Medications ramble/vent/question PDD-nos, GAD, ADHD, SPD

[Tap]

DD5.5 has been on medications since she was 4yo. We have to medicate her due to her extreme physical behaviors. Without them she will do things like... get out of her car seat and start punching me and kicking me in the head as we are driving down the freeway.

 

She has had over 100 OT sessions, 100 BT sessions and has had a psychiatrist for 18mths. Medication was not the first thing we tried and it will never be used without ongoing therapy also.

 

Her current medication regimen is helping, but for the amount of meds she takes, I would like to see better results. It seems like we are micromanaging her behaviors, tit for tat, with meds.

 

Currently she is on

 

Risperdal-helps reduce violence but doesn't eliminate it

Trazodone-keeps her asleep at night, otherwise she is awake walking around 3-5 times.

Strattera-for ADHD, this particular med has helped to unstick parts of her brain and has a huge impact on her reasoning/imaginative part of the the brain.

Zoloft-makes her more content, less likely to go into rages.

 

We use Prazosin, if we need to. We use it when she will be in a high stress situation. It reduces her fight/flight response and her adrenalin fed behaviors.

 

We are reintroducing Abilify, to see if it we can replace the risperdal with it. We tried once before and it wasn't really effective, but her current meds are different than when we tried it the first time, so the psychiatrist wants to see what will happen with it now.

 

 

It is just such a strong list of meds for her age. SHE is 70lbs and is the size of an 8yo, so she is dosed according to this, not her biological age so much.

 

 

Her psychiatrist and I were talking the other night, and I asked if he knows any other doctors who may be able to give us some more recommendations or if there are any tests that can be done, so we can stop the "try this and see what happens approach". He said he would call a friend "who knows phych meds better than anyone else he knows", but I don't know what to do otherwise.

 

Does anyone know of any specific training or credentials I can look for in a doctor who may be able to help us? We routinely try to taper off of meds to no avail. Her current list is the lowest we can go and keep her functioning in society. Even with all of these meds she has to have a one-on=one at daycare/preschool. I know medications won't cure her problems, but I would like to get to the point that they at least help enough that she can be seen as a 'hard to raise kid' not 'the kid that you need to keep at arms reach, less because she will chase/punch/kick you'.

[funnygirl]

First, :grouphug: I have a very similar dd who has been on meds since she was four. I feel your pain.

 

I'm assuming you're seeing a child psychiatrist? The next question to ask would be how many other patients does he have who are on complicated cocktails, like your dd. How experienced is he with complex mental illness in young children?

 

The truth is, though, mental health care in 2012 is more art than science. It's a very subjective process of trial and error, based on what the doctor's personal experience, and (hopefully!) based on what he is reading in current literature and learning at annual conferences.

 

Your dd's med combination sounds very reasonable to me. (Like I said, btdt.) Unfortunately there isn't a magic pill, nor is there a blood test to say "we need to lower this or increase that". Someday, but not yet.

 

It is immensely hard to tease out which behaviors are can be helped by meds, and which are just those things that will have to be handled through other means. And just wait until she hits puberty. Good grief. It is my daily struggle right now to determine what is "normal puberty" and what is "bipolar/adhd/anxiety/etc". (Sorry, I hate when people say "just wait", and I just did it! Ugh.)

 

All that to say, your doc sounds like he's on the right track. Don't be afraid to trust you own gut, though. If there's something that's bothering you, talk to him. (I love that you did this! No need to be afraid to talk to your own doc!) And if you just can't get settled about it, get a second opinion. We changed doctors about two years ago and it's one of the best decisions we ever made. (Ftr, the first doc was a world renowned researcher on the subject of adhd and comorbid (co-occuring) disorders, but he had absolutely NO bedside manner. We switched to someone we could TALK to, and who we felt was hearing us. Made all the difference.)

 

As always, wine and chocolate for all of us!!

