Anybody dealing with BiPolar (BP), Obsessive Compulsive Disorder (OCD) and Tourette's?

Discussion in 'General Parenting' started by DDD, Feb 18, 2012.

  1. DDD

    DDD Well-Known Member

    My best friend is helping to raise her bright and beautiful gdaughter. She and the child's Mom are into organic and natural solutions and finally have recognized that medications are necessary. I'm going up to spend the night next week and she asked what medications worked best...with the fewest side effects, etc.

    Obviously they are seeing a psychiatrist but I thought I'd just toss out the question to you guys. I've never had that combo of diagnosis's in our family and after all these years I totally realize what works for one may not work for another. on the other hand, thought I'd get updated via this post. DDD
     
  2. klmno

    klmno Active Member

    That's a tough one. difficult child obviously has his defiance issues and a mood disorder that has been treated as BiPolar (BP) in the past with mood stabilizers. From what I gather, even the typically used MSs have varying effects on kids ond adults. Throw in Tourretes when MSs can cause such side effects and I'm at a complete loss. The best I can suggest is to make sure a complete and thorough neuropsychologist and physical/blood test are done prior to anything and then make absolutely sure this is a competent, Child & Adolescent Certified psychiatrist. Then cross fingers and be prepared for many medication trials. And get an IEP going- the medications alone will probagbly result in the need for one because they can result in a drastic change in behavior.

    How old is the girl?
     
  3. DDD

    DDD Well-Known Member

    She's newly ten. The combo is beyond my knowledge, too. They do have professional help now but it's not working out the way they hoped. Many of us, of course, have been there done that. Trialing different combos seems to be particularly hard for them as they are so into natural supplements etc. Both my friend and her adult daughter are smart people but I figured it wouldn't hurt to see if any of the family has dealt with that combo of disorders and found some success.

    I'm looking forward to a day out of town. I may have to eat tofu but I know there will be some Cutty waiting for me so I can wash it down. :bigsmile: DDD
     
  4. klmno

    klmno Active Member

    LOL! Enjoy your day!!

    Re. the child, the only other thing I can think of is to ask if they are sure of the diagnosis- has she had EEG and an evaluation by a neurologist?
     
  5. tictoc

    tictoc New Member

    My 9 year old difficult child has that combination of diagnosis's. And, medication has been difficult because we have to work on so many issues at the same time. My husband started out adamantly opposed to medications, but over time came around because we were not making any progress without medications and difficult child was miserable.

    To start, the parents are going to need to familiarize themselves with the various classes of psychiatric medications, because their daughter probably will need several. I recommend, " Straight Talk About Psychiatric Medications for Kids," by Timothy Wilens.

    Our difficult child's tics have never been the primary issue. They are bothersome to him, but have not impacted his life in the way that his mood cycling and aggression has. So, for us, regulating his moods and dealing with aggression have always been the most important issues. difficult child's Obsessive Compulsive Disorder (OCD) has been serious, but has always taken a backseat in treatment plans because it is hard to do anything about the Obsessive Compulsive Disorder (OCD) without first getting the moods under control (since Obsessive Compulsive Disorder (OCD) is best treated with SSRIs).

    With this diagnosis combination, some psychiatrists argue for going straight to the atypical APs because they work well with aggression and also help with tics. And, many psychiatrists argue that the atypical APs also have mood stabilizing qualities (which we have found to be true for difficult child). However, given the parents' position on medications, this might be a difficult step for them to take. If their daughter does NOT have a lot of aggression and her tics are NOT a major concern, then starting with a mood stabilizer instead of an AP could be a sound position.

    A note on AP side effects: husband and I were very worried about trying APs. The side effects just sounded too horrendous to even risk. But, we eventually had to try them because difficult child's progress on mood stabilizers had stalled. difficult child has tried Abilify, Seroquel, and Risperdal. None of them are perfect. All three have been effective for difficult child's tics, though he eventually developed akathisia (restlessness and muscle twitches) on Abilify. These symptoms were very different from his tics and there was no question of confusing the two. One advantage of Abilify is that it generally does not lead to the weight gain that other APs often cause. Of the three, we have found Risperdal to be the best for difficult child. It did cause some short term weight gain, but with a good diet and plenty of exercise it has not been a major concern.

    The mood stabilizers: As I said above, if aggression and tics are NOT major concerns, then maybe a mood stabilizer is a good place to start. Many people think Lithium is scary (I used to), but that might be a good place for the parents to start their research, especially if their daughter's moods tend towards mania rather than depression. Lithium has not been a cure-all for our difficult child, but it did give us a huge step in the right direction and I think our subsequent progress would not have been possible without it. Lithium has been around for a long time and its dangers and side effects are well-known. It does require somewhat frequent blood draws, but our difficult child (who generally is not a very cooperative child) does well with them.

    We have also had good luck with Trileptal (and no side effects), though it did not work for difficult child long-term.

    Finally, the SSRIs: We tried both Zoloft and Prozac when difficult child was only diagnosis'd with Tourette Syndrome. Disaster! Both caused mania, so we were very reluctant to ever try an SSRI again. However, difficult child's Obsessive Compulsive Disorder (OCD) eventually got bad enough that we had to do something. With both a mood stabilizer and AP already on board, we decided to try Luvox. difficult child's Obsessive Compulsive Disorder (OCD) abated in three days. Getting the Obsessive Compulsive Disorder (OCD) under control has made a huge difference in his quality of life, but we couldn't do that until we had his moods under control. I have since read that Luvox is a good SSRI to start with because it has a very short half-life, so if it does cause mania it will get out of the child's system faster than others.

    I wish your friends and their daughter luck!
     
  6. DDD

    DDD Well-Known Member

    Thank you so much, Tictoc! Your response is exactly what I was hoping to receive. Using your guidelines I will read up a bit so I can either share ideas or be a good informed listener. The only things I know for sure is that she holds it together at school well (the school is small and specialized I believe) but not infrequently explodes at her home or at my friends home where she spends alot of time. I believe that she has been on Intuiv (so?) but don't what else. She also is going to a specialized "gym" for kids with sensory issues. My friend thinks that workout time is the most valuable therapy they have going. Oh yeah, lol, she stays on the move/go in every free moment. Having raised three ADHD kids and observing her...well, there's a difference. It's not hyperkinetic movement but it sure isn't peaceful either.

    Anyway, again, I appreciate your post. I'll print it out and review it myself before I go next week. My friend is an avid reader but I'll make sure to suggest that book in case she's missed it. Hugs DDD
     
  7. tictoc

    tictoc New Member

    DDD, Glad to be of some help. I forgot to add that the parents should check out the Child and Adolescent Bipolar Foundation website (www.thebalancedmind.org, formerly bpkids.org). This is not an uncommon combination of diagnosis's over there and the support groups are very good.

    And, yes, I agree that the the type of "on the go" with a mood disorder is very different from ADHD. You just have to see it to know that there is a huge difference.
     
  8. DDD

    DDD Well-Known Member

    Thanks again. I ordered the book online this afternoon and hope to receive it in time to take it with me next Sunday.
    I do know that her Mom is part of the Tourette's online support group as a Mod ?? or leader if some type. DDD
     
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