Need Feedback on Depakote-difficult child at it again!!!!!

Discussion in 'General Parenting' started by wjaes, Mar 22, 2007.

  1. wjaes

    wjaes New Member

    Hello, I have been away for awhile and need advice. My difficult child is diagnosed with bi-polar. He has currently been taking Abilify 10.0 mg 1x/day and Clonidine 2 times/day (1/2 pill in am and 1 and 1/2 pill at bedtime). He continues to struggle with moods,oppositional behavior and has started some new behavior (playing with lighters). He is on spring break this week and my college age daughter has been watching him because the day care he usually goes to said they were full this week(think they probably didn't want him). She (college daughter) called 6 times between 10:00 and 12:30 because of his behavior. He wouldn't listen to her, wouldn't follow any rules etc. In the end, he locked himself in my bedroom and I had to come home from work and am not working today or tomorrow. I called the p-doctor and he said that he thinks we need to stop the abilify and start depakote. I am scared to death of the side effects. He has gained 23 pounds on the abilify (started the school year at 67 pounds and is not 90+). I have had to buy school clothes 3 times. I am worried about more weight gain, shakes and tremors etc. They would also like him to go to partial treatment at the hospital. We have did the partial thing 2 times and it's sort of good for nothing it seems. I drop him off and tell them how they day has been, I pick him up and the person who I pick him up from really doesn't know much of how they day went. There is not d/c staffing and then we are back home again. No ongoing plan, recommendations, etc. On top of that, it costs a bunch of money. I am certain there probably isn't a "magic pill" that will make all of this better but I am really worried about the depakote. The last time he was hospitalized (last Feb.) they recommended residential placement but I am afraid they will just medicate him into complacency and when he returns he will be more "different" than he is now, plus am mot sure if I can repeat that type of structure at home. Any feedback and all feedback would be welecomed. I am at the end of my rope (been here more times than i can count).
     
  2. Alisonlg

    Alisonlg New Member

    Oh hun. I haven't been there (yet), so I don't have any feedback or advice, but I just wanted to reach out to you and send you some big :::hugs:::
     
  3. wjaes

    wjaes New Member

    Thanks Alison...this is a long and not always very pretty road. thanks for the hug.
     
  4. mstang67chic

    mstang67chic Going Green

    My difficult child has been on Depakote for about 6 1/2 years and it has worked very well for him. Actually when he first went on it I saw an almost immediate difference in his behavior. (within about 2 weeks) Of course in his situation, he was on a completely wrong mix of medications. (He had been diagnosis'd with Bipolar before we got him but it was never kept up with so his behavior was just out of control. We had no idea about it until about a year after we got him) As for the side effects, he hasn't had any weight gain, he's a stick actually. (about 6 feet tall and around 130 lbs or so) I do notice his hands shaking now and then but nothing that is constant or seems to be bad enough to affect him at all.

    Granted, all kids react differently to different medications so take this with a grain of salt. And also, my difficult child isn't on any of the same medications as yours so I don't know about how the medications interact with each other. For us though, it was been a good thing with no real side effects. It did make him a little sleepy at first but he seemed to adjust to it. Currently though, he takes his Depakote at night so it's not an issue.
     
  5. wjaes

    wjaes New Member

    thanks Mustang...I am scared, have they increased the dose over time? what is his dosage?
     
  6. timer lady

    timer lady Queen of Hearts

    wjaes,

    A couple of thoughts....while depakote may indeed cause weight gain I would think the bigger picture would be stability. We went through several new "wardrobes" for kt when she started the depakote & then again with the tegretol.

    Having said that, the weight gain has leveled off, she's getting taller & thinning out.

    On Residential Treatment Center (RTC) placements - no one can match the level of structure provided in that type of setting. Home & family life is simply not able to maintain a schedule/structure of this type. Residential Treatment Center (RTC), at it's best, is used to stabilize then teach a difficult child coping/life skills. And it's generally not a short term endeavor. If any given Residential Treatment Center (RTC) doesn't have family counseling & parent strategies, a discharge/treatment plan in place before a difficult child is discharged, it's been a waste of time & money.

    Educate yourself, weigh the pros & cons to treatment with depakote.

    Take some deep breaths & calm your spirit....you've been at this a long time & it's not going away today or tomorrow. A decision isn't needed today. :flower:
     
  7. wakeupcall

    wakeupcall Well-Known Member

    Our doctor has always said he would rather difficult child be chunky and stable than the other way. Depakote didn't work for us at all. difficult child tried it two different times; the first time it made him vomit for three days, the second time he became very, very violent on it. NOT a pretty picture. Two days ago he started Lithium, so we'll see. Just keep an eye on your difficult child...maybe this Depakote will be the answer....
     
  8. wjaes

    wjaes New Member

    thanks timer lady...he has already gained so much weight, doesn't have coping skills and i am concerned about kids making fun of him for being overweight and his reaction...i am so tired of not being able to make anything better.
     
  9. wjaes

    wjaes New Member

    thanks pamela...i feel that things aren't cohesive and/or collaborated...i am the guardian of a mentally disabled man (friend of the family)..he was on depakote (he lives in a group home) and was very sedated, shaky (couldn't even hold a cup without spilling). this is the image i have in my mind...i am also concerned about how this might impact him as time goes on (higher doses,more side effects....). my brother is bi-polar and was his very most stable on lithium
     
  10. mstang67chic

    mstang67chic Going Green

    The psychiatrist has tweaked his medications over the years. Partly, I'm sure, due to the fact of his mutant growth spurts. Currently he's on 1500 mg of Depakote. According to the psychiatrist, it's as high as she wants to go (hence some of the other medications to help with it) but he's by no means a zombie. People see his medications and freak thinking that he can't possibly function but he does. Lately he's been sleeping a lot but he's been complaining of his legs and feet hurting so I think he's got another growth spurt coming on. ( so not looking forward to that! lol) Like I said before, everyone reacts differently but as long as the cons don't outweigh the pros, I would give it a try.
     