Edited March 8, 2012 by funnygirl

[Ottakee]

Risperdal-helps reduce violence but doesn't eliminate it

Trazodone-keeps her asleep at night, otherwise she is awake walking around 3-5 times.

Strattera-for ADHD, this particular med has helped to unstick parts of her brain and has a huge impact on her reasoning/imaginative part of the the brain.

Zoloft-makes her more content, less likely to go into rages.

 

.

 

Does she have a working diagnosis? What meds did you start in what order? Have you tried maxing out 1 or 2 without the others? Have you tried Melatonin for sleep?

 

Just thinking out loud here as I know what you mean about the meds. My now 16dd is on Keppra XR and Lamictal (seizure meds also used for bipolar), Risperdal and Dexedrine (older ADHD med).

 

I guess my question would be why is she on 3 antidpressants? I know they all work differently but Zoloft I think is an SSRI, while the Strattera is an SNRI (cousin), and Trazadone is an older AD.

 

Was she ever on the Risperdal WITHOUT the Strattera? I ask as Strattera caused more behavioral issues with 2 of my kids that took it. One even became violent that wasn't violent before.

 

I guess the question is--do you need all of the meds or are you using some of them to cover up the negative side effects from another med? Again...NOT blaming you at all, just asking the tough questions.

 

Have they ever tried her on a mood stabilizer? Lamictal is very good for moods including rages and depression. Lithium was wonderful here but my daughter couldn't take it when they stopped making a certain name brand one (she has a rare mito issue though). Tegretol and Depakote are others commonly used. It might be that a mood stabilizer would help and eliminate the need for some of the other meds.

 

Right now my daughter who is very complex is on 2 seizure meds (also used for her bipolar), Risperdal (an atypical antipsychotic) and Dexedrine (used for ADHD but doesn't trigger mood issues).

 

One place to look for good doctors is http://www.bpkids.org and look for the "find a doctor" link. Even if you aren't dealing with a mood issue, these doctors tend to be very good.

 

If you are in driving distance of West Michigan, I LOVE LOVE LOVE our ped. psychiatrist.

[Ottakee]

OK, just re-read your post and saw that she is foster to adopt. Any history of drug/alcohol exposure prenatally? How about mental illness in the birth family? Sounds like a lot of her behaviors could fit with a mood disorder/bipolar.

[Tap]

OK, just re-read your post and saw that she is foster to adopt. Yep.

Any history of drug/alcohol exposure prenatally? Yep.

How about mental illness in the birth family? Yep, both sides.

 

Sounds like a lot of her behaviors could fit with a mood disorder/bipolar. Yep.

 

 

LOL you nailed it! DD5 is my great niece. He mother is my niece. He mother tested positive to drugs/alcohol during pregnancy and marijuana at delivery. She has a heavy dose of mental illness on both sides, including bipolar. DD5's behaviors are cyclic so we suspect bipolar may be a component but it isn't diagnosable at this age.

[Ottakee]

I disagree about bipolar being diagnosed at that age. My daughter was and it was accurate. Most pdocs though will go with a "working diagnosis" of Mood disorder NOS at that age.

 

http://www.bpchildren.org/files/Download/TreatmentGuidelines.pdf This is older and they don't like Lamictal (which has since proven much safer and effective) but it is well worth printing out, highlighting, reviewing, etc.

 

Honestly, everything you wrote screams early onset bipolar to me..........but I am not a doctor and don't even get to play one on TV.

 

IF it is bipolar, I would really worry about the 3 antidepressant family of meds she is on. Those usually cause more cycling over time.

 

I would ask the doctor about a mood stabilizer for her. The general formula for this would be 1-2 mood stabilizer with an AP (the Ripserdal) and then later a med for ADD/ADHD if needed (and our pdoc said that Dexedrine is the one she finds that works the best without triggering more mood issues).

 

I dont' know if she would do a phone consult with your doctor or not but ours sure knows her stuff and started seeing our older dd at age 2.

