Love & Potions: In Cat We Trust Pharmacotherapy to support relationships In a graphic novella Love & Autism Conference San Diego, August 24, 2014 Joshua D Feder, MD Child and Family Psychiatry jdfeder@mac.com Â
Disclosures, August 2104 clinic: my main job iPad -UCI research peace building COC – policy work !
UCSD toddler research Circlestretch – web info Cherry Crisp – media
Relias – courses for para’s
Thank You • Jenny Palmiotto • Mara Goverman • Caron Schiffman
Outline • You are eating…I am talking…. • I made you a graphic novel (a aka comic book): Jill and Robert - In cat we trust • Q & A
There are so many stories in the city. This one begins in a suburban home…
Jill: He didn’t notice my new hybrid car…
Jill: What mom? It’s NOT stalking….
Jill: I ts’ leg i t . He across works the pa rking l met at ot…we the pic nic tab les…
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Mom: Dr. Lewis will see you both?
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Jill: If I can get him there - it’s like herding the cat..
Later that month… Dr. Lewis: It looks like Jill dragged you here….
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Robert: My parents think I should settle down‌
Dr. Lewis: Jill, you can be pretty intense – Robert you seem more low key.
Jill: We want medication Robert: Ow - Don’t grab!
Dr. Lewis: I get it – we need to cool you down and try to warm him up…
Dr. Lewis: Medication can help a good plan, but you need a good plan. Â
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Dr. Lewis: Love is about selfless giving and treasuring time together.
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Dr. Lewis: to do that you both need to be calm, connected and communicating.
Dr. Lewis: Let’s go slow with the medications.
Across town afterward… Jill: We can work this out.
Jill: I’ll have spicy arribiata, please Robert: Plain pasta for me thanks
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Jill: Maybe the wine is a good medicine.
Robert: I don’t drink.
Jill: Smells can work: cheese, musk, mushrooms, meat..
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Jill: Anyway, Dr. Lewis said it’s more than meds…
Jill: …we have to connect... Hey! Robert! ARE YOU LISTENING?!?
Robert: We have to be calm first – you have to stop freaking me out
Jill: ok, ok I’ll warn you before I touch you
Robert: The Prozac might help but it might make my concentration worse.
Robert: And if it makes my parts down there not work so well, that’s not good, if you know what I mean…
Jill: I know what you mean – SSRIs did that to me.
Jill: But it’s better than the Xanax from Dr. Smith.
Robert: Benzos…hmmm… yuck: falls, forgetting, accidents, addiction…
Jill: Yeah – I stay away from those
Robert: Dr. Lewis talked about Adderall for concentration…
Jill: Concerta is a stimulant too – it keep me awake…
Jill: And I got depressed on it
Robert: Dr. Lewis said it’s tricky to balance stimulants and SSRIs…
Jill: I liked it when the Concerta killed my appetite
Jill: But it made my blood pressure go up…
Jill: And I had to get an EKG…
Robert: If the Adderall doesn’t work for me I want guanfacine.
Jill: Look at them…I want us to be them…
Robert: maybe guanfacine will help me be calm enough for that. Dr. Lewis said its calming and not addicting.
Jill: It might also make you dizzy.
Robert: I keep hearing about research on oxytocin….
Jill: That’s the hormone that helps labor and birth, nursing, and rodent bonding…
Jill: If we hug 8 times a day it makes your brain release the right amount of oxytocin..
Robert: Uh.. I’ll try the hormone nasal spray first....
Jill: I hope it works…
Jill: I’m willing to pay for the Abilify if it will settle me down
Robert: I thought it’s supposed to be for psychosis…
Jill: It’s FDA approved for marketing for irritability in ASDs…
Robert: Got to watch for weight gain and other side effects…
Jill: Maybe it will build my bust…
Robert: You won’t be happy if you get milk with that…
Jill: Oy. Robert: Yeah. Oy. But I guess they do help sometimes, and if we’re careful and we get a good check up we’ll be ok?
18 Months later…
Robert: We found stuff in common…
Robert: We both love the green and tech…and cats…
Robert: I knew it was love when she got me the poster…
Robert: She gives me some space to do my thing…
Bill: I want to find someone too…
Bill: You do seem calmer, and happier…
Bill: But Jill can be a firecracker…
Robert: we’re both better – and it’s more than meds… it’s sharing…
Robert: …when we do stuff together we are both better people
Robert: …But that first kiss nearly killed me.
Across the parking lot…
Jill: We talk – there’s lots of missed cues….
Jill: but we’re getting better at fixing things.
Jill: When I slow down he comes to me…
Mary: But he doesn’t look at you…
Jill: It’s not about eye contact…it’s about caring.
Mary: Wow. Can you introduce me to his friend?
A few months later… Dr. Lewis: Its been quite a ride
Dr. Lewis: There’s a lot more ahead…
Robert: It’s stressful but good…
Jill: Scary, wonderful… but not so crazy
Robert: And we’ll figure it all out…
O/C, rigidity Persevera+ve
Reciprocal interac+on
Sensory Sensi+vity
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Sleep BP
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AEDs
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Steroids
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Central Alpha Agonists
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Etc… LIST OTHER TREATMENTS!
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Kim: tearful