Abilify

[crazymama30]

For those of you with kiddos on abilfy, I have a question. difficult child was just increased to 5mg. I have always given it at night. psychiatrist mentioned difficult child may need a morning dose and I was just wondering if anyone had given abilify twice a day and did it seem more effective when given this way?

difficult child has been getting increasingly irritable and moody. Frustrated to the point of tears too often. He has been hypomanic several times, and his attention has been lacking. I am concerned as school starts next week and I was hoping to have him in a better place. psychiatrist mentioned increasing Daytrana--but I want to wait on that as the last scrip he wrote me was for 90 days of Daytrana. I have 3 boxes of patches at home to use up and I really don't want to waste them unless I have to. They are too blasted expensive, but I would replace them if I had too.

I am really nervous about difficult child's field trip next week. He leaves on Wednesday for a 2 night field trip. He will return on Friday. I dropped off his medications at the school yesterday and told the director of the school that I could leave work at anytime during the week. I am fortunate to work in a flexible dept during the week. I am not going on the field trip, I think that I am doing the right thing for difficult child, but I am going to be a nervous wreck.

 

[TerryJ2]

Aw, Crazymama, I feel for you. He'll probably be okay and of course you'll be a wreck. My motto has always been "No news is good news."
That's why I hate it when the phone rings!
Others here will have more experience and advice in regard to the Daytrana and Abilify.

 

[ML]

I sure hope you get the right medication combo worked out. That is so hard. I think manster is having a good ride right now but it's a odaat gig. The 2 day field trip is next year here and I'm not looking forward it. My prayers are with you that he does great and you hear nothing. Hugs, ML

 

[klmno]

I don't know about giving 2 dosages a day- sorry. I wanted to remind you though that if this worsening of behavior happened after giving abilify, it might be the abilify causing it. It has an adverse effect on some kids.

 

[rlsnights]

with mood cycling you're reporting (irritability could be hypomanic) I would increase lamictal first. also has lower likelihood of metabolic effects.

has he had a speech assessment? if not I would get one - preferably on your own since schools tend to do very poor speech assessment. you may find that there is a undiscovered language issue complicating everything. true with my son who sounds very similar. and I mean language - not speech. speech pathologists work on more than just the ability to pronounce words. think pragmatic speech issues for example.

 

[pepsichic9115]

My difficult child is on Abilify. But thats the only thing she is on. She started out on 2 mg @ night, then upped to 2 in the am and 2 in the pm. It didnt help @ all. The dr then upped to 5mg @ night and a week later added 2mg more in the am. It just doesnt seem to be helping at all.

When psychiatrist gets back from vacation after the 23rd, we will be requesting either all new medications or something added.

 

[totoro]

Hey Mama!
K splits hers. 2.5 in the a.m and 2.5 in the p.m.
She was doing the whole 5 mg in the a.m. but she was getting agitated and to worked up in the evening.

Now after a few months of this who knows if it is working... sigh.
But it did for a bit!

 

[crazymama30]

Ok, try to addresss all the questions. difficult child has had extensive speech therapy, just graduated in 5th grade from it. He was evaled by the school and also had an independent evaluation. He still has speech issues mainly due to impulsivity in the area of fluency.

He has Occupational Therapist (OT) weekly (once school gets in a good rythm and the field trip is done) by an independent person, not through the schools. I am fortunate to have good insurance that covers this and his counselor visits. Poor kid will be busy this school year, with Occupational Therapist (OT), therapy and then he wants to do basketball and wrestling!

He was on 4mg of abilify before Thursday and it did wonders for him. He was doing great for the last 3 months, but I think the beginning of school and going hunting with daddy and having his schedule thrown off from that have caught up with him. I don't think the abilify is causing the mood issues, I think that he needs to get back on a schedule and a small bump in medications might help too.

psychiatrist does not want to increase the Lamictal, he is on 250mg. psychiatrist says his gut tells him not to, and I agree.

I think I may e-mail psychiatrist and cut the pills in half like you do toto, I think that would help. But the problem is the scrip says 1 pill a day and he goes on that field trip next week and they have to go by what the bottle says. I think I will wait and see, adn then change after the field trip. I don't think I could get a different scrip by the time he leaves on Wednesday, that would be hard. I so wanted to have this udner control before school started.

 

[gcvmom]

I would NOT increase the Daytrana. in my opinion that only makes mood issues worse. His attention issues can be made worse by unstable mood. I would either try the Abilify increase like the psychiatrist is recommending, or talk to him further about whether the Lamictal is doing enough and may need a bump as well.

Hopefully you can get things settled better for him by the time the field trip is here. I'd be nervous, too, if he was feeling like this and about to go on the trip without me. Maybe you can leave a message this weekend so you get an answer back by Tuesday. I know that doesn't leave you much time to see if any changes you make are helpful... then again, if your psychiatrist is like ours, he'll call on the weekend if he knows we're in a crunch for time.

 

[totoro]

If your psychiatrist gets the e-mail can he/she just fax in the change to the pharmacy? That is what mine has done.
Let him know you need it ASAP, if he agrees.
Just a thought.

We are falling apart now as well, I feel for you. We see psychiatrist Wednesday. Likely gonna mess with the medications! YEAH!
Hope things stabilize soon. Likely not for a bit... schedules take a bit. We still haven't gotten the school down and now we have the 3 day weekend. We have been back at school for almost a month now.