[Tap]

Does she have a working diagnosis? PDD-NOS most like Aspergers, SPD, GAD.

What meds did you start in what order? Of her current meds (many others have tried/failed) Trazodone, Risperdal, Strattera, Zoloft.Have you tried maxing out 1 or 2 without the others? Yes, as we added each drug we went up to a threshold, then back down, to find her 'sweet spot'. Over time we have played with them as other meds were added. Have you tried Melatonin for sleep? not effective for her.

 

Just thinking out loud here as I know what you mean about the meds. My now 16dd is on Keppra XR and Lamictal (seizure meds also used for bipolar), Risperdal and Dexedrine (older ADHD med).

 

I guess my question would be why is she on 3 antidepressants? I know they all work differently but Zoloft I think is an SSRI, while the Strattera is an SNRI (cousin), and Trazadone is an older AD. Yes, you are correct. We use them all because they affect different chemicals. Zoloft is seratonin, Strattera is Nor epinephrine, Trazodone is a tetracyclic antidepressant.

 

Was she ever on the Risperdal WITHOUT the Strattera? Yes. twice. On it, off 6mths/switched to Abilify, back on/dropped Abilify. We just added the Strattera in January. I ask as Strattera caused more behavioral issues with 2 of my kids that took it. One even became violent that wasn't violent before. Strattera for her is a wonderful drug. It has opened up parts of her brain/thinking that wasn't accessible before. Things like creativity and playing with toys are 2 of the most notable. She had tried/failed 2 other meds for ADHD first.

 

 

I guess the question is--do you need all of the meds or are you using some of them to cover up the negative side effects from another med? Again...NOT blaming you at all, just asking the tough questions. I am open to any questions that may help me find an answer. I am very thick skinned. You would have to hit me with a stick to offend me. LOL No, I really don't think we are using them to treat side effects. Each med has a specific effect on her. She doesn't seem to have many side effects from her meds. She has in the past, but not her current ones. Each time we add a new med and get stable on it, I try to reduce her Risperdal or Trazodone, but both are at the minimum dose that is therapeutic for her. In fact they have both increased in the past year. Her doctor really doesn't like her on the dose of Risperdal at her age. He would prefer her on a different med since it isn't doing all we hoped it would. BUT it does help, so we keep her on it.

 

 

 

Have they ever tried her on a mood stabilizer? Lamictal is very good for moods including rages and depression. Lithium was wonderful here but my daughter couldn't take it when they stopped making a certain name brand one (she has a rare mito issue though). Tegretol and Depakote are others commonly used. It might be that a mood stabilizer would help and eliminate the need for some of the other meds. Her psychiatrist and I were just going over these meds last night. We are considering them, but we decided to try adding the Abilify back in first and then try to reduce the Risperdal. We tried this before, but her Dr wants to try it again, because she wasn't on the Strattera and Zoloft before. I agreed to a 2 week addition and we will see from there. I won't spend 6mths on it this time like last year. In theory it should work better than the Risperdal. If the Abilify doesn't work this time, we are moving to a anti-seizure med instead.

 

Right now my daughter who is very complex is on 2 seizure meds (also used for her bipolar), Risperdal (an atypical antipsychotic) and Dexedrine (used for ADHD but doesn't trigger mood issues).

 

One place to look for good doctors is http://www.bpkids.org and look for the "find a doctor" link. Even if you aren't dealing with a mood issue, these doctors tend to be very good.

 

This site looks interesting, thank you. If you are in driving distance of West Michigan, I LOVE LOVE LOVE our ped. psychiatrist. Little too far from Washington. :0)

 

 

I feel like we have a pretty good doctor but we may need some fresh eyes on her. He specializes in Children and goes to extra conferences each year to stay current. I feel like he listens to me (I work in pharmacy and I feel like he discusses the medicines with me more than he would most parents. --based on our first visits before he knew what I did for a living). He definitely makes me feel like I am part of the decision making process. The other thing I like, is that he will see her once a month, but encourages me to call once a week to talk to him, if we are changing medicine or are struggling. Her behavior therapist, that we see weekly, is in the same group, so he also has immediate access to her notes as well. They discuss her case at round table with all the clinicians, often. LOL

 

 

 

Some things we have tried/failed (just the ones off the top of my head).

