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Lack of drive

Posted by AOB on June 19, 2003, at 19:03:07

My son(age 21)is lost in a maze of diagnosis, comorbidity and medications. His survival out in the world is seriously in doubt because of a total lack of drive. In looking for answers, I've come across the drugs Adrafinil and Provigil. Light bulbs went off when I started reading about the effects these drugs may have on the brain. The description of what the ventral striatum area contols is almost an exact definition of what my son lacks - cognitive flexibility, coherence, vigor, goal oriented behavior and associative learning. Has anyone seen an increase of drive or setting and attaining goals or sustaining effort on Adrafinil, Provigil or other meds?

He definitely has a history of some sort of PDD. He matches so many symptoms in the DSM but does not match any diagnosis definitively. The psychologist who treated him for years referred to his diagnosis as spaghetti. Diagnosis history includes Asperger's, ADD, bipolar, depression, ODD and depression. Meds seem to lead to only temporary improvement or change. He has been on so many different meds I honestly don't know the difference between symptoms and side efffects.

If he has Asperger's how can he be a pathological liar? How can his early language skills be classic hyperlexic but didn't read until age 7 and has good comprehension? How can he have ODD but has never been in any real trouble at school or with the police? How can he be bipolar but never really manic? The huge spread between high verbal IQ 125 and low performance IQ 72 result in expectations being too high or too low. The resulting frustration has led to some of his seething anger but does not really explain his temper outbursts. Positve reinforcement doesn't work at all, he rebuffs and dismisses positive comments.

He got through high school with lots of prodding and case management. Since then he has been unable to successfully complete classes or keep a job, or stay in agency programs. Late in high school Risperdal was added to his mix of meds. Since then he has gained a lot of weight, overeats, sleeps a lot and complains of lack of feelings. Does this sound familiar to anyone? I think Risperdal is making things worse - has anyone experienced this also? Currently he is on Risperdal and Zoloft.


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