 

[rlsnights]

got it - you've covered many of the bases and I agree disruption in schedule + anxiety = trouble

agree with psychiatrist about lamictal = diminishing returns after 100 mg make raising it above 250 unlikely to make big difference although I am at 300 and found it has made a big difference for me.

rx issue - ask psychiatrist if he will tell pharmacy of change and ask them to just give you a new bottle with a different label - no rx just new label. have done this with my son when we had similar issue. worked out great. or you can ask pharmacist about it and she/he may be willing to call psychiatrist for permission.

treat anxiety short term with tiny dose of clonapin at night? may contribute to mood stabilization too but psychiatrist is one to ask. maybe just ask about option for prn medication for anxiety.

do relaxation exercises with him like deep breathing often so he gets used to that and he may remember to use it on his own and may be cooperative when you remind him in times of stress

do deep muscle/joint stimulation if you're not already - tug of war, wall push ups, roll up with sheet and pressure

articulate for him what's going on inside him * ask him, are you worried about the field trip - feeling all fluttery inside when you think about it? breathe deeply when you start feeing that - it will really help (then do a couple deep breaths yourself and it's likely he will do the same cause it's catching) * it's been hard to have our schedule disrupted - it will feel good to get back on track after the field trip* What would feel good to help you get ready for the trip? Pick out what you're going to take? Get your backpack ready? Plan a special lunch for the bus or snack to take? Walk to school with friends that day - call and talk about it? plan who to sit with on the bus for the trip? find out more details about where they're staying like who he'll be sharing a room with, what kind of food they'll be having etc?

 

[crazymama30]

rls--I think I am, no I know I am way more nervous about the field trip than he is. He will get nervous the day before he goes.

rx issue - ask psychiatrist if he will tell pharmacy of change and ask them to just give you a new bottle with a different label - no rx just new label.

That is a great idea I had not thought of. Will definately make use of that one.

I think I will hold off on the klonopin at night, pretty sure psychiatrist would not like that one too much, and it is not so much at night but during the day and from what I understand about klonopin (husband takes it) it mainly lasts for 12 hours. We have been pretty lucky with melatonin being all difficult child needs to help hm calm down to sleep.

You have given me some good sugestions and things to think about. Thanks, I will try to use some of them. It is so hard when he gets wound up to use these things, as sometimes it is all I can do to stay calm myself and try to get husband and easy child to not excerbate everything.

 

[pepperidge]

At one point when we were going up on Abilify we tried splitting it but am not sure it made a difference. I do think it might be a good idea though. I would be worried about going up on the daytrana because sometimes that can lead to greater anxiety. Before I threw out a bunch of patches, I would maybe ask the psychiatrist about bumping it with an add on pill form (Concerta?) --get a week's prescription or so and see what it does before going the 90 day route. What I would counsel against is going up both on Abilify and Daytrana at the same time. You should be able to tell in a few days whether you like the effects of Daytrana.

My youngest was on abiliby for several years. He totally bombed on all stims--made him anxious, hyperaware, more obsessed with wahtever idea. Abilify had a great impact on toning down his impulsiveness and I think it did also help his focus (which it has been reported to do, since it helps regulate dopamine). But now that he is going through puberty, we have definitely seen an increase in argumentiveness, modiness etc. He is not a BiPolar (BP) kid, though, more just emtionally disregulated with definite frontal lobe problems. We tried going up to 5 mg, but it made the moodiness and irritability worse. We then took him off of it, and it actually his mood seemed to have improved. So he is off anything for the moment. He's tried every class of drug and abilify is the only thing that helped even a little.

We also tried my oldest on abilify--who has definite depression issues--it didn't do anything.Niether did anti-depressants. Lamictal was what really made a difference in depression and irritability.

Just my experience, not trying to counsel you on what to do. Just whatever you do, do it step by step and one at a time.

I think new school, field trip, scheduling issues etc can throw all kids for a loop. Maybe you want to think about waiting a week until things settle down a little and then doing some medication changes.

Good luck. I bet the field trip will go well. They tend to do better without us sometimes,and the program he is in has surely dealt with kids with similar issues. I would be on tenderhooks too though. They'll be in touch if they need you...

Hugs.

 

[midwestdad]

We've done it both at night and twice a day, and it did seem to make a difference, both positive and negative. The plus side seems to be that activity level is a little more even.

 

[crazymama30]

All this info is great, thank you all so much. It really helps to have others point out different things I may not think about.

P--I only change 1 medication at a time. Sometimes psychiatrist has suggested both and we work around it. difficult child has been out of sorts for the last 3 weeks, but I could see it increasing and that was why we increased the abilify from 4mg to 5mg. I don't know if that small of a dose increase will do anything, but I would rather go slow.

Midwest dad--what were the negatives of giving twice a day?

 

[wakeupcall]

difficult child was put on Abilify, 5mg AM and 5mg PM. We did this for several months and I could never tell it did a thing to help him, so I weaned him off. It's waaaay too expensive if it isn't helping. difficult child is thirteen and weighs 120 lbs. He's small for his age. Is your difficult child close to mine in size?

 

[compassion]

My daughter is on 20 mg. in morning. She gets Lactimal 150 PM. My underwstanding is theat abilify is activating . Compassion

 

[crazymama30]

the abilify does/did help, so I am hoping it continues to help. My difficult child is a lot smaller than yours, mine is 11 and weighs 73lbs. He is dynamite in a pint sized package.

Abilify can be activating, but so can Lamictal. Thank you for reminding me of this as the last dose increase we had with abilify difficult child was activated for a day or two, and then things got dramatically better. I am surprised I forgot this.

 

[compassion]

Abilify helps lots with her rages. She has been medication adherent for 6 weeks now and no violence. Compassion

 

[totoro]

We give K her Abilify at 4:30 so it is usually done by bedtime as far as activating her.
7:30 am and 4:30 pm.
I actually may give it to her at 3:30 now that school is back in.
We are lucky though in regards to that fact that she is a good sleeper right now.
(Strict schedules do work sometimes! )