Clonodine--zombie

Kapvay (long acting Clonodine)-zombie

Amantadine--don't remember

Prazosin wasn't a fail but we are using zoloft instead right now

Adderall--no effect/irritability

Methlyin--no effect/irritability

Abilfy (trying again right now)--made many things worse

Guanfacine--made her angry

 

 

Our next steps will be to try the antiseizure meds. Most likely Lithium or Lamictal. She gained a lot of weight on the Risperdal/Abilify in the beginning so we are concered about the weight gain on Lamictal too.

[Tap]

I disagree about bipolar being diagnosed at that age. My daughter was and it was accurate. Most pdocs though will go with a "working diagnosis" of Mood disorder NOS at that age.

 

http://www.bpchildren.org/files/Download/TreatmentGuidelines.pdf This is older and they don't like Lamictal (which has since proven much safer and effective) but it is well worth printing out, highlighting, reviewing, etc.

 

Honestly, everything you wrote screams early onset bipolar to me..........but I am not a doctor and don't even get to play one on TV.

 

IF it is bipolar, I would really worry about the 3 antidepressant family of meds she is on. Those usually cause more cycling over time.

 

I would ask the doctor about a mood stabilizer for her. The general formula for this would be 1-2 mood stabilizer with an AP (the Risperdal) and then later a med for ADD/ADHD if needed (and our pdoc said that Dexedrine is the one she finds that works the best without triggering more mood issues).

 

I dont' know if she would do a phone consult with your doctor or not but ours sure knows her stuff and started seeing our older dd at age 2.

 

He recognizes that she may end up with a Bi-polar diagnosis. We have talked about it a few times. Especially since she is cyclic, to the same week each month. Her 3 worst days each month are predictable, and then they are followed by a day of clarity, then she goes back to her regular difficult self. His sticking point with her, is that she doesn't have the depression with it. She has aggravation but not depression. He agrees that it is a likely diagnosis. He doesn't want to put that label on her yet as he feels we already have enough to work with and he would use similar meds to treat it. He is treating her symptoms and just not trying to worry about labels, aside from what we have to have to get medications approved by the insurance and her aid for school, etc. That is why he left the diagnosis as PDD-NOS for now instead of Aspergers. He doesn't want to limit her with a more confined diagnosis.

[WeeBeaks]

Our next steps will be to try the antiseizure meds. Most likely Lithium or Lamictal. She gained a lot of weight on the Risperdal/Abilify in the beginning so we are concered about the weight gain on Lamictal too.

 

My DS is ADHD/bipolar. He was like what you are describing at that age. He has stabilized incredibly since he was put on antiseizure meds to stabilize moods. He then was able to get off the risperdal. He takes Trileptal. It has not caused any weight gain (I wish it would, he is 9-1/2 and 57 pounds).

 

Your doc actually sounds decent to me. We have a really really old school psychiatrist who is also good. My son is now in a partial hospitalization program for therapies. His meds seem adjusted, and he is getting 6 hours of therapy a day now to try to address some social skills and behavioral issues.

 

Our son takes the Trileptal (mood stabilizer), Intuniv (long acting guanfacine or Tenex) for impulsivity and generalized hyperness and an older stimulant of dextroamphetamine. We only use melatonin occasionally now, and he sleeps reasonably well. His huge bash the house down rages are gone on the Trileptal whereis they were not on the Risperdal he used to take. What a relief. The other stuff I can work on.

[Tap]

First, :grouphug: I have a very similar dd who has been on meds since she was four. I feel your pain.

