Depakote trial update and questions...

Discussion in 'General Parenting' started by gcvmom, Jul 27, 2007.

  1. gcvmom

    gcvmom Here we go again!

    difficult child 2 has been on Depakote for about 5 weeks now and husband and I definitely see improvement from the medication wash period and the first few days on the new medication.

    Things that are noticeably better: oppositionality, argumentativeness, tantrums, obsessions, irritability, aggression, anxiety.

    Things that are slightly better: impulsiveness, grandiosity, silliness, boundaries.

    Things that are unchanged (or very minimally): hyperactivity, inattention/distractibility.

    There are many other behaviors I could mention, but these are the biggies in my mind.

    For the BiPolar (BP)/ADHD kids out there, does this sound like a typical response? What other medications did you end up adding to address the ADHD issues? I'm really hoping we're on the right path and wondering what to expect next.
  2. smallworld

    smallworld Moderator

    Sounds as if you've gotten a positive response to Depakote. Is he currently taking a therapeutic dose? You may have to wait a few more weeks (6 to 8 total) to see full effectiveness.

    My son's inattention and depression were not addressed by Depakote at all, although his mania was stopped dead in its tracks. We switched him over to the mood stabilizer Lamictal to address the depression and added a low dose of Lexapro. He also takes a low dose of Focalin XR (10 mg) to help him focus on school days.
  3. Steely

    Steely Active Member

    Yay! It sounds like you have gotten a great response to the Depakote in terms of mood stabilization!

    When my son was on it, it in no way addressed my son's inattention. At the time we added Seroquel, which helped some - however now that we have switched to Clonidine, that has seemed to help the most with the ADHD symptoms.

    Good luck!
  4. pepperidge

    pepperidge New Member

    My son is on 5-10 mg
    Adderall XR In addition to everything else. It is the only thing that seems to help him focus at school. Lamictal helped depression, and the risperdal keeps anger and aggression at bay--though to be honest, the Adderall may not help in that department. Risperdal also helps with the extreme silliness. Abilfy helped my youngest with impulsivity.

    May be worth trying lowest dose of stimulant (or maybe Abilify) to see if they help.
  5. gcvmom

    gcvmom Here we go again!


    He's holding at 750mg and had labs done this week -- psychiatrist's secretary left a message saying me that the levels were fine (I need to get a copy of the report) and to leave the dosage where it is.

    I left word for him about what I'm seeing, and want to know how we're going to address his other symptoms.

    Thanks for the info on the medications that helped your difficult child :smile:
  6. gcvmom

    gcvmom Here we go again!

    Thanks Weepingwillow for sharing that info with me :smile:
  7. gcvmom

    gcvmom Here we go again!


    Adderall XR was not good for aggression/anger in difficult child 2 when he was on it a few years ago, so I don't think we'll go back to that.

    He did do really well on Concerta and even Focalin XR/Focalin for a while. So maybe a very low dose of that would help -- I know the stims did a lot for his attention and focus before things started to fall apart.
  8. DDD

    DDD Well-Known Member

    My youngest difficult child (now 16) started on Concerta (72 mg, believe it
    or not) and then Depakote and Risperdal were added. It has been
    a terrific combo for him. Now he has good grades, good conduct
    and is making progress toward maturing into having a good life.
    It's tricky but if you hang in there you can find the right
    combination. DDD
  9. mattsmum

    mattsmum New Member

    My difficult child was on 750mg of was just increased to 1000mg. He is having blood work done next week to check levels.\

    He has been on Depakote since end of June. I have noticed that he seems to be more in control of his anger and is more "teachable."

    The true test will come once he is back in school.
  10. gcvmom

    gcvmom Here we go again!

    Okay! DDD and Mattsmum, this is very encouraging to hear :smile:

    We were at a family party today and many of the folks haven't seen difficult child 2 since the start of his medication wash. Everyone said they thought he was doing much, much better than before (love that validation/affirmation, whatever)!

    We've also now got a new therapist who I think is going to be an excellent fit for difficult child 2's needs and who also knows our psychiatrist very well AND who has extensive experience with our school district (which will come in handy when we need to modify or possibly even change the 504 to an IEP).

    I think I'm actually starting to relax a little!
  11. Janna

    Janna New Member

    It sounds like the Depakote is really working well! That's good news. Dylan tried it too, and we started to see small differences (in conjunction with the Lithium) at 500 mg. per day, but he got really ill belly aches, and started cramping and such, so we had to discontinue it.

    There seem to be quite a few kiddos here that can tolerate ADHD medications, which surprises me. We have tried them all, every one of them, even recently again, trying Concerta, because Dylan was SO incredibly, miraculously well. And it failed.

    I would try reading up on the atypical antipsychotics (Abilify, Seroquel, Risperdal, Geodon) and consider something along those lines. Although they are not targeted to deal with ADHD symptoms specifically, we had good luck with the Abilify, because it slowed Dylan down some, took care of the hyperactivity and impulsivity.

    We had to put him into a special class, Emotional Support, because there's just no way he can keep up with the mainstream kids. If you can treat the ADHD, that's awesome, but if you can't, you may want to look for other interventions in school to help your difficult child get along.
  12. Wiped Out

    Wiped Out Well-Known Member Staff Member

    Our difficult child was on Depakote for almost 2 years at one point. While on that he was on other ADHD medications as well. Unfortunately, for our difficult child he just can't tolerate any ADHD medications because of his BiPolar (BP) but there are some that can!
  13. gcvmom

    gcvmom Here we go again!

    That's interesting to know... he's used Risperdal and then Abilify with the stims in the past with hopes of helping his emotional outbursts and impulsivity where they were almost daily issues on the playground. The helped a bit, but not enough. So perhaps those will be revisited in a few weeks (I think I still have some of both!)

    I may be asking this group later for some ideas on what interventions have worked in the school setting because his current 504 plan does not take his current mental/behavioral landscape into account.

    Thanks again :smile:
  14. gcvmom

    gcvmom Here we go again!

    I hope that's not the case for difficult child 2... but I know it's possible that he won't be able to take stims any more.

    During that 2 year time on Depakote, were the stims sort of working, not working at all, or making things worse for your difficult child?