Slide 78:

Now we are into 1997 and he’s on a combination of Prozac, Amphoteracin B and a little kyodophilis. His speech is getting better but his behavioral problems are still there. Remember what I said on the other child. Just because your children are functioning better cognitively doesn’t mean they’re going to decide to listen to you and behave. In fact, you almost get the other direction. They’ve never gone through the normal 2, 3, 4 year old, "Who’s in charge?". So what I had to get used to as a pediatrician is a 6, 7 year old child giving you the ‘terrible two’s’. The trouble is they can be a lot more destructive and a lot bigger problem at that age. But it really is just a behavioral development. The brain has to grow up and mature.

So, this child was doing well but still had brief periods of ‘spaciness’. I changed him to Diflucan, re-adjusted Prozac and he actually went through a little period of readjustment where he did worse, but then came out of it doing better. This is something that I’ve gotten used to with many of your children. It’s like when you first make the adjustment on an SSRI, if a child goes hyper, bouncing off the walls, and it lasts more than a day or two, I generally know that’s not going to be the right thing for that child. But, if they go ‘spacey’ or a little ‘zoney’, I’ve begun to appreciate that maybe it’s reflecting that you’re turning on these circuits that haven’t been working. I almost look at it like the kid is overloaded for a while, but then starts to process.

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