 

I'm assuming you're seeing a child psychiatrist? The next question to ask would be how many other patients does he have who are on complicated cocktails, like your dd. How experienced is he with complex mental illness in young children?

 

The truth is, though, mental health care in 2012 is more art than science. It's a very subjective process of trial and error, based on what the doctor's personal experience, and (hopefully!) based on what he is reading in current literature and learning at annual conferences.

 

Your dd's med combination sounds very reasonable to me. (Like I said, btdt.) Unfortunately there isn't a magic pill, nor is there a blood test to say "we need to lower this or increase that". Someday, but not yet.

 

It is immensely hard to tease out which behaviors are can be helped by meds, and which are just those things that will have to be handled through other means. And just wait until she hits puberty. Good grief. It is my daily struggle right now to determine what is "normal puberty" and what is "bipolar/adhd/anxiety/etc". (Sorry, I hate when people say "just wait", and I just did it! Ugh.)

 

All that to say, your doc sounds like he's on the right track. Don't be afraid to trust you own gut, though. If there's something that's bothering you, talk to him. (I love that you did this! No need to be afraid to talk to your own doc!) And if you just can't get settled about it, get a second opinion. We changed doctors about two years ago and it's one of the best decisions we ever made. (Ftr, the first doc was a world renowned researcher on the subject of adhd and comorbid (co-occuring) disorders, but he had absolutely NO bedside manner. We switched to someone we could TALK to, and who we felt was hearing us. Made all the difference.)

 

As always, wine and chocolate for all of us!!

 

I dread puberty....absolutely dread it. I tell her doctor that when she hit puberty, both dd and I will be well medicated. LOL DD5 is my great-niece and I know what her mother was like as a teen.....:banghead: Just one example, her mother kicked out the car windshield, as my sister was driving down the road!

[Tap]

A Q for those with bipolar that showed up in young children. Did you see the typical depression? What did it look like for you child? What age did it start?

[WeeBeaks]

A Q for those with bipolar that showed up in young children. Did you see the typical depression? What did it look like for you child? What age did it start?

 

We have never seen typical depression as I would expect it in an adult. He does get angry/tearful versus a kind of mania. Mine was diagnosed questionable bipolar about 6ish, more confident now it probably is (he is 9-1/2).

[swellmomma]

:grouphug: Gosh you just described my son at that age, toss in fire starting and running away and you have my life back then. At least by 5 he had stopped smearing feces everyday.

 

I have no answers for you, as most here know ds is still a major struggle at 13. He was on risperdal at age 3 but we took him off. THen at 6 started ritalin, at age 7 was celexa for a spell. He has never been on a cocktail like you wrote so I have no ideas as to that. In fact he has been med free for 2 years. YOu know what it is like with your dd without meds. Yeah have that in the 130lb body of a teen boy.

[swellmomma]

We have never seen typical depression as I would expect it in an adult. He does get angry/tearful versus a kind of mania. Mine was diagnosed questionable bipolar about 6ish, more confident now it probably is (he is 9-1/2).

 

:iagree: Both my ds and I present with anger and irritability when depressed. Neither of us have crying/weepiness that you would think would show depression. Nope we get ready to fight the whole world when depressed.

[Tap]

:grouphug: Gosh you just described my son at that age, toss in fire starting and running away and you have my life back then. At least by 5 he had stopped smearing feces everyday. Yeah, she stopped that by about 3yo. Those were the days! LOL I have no answers for you, as most here know ds is still a major struggle at 13. He was on risperdal at age 3 but we took him off. THen at 6 started ritalin, at age 7 was celexa for a spell. He has never been on a cocktail like you wrote so I have no ideas as to that. In fact he has been med free for 2 years. YOu know what it is like with your dd without meds. Yeah have that in the 130lb body of a teen boy.

