medication questions

[Loving Abbey 2]

difficult child is going to start taking Lithobid instead of generic Lithium. And she is starting Depakote ER (the 24 hour one) instead of the regular one. Now both of these cost more. Has anyone had any experience that these are actually better?

The psychiatrist says they have a few less side effects and are "smoother" throught the day.

Michelle

 

[smallworld]

Michelle, in general, extended-release versions of medications do tend to keep kids more even throughout the day. We've never used either Lithobid or Depakote ER, but we have trialed ER versions of other medications. Right now my son is trialing Seroquel XR (switched from regular Seroquel) to see if his morning fatigue improves. It's only been a few days so the jury is still out.

Unfortunately, the only way you'll know if it's better, worse or about the same for Abbey is if you try it. If things do improve, I personally think it's worth the higher cost. We recently had to switch from generic Zonegran to brand Zonegran because the generic just wasn't as effective. Our psychiatrist and neuro said this is very common with anticonvulsants. So we are paying more, but it is worth it for efficacy.

You might want to make one change at a time instead of switching both medications at the same time. That way you'll know for certain what the effect of each medication switch is.

 

[gcvmom]

My difficult child 2 has been taking Depakote ER for about a year now. I don't have anything esle to compare it to, though so I can't help much there. It has helped his mania symptoms pretty well so far. He recently added Seroquel XR and it is helping with his angry outbursts to a certain degree, as well as his attention, of all things. Although I don't think he's at a high enough level yet.

Like Smallworld said, you won't know if the new medication is better, worse or indifferent until you try it. That's the biggest problem we all face in trying to find the right treatment for our kids (or ourselves!)...

psychiatrists typically know their psychiatric medications really well, so hopefully the reasons yours has for switching your difficult child are on target.

Not knowing your insurance situation, have you shopped pharmacies in your area for pricing on the new medications? Some of the warehouse chain pharmacies are known for lower prices. There are also mail order pharmacies...

 

[Bugsy]

I am so short on time right now but I did want to say my son was hospitalized in March (probably due to strattera). None the less since then he has been doing very well on the extended release lithium and extended release depakote. Let me just put it this way. We went to Chuck E Cheese today for almost 3 hours. It was crowded! My father looked at me and said, "Look at him! He never could have done this a year ago."

This is the first extended period of time that he has been able to play in the house (building things, video games, etc), go to the pool without incident, go to a pool party, etc.

I have his blood checked every month and monitor it closely that he stays at a good therapeutic level for him.

good luck,
bugsy's mom

 

[klmno]

That's the same combination my son is on, too. When he reached therapuetic level on regular lithium, it make him sick at his stomach all the time. So, he was switched to lithobid. Later, when depakote was added, psychiatrist just automatically went with the ER type. difficult child has been on lithobid since last Sept., I think, and Depakote since either late Oct or early Nov.

 

[GoingNorth]

I can't take Lithium due to kidney issues, but I did switch from regular Depakote (valproic acid) to Depakote ER.

I LOVE the ER stuff. My blood levels used to be all over the map and I could really tell when it was wearing off, plus it upset my stomach.

Now, with the ER, my blood levels stay on an even keel, my stomach is much happier, AND I get better symptom control.

The one downside to the ER dosing is that I'm highly medication resistant and take a very high dose of Depakote. The pills are HUGE.

 

[klmno]

difficult child is prescribed 500 mg (total) per day, but since the 500mg pills are even bigger than the 250 mg, psychiatrist prescribed him 250 mg tablets. He wrote the script like difficult child was supposed to take one in am and one in pm- otherwise insurance wouldn't pay- but said difficult child could take both in am. difficult child prefers to take 2 250mg at one time over 1 horse pill!

Oh- you can't cut them in two and give half at a time- psychiatrist said it messes up the ER stuff in them.

 

[Sara PA]

Eskalith CR , another extended release version of lithium, is the only extended release drug that I know of -- not that I know a lot of drugs other than psychotropics -- that doesn't have the "must be swallowed whole and never chewed or crushed" warning.

 

[Loving Abbey 2]

I picked up the medication's last night at the pharmacy and then realized they gave me the extended release Lithium, but still generic not the Lithobid. The psychiatrist didn't check the little box that says dispense name brand--but he wrote lithobid! Pharmacy is going to call him but they are saying there is a shortage of all types of lithium-generic or name brand. They don't have any of the Lithobid and the drug company said it will be at least a week before they have any more to ship out. Since she is all out of the reg. lithium we are trying the generic ER for now.

As for the price issue...we go to Walmart because they are the cheapest. I do have insurance it's just the co-pays are alot when you have 3 medications, and several appointments a week for various docs and therapists. And her medications are being tweeked every few weeks to a month so I can't really order a 3 month supply. I would like to do that once she is stable.

I've also applied for a special insurance my state offers for kids with disablities. (She had been found eligible for Social Security but the claimed I made too much money...REALLY WHERE IS IT???) Anyway this program only looks at the kids disability and thier resources NOT the parents. I'm keeping my fingers crossed. It could take up to a month for a reply. I have heard that most people are denied and have to appeal to get it. The program would pick up everything my insurance doesn't cover including co-pays.

Thanks for all the info. I'll let you know how it goes!!

 

[butterflydreams]

Good luck on the whole insurance thing! I still have applications out for my difficult child. These medications and dr copays really add up.

Christy