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Love & Potions:
In Cat We Trust
Pharmacotherapy to support relationshipsIn a graphic novella
Love & Autism ConferenceSan Diego, August 24, 2014
Joshua D Feder, MDChild and Family [email protected]
mailto:[email protected]:[email protected] -
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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 paras
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Thank You
Jenny Palmiotto
Mara Goverman
Caron Schiffman
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Outline
You are eatingI am talking.
I made you a graphic novel (a aka comic
book): Jill and Robert - In cat we trust Q & A
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There are so manystories in the city.This one begins in a
suburban home
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Jill: He didnt noticemy new hybrid car
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Jill: What mom?
Its NOT stalking.
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Mom: Dr. Lewis will
see you both?
Jill If I t hi
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Jill: If I can get himthere - its like
herding the cat..
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Laterthatmonth
Dr. Lewis:It
lookslikeJill
draggedyou
here.
R b t M t
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Robert: My parentsthink I should settle
down
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Dr. Lewis: Jill, you can bepretty intense Robertyou seem more low key.
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Jill: We wantmedicationRobert: Ow - Dont
grab!
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Dr. Lewis: Medication canhelp a good plan, but you
need a good plan.
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Dr. Lewis: Love is aboutselfless giving and
treasuring time together.
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Dr. Lewis: to do that youboth need to be calm,
connected and
communicating.
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Dr. Lewis: Lets go slow
with the medications.
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Across town afterward
Jill: We can work this out.
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Jill: Ill have spicy arribiata, pleaseRobert: Plain pasta for me thanks
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Jill: Maybe the wine is agood medicine.
Robert: I dont drink.
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Jill: Smells can work: cheese,musk, mushrooms, meat..
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Jill: Anyway, Dr. Lewis saidits more than meds
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Jill: we have to connect...Hey! Robert!
ARE YOU LISTENING?!?
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Robert: We have to becalm first you have to
stop freaking me out
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Jill: ok, ok Ill warn youbefore I touch you
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Robert: The Prozac might helpbut it might make my
concentration worse.
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Robert: And if it makes myparts down there not workso well, thats not good, if
you know what I mean
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Jill: I know what you mean SSRIs did that to me.
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Jill: But its better than theXanax from Dr. Smith.
o er :
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o er :Benzoshmmmyuck: falls,
forgetting, accidents,
addiction
Jill Y h I
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Jill: Yeah I stay awayfrom those
lk d
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Robert: Dr. Lewis talked aboutAdderall for concentration
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Jill: Concerta is a stimulant
too it keep me awake
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Jill: And I got
depressed on it
Robert: Dr Lewis said its
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Robert: Dr. Lewis said it stricky to balance stimulants
and SSRIs
Jill I lik d it h th
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Jill: I liked it when theConcerta killed my appetite
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Jill: But it made my blood
pressure go up
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Jill: And I had to
get an EKG
R b t If th Add ll d t
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Robert: If the Adderall doesntwork for me I want guanfacine.
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Jill: Look at themI want us
to be them
Robert: maybe guanfacine will
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Robert: maybe guanfacine willhelp me be calm enough for
that. Dr. Lewis said its calming
and not addicting.
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Jill: It might also makeyou dizzy.
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Robert: I keep hearingabout research on
oxytocin.
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Jill: Thats the hormonethat helps labor and birth,
nursing, and rodent bonding
Jill: If we hug 8 times a day it
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Jill: If we hug 8 times a day itmakes your brain release theright amount of oxytocin..
Robert: Uh Ill
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Robert: Uh.. I lltry the hormone
nasal sprayfirst....
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Jill: I hope it works
Jill: Im willing to pay for the
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Jill: I m willing to pay for theAbilify if it will settle me down
Robert: I thought its supposed to
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Robert: I thought it s supposed tobe for psychosis
Jill: Its FDA approved for
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Jill: It s FDA approved formarketing for irritability in
ASDs
Robert: Got to watch for
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Robert: Got to watch forweight gain and other side
effects
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Jill: Maybe it will build mybust
Robert: You wont be happy
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Robert: You won t be happyif you get milk with that
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Jill: Oy.
Robert:Yeah. Oy.But I guessthey do helpsometimes,and if werecareful andwe get a
good checkup well beok?
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18 Monthslater
Robert:We foundstuff incommon
Robert: We both love the
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Robert: We both love thegreen and techand cats
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Robert:I knew itwas love
when shegot me
the
poster
Robert: She gives me some
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Robert: She gives me somespace to do my thing
Bill: I want to find
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Bill: I want to findsomeone too
Bill: You do seem calmer
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Bill: You do seem calmer,and happier
Bill: But Jill can be a
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Bill: But Jill can be afirecracker
Robert: were both better d i h d
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and its more than medsits sharing
Robert: when we do stufft th b th b tt
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together we are both betterpeople
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Robert: But that first kissnearly killed me.
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Across theparking lot
Jill: We talk theres lots of
missed cues.
Jill: but were getting
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J ut w r g tt ngbetter at fixing things.
Jill: When I slow down he
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J Wcomes to me
Mary: But he doesnt
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y
lookat you
Jill: Its not about eye
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ycontactits about caring.
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Mary: Wow. Can youintroduce me to his friend?
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A few
monthslater
Dr.Lewis:
Itsbeen
quite aride
Dr. Lewis: Theres a lot
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more ahead
Robert: Its stressful but
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good
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Jill: Scary, wonderfulbut not so crazy
Robert: And well figure it
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gall out
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Targets
Activity
Attention
Anxiety
Cognition
Depression
Mood
Instability
aggression
Motor
Planning
O/C,ri
gidity
Persev
erative
Reciprocal
interac
tion
Sensor
y
Sensitivity
Tics
Sleep
Etc
Comments
Stimulants +/- +/- - +/- - - +/- - +? - - - Wt
Ht
tics
SSRIs - - +/- -/+ +? -/+ +? +? -/+ Wt, Ht
Sz
Neuroleptics +? -? + -/+ +? ++? - +? ++?? +? + + Wt. Sz
TD
NMS
AEDs +? -/+ + -
/+?
+? ++? -? +? +? +? +? +/- Mult.
SE
Steroids -? -? +? +? -/+ -? +? -? ++? -? +? -? Mult
SE
Central Alpha
Agonists
+? +? +? -/+ +/- 1/+? -/+? +? +? +? +? + Sleep
BP
Etc
LIST OTHER
TREATMENTS!
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Kim:
tearful
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