 

:banghead:<<< Yeah, I feel like this many days already. She is an 70lb 5yo who is a mass of muscle. I have to sit on my knees, straddling her to restrain her. Even then, she can just about throw me and I weigh 135lbs. . I look at my friends new baby and you can just feel the sweetness. DD5 came to us at 5mo...she never had that feeling to her, even before we started to figure out that she had issues. :(

[swellmomma]

:banghead:<<< Yeah, I feel like this many days already. She is an 70lb 5yo who is a mass of muscle. I have to sit on my knees, straddling her to restrain her. Even then, she can just about throw me and I weigh 135lbs. . I look at my friends new baby and you can just feel the sweetness. DD5 came to us at 5mo...she never had that feeling to her, even before we started to figure out that she had issues. :(

 

I used to sit behind him with my legs wrapped around him cross legged and my arms around him in a bear hug and my head tipped sideways to avoid having my nose broken by his head when I needed to restrain him. He is too big for that now, but sometimes it was the only way to calm him down. Of course the judgemental comments and looks from those who didn't get it and would assume I was hurting him and that was why he was freaking out.

 

Ds never had that vibe coming off him either even as a brand new baby. I knew when he was 3 months old something wasn't right. I have been struggling with him his whole life with very few answers. My other kids had that baby sweetness roll right off them. I loved ds from the minute the line turned pink, so it wasn't that I wasn't wanting it, nor was it that I didn't know what I was talking about, I had worked with kids for over a decade when I had him (of course because I was young it was assumed I had no idea what was normal etc). I still love him dearly, I will never quit trying to help him. But I do not like him at all. These last 2 years have been so flipping hard, and not getting any better. I wish I could go back to when he was 5. HE was a huge trouble maker back then, but he was still a cutey too so it was easier to cope. Or maybe I just wasn't so tired back then.

 

I hope you find a treatment plan that works for you and your dd. :grouphug:

[Tap]

I used to sit behind him with my legs wrapped around him cross legged and my arms around him in a bear hug and my head tipped sideways to avoid having my nose broken by his head when I needed to restrain him. He is too big for that now, but sometimes it was the only way to calm him down. Of course the judgemental comments and looks from those who didn't get it and would assume I was hurting him and that was why he was freaking out.

 

Ds never had that vibe coming off him either even as a brand new baby. I knew when he was 3 months old something wasn't right. I have been struggling with him his whole life with very few answers. My other kids had that baby sweetness roll right off them. I loved ds from the minute the line turned pink, so it wasn't that I wasn't wanting it, nor was it that I didn't know what I was talking about, I had worked with kids for over a decade when I had him (of course because I was young it was assumed I had no idea what was normal etc). I still love him dearly, I will never quit trying to help him. But I do not like him at all. These last 2 years have been so flipping hard, and not getting any better. I wish I could go back to when he was 5. HE was a huge trouble maker back then, but he was still a cutey too so it was easier to cope. Or maybe I just wasn't so tired back then.

 

I hope you find a treatment plan that works for you and your dd. :grouphug:

 

She has head butted me so many times! The last time I restrained her by holding her from behind, I think she gave me a bit of a concussion with her head butt. She went back wards, and I dodged, but not far enough. I think she finally got tall enough to reach me with full force. She caught the side of my head right behind my ear. I can still hear the 'thud' inside my head when I think about it. My brain just felt 'broken' for few days but I got better.

 

Her therapy helps. It really does. I see little things every day that show me that things we did 2 years ago, stuck in her mind, even if it didn't seem to at the time. There are times when I want to stop because I don't see any real time benefits, but then something that we did sooo very long ago, comes to the forefront and I know to press on.

 

I hear so many stories like yours of a hellacious teenage period. I can't imagine the toll it takes on the family. :grouphug::grouphug:

[jewellsmommy]

I see ds in so many of these posts. :grouphug:

 

We are his guardians, and he has a lot of trauma plus mental illness.

The official diagnoses is severe ADHD, ODD, PTSD and mood disorder (though they strongly suspect bi-polar, they won't give that official diagnosis yet.) The psych. is also still tossing around an attachment disorder possibility (DAD).

