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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  

++??

+?

+

++?

-­‐?

+?

+?

+?

+? +/-­‐  

Mult. SE…  

-­‐/+

-­‐?

+?

-­‐?

++?

-­‐?

+? -­‐?  

Mult SE…  

+/-­‐

1/+?

-­‐/+?

+?

+?

+?

+? +  

Sleep BP  

+/-­‐

-­‐

-­‐

SSRIs

-­‐

-­‐

+/-­‐

-­‐/+

+?

-­‐/+

Neurolep+cs

+?

-­‐?

+

-­‐/+

+?

++?

AEDs

+?

-­‐/+

+

-­‐/ +?

+?

Steroids

-­‐?

-­‐?

+?

+?

Central Alpha   Agonists  

+?

+?

+?

-­‐/+

Etc… LIST  OTHER   TREATMENTS!  

-­‐

-­‐

Wt Ht   +cs  

-­‐/+

Wt, Ht   Sz  

+

Wt. Sz   TD   NMS  

Etc…

-­‐

Sleep

+/-­‐

Tics

+/-­‐

Comments

Motor Planning  

+?

Mood Instability   “aggression”  

-­‐

Depression

+?

Cogni+on

+?

Anxiety

-­‐

A/en+on

+?

Ac+vity

-­‐

Targets

+/-­‐

S+mulants


Kim: tearful


Profile for Circlestretch

Love & potions august 2014 (1 1 for posting)  

A graphic novella about young adults on the autism spectrum and the possible roles and side effects of using medication to help them connect...

Love & potions august 2014 (1 1 for posting)  

A graphic novella about young adults on the autism spectrum and the possible roles and side effects of using medication to help them connect...

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