  11. smallworld

    smallworld Moderator

    Following my son's prolonged intense manic reaction to Zoloft, which caused out-of-control rages, he was prescribed Depakote. After 6 weeks at a therapeutic level (1000 mg in my son's case), the rages completely stopped. He gained a little weight, but not as much as when he was on Risperdal (Abilify's cousin). In my experience the atypical antipsychotics (Abilify, Risperdal) are much more likely to pack the pounds on than mood stabilizers (Depakote). Furthermore, the therapeutic level of Depakote can and should be measured by a blood test, which should diminish side effects like shakiness and sedation. Finally, if you start low and go slow with any medication, side effects can be tracked more easily.
     
  12. oceans

    oceans New Member

    I don't have experience with Depakote, but there are other mood stabilizers that don't cause weight gain. There is Lamictal and Tegretol. My nephew is on Tegretol and has lost weight. All you can do is to try one of the mood stabilizers and if you need to you can switch to another one. It is important that your difficult child becomes stable.

    I would consider an Residential Treatment Center (RTC) for major medication adjustments. The structure would be wonderful and combined with the right medications, he might be able to return home stable and with new coping skills.

    Going in the direction of stability is better than the place you are at right now...even if you start the mood stabilizer and keep him at home it will be better than refusing to try a mood stabiliZer.
     
  13. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    It depends on each individual. My daughter was on it for about a year and she ended up tossing it in the garbage. She was a teenager and she said it made her "stupid" and "feel drugged." She shook too, and developed ovarian cysts which can be a problem for girls. I remember she slept all the time and couldn't do her school work. If my kid had a BiPolar (BP) diagnosis., I'd want Lamictal or Lithium. I've especially heard a lot of people on Lamictal do well without those nasty side effects. Of course, there is no one perfect medication for every person. Remember, mood stabilizers take a full eight weeks to kick in, sometimes longer.
     
  14. wjaes

    wjaes New Member

    Thanks smallworld, oceans and midwest mom. We had a crisis tonight, he said he was going to the neighbors..I said no, he said yes (after yelling,crying, hitting his head, slamming doors)..i said , "if i can't keep you safe at home, i don't know if you can be at home"...he said, "fine, send me somewhere" and left. it's the first time I have been scared for my own safety. his dad called (we are not really together, he doesn't believe in his mental health diagnosis and contributes most of this to my poor parenting) and i was crying...he asked what was up and i said i was having a nervous breakdown and than our son has left. he said he would pick him up and he did. they came back here and now they are cleaning out his closet. difficult child is calm and as happy as a lark (when he came in he said his dad hit him in the eye)..i am sosooooooooo tired. i talked to the p-doctor and they said i could call the police to pick him up. his dad hasn't said a word to me since he got here.....i am so concerned!!!!
     
  15. Wiped Out

    Wiped Out Well-Known Member Staff Member

    My difficult child isn't on Depakote any more but he was for quite awhile and suffered no weight gain at all.
     
  16. Sara PA

    Sara PA New Member

    I'm always surprised when people express concern about weight gain with the anticonvulsants when there are antipsychotics involved. By far the drugs most likely to cause extreme weight gain are the antipsychotics -- Risperdal, Seroquel, Zyprexa, even Abilify and Geodon, just to name a few.
     
  17. GoingNorth

    GoingNorth Crazy Cat Lady

    These medications all have to be individually titrated according to the individual. I take 2250 mg of Depakote ER per night. That is what is required to keep me at a therapeutic level in the low 90s.

    Its a lot of medications, but I metabolize them quickly. I cannot take Lamictal due to suffering a psychotic reaction to the medication at all of 75ng,

    You have to remember that these medications are very different as is one's reaction to them. I noticed a small amount of weight gain on Depakote, but it wasn't until 10mg of zyprexa was added that I put on weight.

    You know something? I'd rather be stable than thin. That's my choice as an adult and that with requiring Cogentin to deal with side effects from the zyprexa.
     
  18. wjaes

    wjaes New Member

    SaraPA, Wiped Out and Going North,
    I appreciate and welcome all of your feedback. Last night was pretty rough and now we'll see how today goes. His dr. appointment. is at 11:30. I talked with the dr.'s office again yesterday in tears based on his latest rage.

    As shared in my earlier post, his dad came over and basically had him clean his room and then after he went to bed blamed me for how he is. Said I have never made it behave. Whatever.

    Going North..I agree, I would rather have him stable than thin too, but am just trying to weigh out consequences. Up to this point, he hasn't ever been stable,except for maybe the first few days/weeks after a medication. change. I am exhausted.

    I visited with my brother last night. He is on 1800mg. of Depakote and he says it works good for him and hasn't really noticed a weight gain.
    Wendy
     
  19. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    in my opinion, if you feel unsafe or he threatens himself as for a transport to a phospital. in my opinion the juvy justice system has no understanding of mental illness and, yes, I've had experience. In a hospital they can start adding a mood stabilizer, which, in my opinion should help more and work better over the long term. If it's a Depakote trial, I'd go with it and see if it helps. BUT--again you won't be able to know for eight weeks or longer, if it's going to help. Some people give up after two weeks. That's not long enough.
     
  20. wjaes

    wjaes New Member

    Well, we will start the depakote tonight at 500mg. and then will have blood drawn in like 5 days. He might raise it after that. I had about 30 min.'s in the p.doctor's office to ask lots of questions and we will see how it goes. Thanks for all.
    Wendy
     
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