here is what I get to deal with:


11yo whose only diagnoses per mom is ADHD and a specific learning disorder (that she didn't know specifically) currently on clonidine 0.1mg qid (total of 0.4mg), vyvanse 40mg, Seroquel tid (total of 400mg), Prozac 40mg.

9yo (same previous psychiatrist) whose only diagnoses are ADHD and a specific learning disorder (again, mom didn't know) currently on paxil, Adderall xr 25mg, intuniv 3mg at noon, remeron 30mg qhs, clonidine 0.2mg qhs, Adderall ir qam and qnoon.

Seriously, wtf? I made the parent fill out a release request to fax directly to the prior doc and refused to change/adjust anything until I understood how they ended up on this stuff. My spidey sense tingled and pointed to something going on with the mom given a few comments and the dynamic, and possible this is a factitious disorder kinda thing or something.

fourth or fifth case in a week like this. I need a vacation.
 
Oi, my condolences. Good for you for not rubber stamping scrips...
 
Neuropsych eval? They can actually see if the kids meet for ADHD/LD and get some psych rule outs in place. Them's a lot of meds for young kids with supposedly only ADHD/LD as a Dx. And, I'm assuming they are just like many people with an ADHD Dx, given some meds after a 5 minute talk with the mom and no other evaluative instruments/full interview given.
 
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