 

His meds include:

 

Risperdal

Trileptal

Adderall

 

He takes meds 4x a day. He was on Intuniv for a time, but his blood pressure went too low. Before us he had ritalin, then daytrana. The stimulants bring out aggression but his ADHD is out of control without them. He would literally forget the first half of sentence before he got to the end. He would have to stop and ask what he was saying.

 

He has major mood swings. He goes from a high bubbly to major aggression and back again in a very short span. His overall mood through the month is cyclic though. Dh and I joke that we always know when the full moon is coming.

 

I had been wanting to ask about others on here who have experience with these meds, but was uneasy about bringing it up. I will be following along. It is sad but reassuring to know that there others in the same boat.

[jewellsmommy]

A Q for those with bipolar that showed up in young children. Did you see the typical depression? What did it look like for you child? What age did it start?

 

 

Ds, as I said, is not official bi-polar but highly suspected to be. We do not see a typical depression. He gets edgy, aggressive, and in an overall bad mood. He will also try to push us into a confrontation and then hurt himself (biting or pulling out hair). Right now he is intent on scrubbing the skin off his hands since he discovered that he can make them dry and irritated by washing them over and over harshly. :confused: And seriously, it seems to be around the the full moon.

[Tap]

Ds, as I said, is not official bi-polar but highly suspected to be. We do not see a typical depression. He gets edgy, aggressive, and in an overall bad mood. He will also try to push us into a confrontation and then hurt himself (biting or pulling out hair). Right now he is intent on scrubbing the skin off his hands since he discovered that he can make them dry and irritated by washing them over and over harshly. :confused: And seriously, it seems to be around the the full moon.

 

 

You are one of the first people that I have talked to who had a child who was predictable in their cycling. Have you figured out anything about it, other than to watch out for it? I have looked for a cause, for years. Hers became apparent the time she was 2yo. It is possible that it was there before that, but that is when I caught on.

[chiguirre]

:grouphug: Tap, tap, tap

 

It's so hard when they're big enough to really hurt you!

 

I've had a similar experience to Ottakee as far as mood stabilizers and APs being the key to behavior improvement. GW takes Depakote and Risperdal and is very manageable even though he's 5'6" and 110 lbs now. Things were MUCH harder when he was an unmedicated 5 yo throwing violent tantrums and randomly hitting me several times a day.

 

We did try Abilify a few years ago and ended up with really intense aggression that built over time. Keep a sharp lookout for that if you do another trial. It was the worst experience I've ever had as a parent. However, it reconfirmed that Risperdal was the med of choice for GW and we haven't had that level of violence again.

[Ottakee]

His sticking point with her, is that she doesn't have the depression with it. She has aggravation but not depression. He agrees that it is a likely diagnosis. .

 

READ the book, THE BIPOLAR CHILD and search the sites http://www.bpkids.org and http://www.bipolarchild.com

 

Depression in young children and teens OFTEN presents as irritability, rages, anger, etc. It is rare to see a child that shows more "adult like" depression--sadness, crying, excessive sleeping, etc.

 

The more you say, the more I really think you and the doctor should strongly consider the Lamictal or other mood stabilizer. Honestly, Lamictal and Lithium together was our dynamic duo. The changes were amazing. She honestly went from my most difficult child to my EASY child. We just couldn't stay on the lithium due to change in formulation and she is very sensitive to that.

 

My idea (again, NOT a doctor) would be to discuss starting and ramping up the Lamictal. You do have to start low and go slow and there are blood tests to help get the right level. My 16dd, 100# is on 200mg am and 175mg pm but my 15dd who is 120# is on 62.5mg twice a day (so less than 1/3 of the dose) and they have the same blood levels.

 

After that you could start SLOWLY weaning some of the ADs and go from there. This honestly might be a process of a year or more unless she is hospitalized but the right med combo here makes like 90% better. We still have a few minor issues but honestly, the meds are 90% of the answer.