Jena

New Member
yes us too it's kinda classic they don't have the everyday structure so the freedom of everyday and being off is almost too much for them if that makes any sense at all.
 

miles2go

Member
Things have been so far so good on 5mg of Abilify although the allergy season now seems to get things into a tired and cranky mode more often, with the far-out behavior more likely.
Also, what kind of weight gain do people here experience with Abilify? His appetite is strong and he's beginning to "fill in" -- no alarm yet I thing, but am curious as to the statistics on this.
 

Lothlorien

Active Member
Weight gain can vary. I was told (with Risperdal and Abilify) that there could be an initial weight gain and then once the body adjusts, it will level off. Other people have different experiences.

The important thing is that he get some regular exercise. Can you put him in a sports program, karate, gymnastics or something like that? Regular exercise will also help with the aggression.

The amount of Abilify for his age sounds correct. My daughter was started on Abilify, but unfortunately it helped, but didn't work as well as we hoped and her rages got to the point where she became dangerous to herself and others. We switched to Risperdal.

Your question about acting up on vacation.....does he have a lot of anxiety? Do you find that he expects things to go a certain way, because he's been thinking about what you are going to do? Do you tell him what you are going to do the next day? If so, he's probably getting over-excited about it. I find that if I don't tell my daughter anything, she's much more even-keeled.

As far as the signature....A simple statement like the following

difficult child...7, bipolar, on Abilify
Me....35 year old dad. Married/divorced or whatever.

Once this thread has passed down the line, at least when you post on other people's threads, they will be able to remember who you are. We do not want anyone to be specific enough that you would be identified, but a little info is all we ask.

Welcome to the site, by the way!
 

miles2go

Member
A first meltdown in a while, screaming at a teacher; I got a call at work but after all my difficult child managed to stay at school till the end of day. Must be a combination of allergy season and daylight savings time. What's worse wife is in another depressive episode veering into the usual dysphoric mania and is starting to talk again about taking him off the medication (no reason, just stigma/superstition or what not). Anyone know of any legislative history on this if push comes to shove (i.e. if one parent + psychiatrist(s)+school+... say yes medication and another parent says no medication)?
His weight gain didn't come suddenly, just his appetite is strong and so the weight is creeping up. He does a lot of swimming but I think he needs more land-based sports. Karate hasn't much of a workout; not sure he's ready for team sports, so am looking elsewhere, maybe tennis.
difficult child, 7y.o. BiPolar (BP) on abilify, PCs older sister, younger brother.
Me, dad ~45
wife, BiPolar (BP) (runs in family)
 

gcvmom

Here we go again!
I found it helps to steer my difficult child towards lower calorie snacks that still fill him up -- raw carrot sticks with low-fat ranch for dipping, apple slices, popcorn (low fat), flavored rice cakes, etc. Cut out the juice and/or sodas and steer them towards water for quenching thirst.

For exercise, soccer is a really great sport that kids don't have to be great at to enjoy. Lots of running and a great outlet for energy (something about using those large muscle groups is very calming for some kids).

Many recreational youth sports leagues have divisions which cater to kids with special needs, too. There's less emphasis on "winning" and more focus on just learning the game and having fun. I don't know about your difficult child, but both of mine benefited from the social interaction that a team provides because their social skills were not quite as developed as they should be.

As for the parental disagreement, I suppose you could get a court order to get her to comply, which is often done in divorce situations, but hopefully simply citing the cold hard facts that are known about untreated bipolar should be sufficient to bring her thinking back in line with yours (and reality).

Here's a link I found that may help:

http://www.healthyplace.com/bipolar...py-for-treating-bipolar-disorder-in-children/

I'm sure you could google "when one parent disagrees on medication" and find similar information.
 

susiestar

Roll With It
I am sorry you are going through all of this. You sound like a pretty great dad.

As for the legal issues of 1 parent wanting medications and 1 parent not, if the psychiatrist and school are behind you, I would say CPS will be too.

You say your wife wants him off medications because stigma/superstition? What superstition does she have? Is it religiously based or based in her own illness.

I would even wonder if she is cycling would taking difficult child off the medications qualify as a danger to someone else? It would mean some time in a psychiatric hospital until she is stable, but it might get her into a better frame of mind to handle the issues involved in parenting with you. Totoro might have some good input here.

Whatever happens PLEASE make sure she does not take him off the medicines cold turkey. That can be very dangerous - it all depends on the medicines difficult child is on.

Is your wife on any medications? Is it time for HER to get a medication tweak or to see a doctor about some medications?

If the legal situation about difficult child and medications gets bad, I would think CPS (Child Protection) would back YOU up regarding the medications IF you have statements from the psychiatrist and school that they are very needed. I am pretty sure I would have school just write about how difficult child is much better on the medications, even if there are some rough times as they adjust the medications.

But hopefully you can just talk wife into leaving difficult child on the medications.

Is difficult child on a mood stabilizer? I know abilify can work as one, but I don't think it is a primary mood stabilizer like depakote or lithium. You should probably ask the doctor about that, in my opinion. Check abilify's mood stabilizing properties out online and with the pharmacist first though.
 

miles2go

Member
Thank you, susiestar and gcvmom.
Susiestar, this forum is read-accessible to the general public and I can get fairly paranoid about wife stumbling upon it. PM me if you want; I think I gained a bit of insight into what this syndrome is like (and how true it runs in families) and I am very glad it is being controlled in my son (knock on wood)-- emotional/mental development with it untreated would be very problematic.
Soccer would be very convenient but he does better with individual sports. Maybe tennis, ping pong and a hoop in the back yard.
Mood stabilizer, how do you mean? Abilify is all he takes, and without it he didn't have mood swings, just a brain on a dopamine high, talking movie dialog to himself, impulsive, and falling into all-out mania at times. If imagine it right, mood swings would come later if untreated.
Thanks for the link, gcvmom -- do you have something concise for the differential diagnostis? I need to anticipate "no he doesn't have this" or "he outgrew this".
Me ~45 y.o. dad
difficult child 7y.o. BiPolar (BP) abilify 5mg
 

miles2go

Member
thanks gcvmom, this is all good stuff. Wish there was an "objective" test for BiPolar (BP), like for diabetes.... To me, his symptomatics are very obvious, his (and her) "spirit" (dopamine?) really throwing about until the medication brings peace.
Things have calmed down a bit, and I am trying to stay strong for the next rough patch.
Me 45 y.o. married dad
difficult child 8 y.o. BiPolar (BP) on Ablfy
 

miles2go

Member
And so more dose-upping hesitations comes with the allergy season and I have a general question on people's attitudes towards medications and conditions they treat. My difficult child's diagnosis is bipolar and is not in doubt. On the question of dosage I used to be conservative -- the minimum that keeps him out of trouble in school, and if there are occasional explosions that he/we can bring under control that's no reason to up the medication.
However, his psychiatrist's arguments make sense as well:
1. His self image begins to include these meltdowns and thus he'll see himself as unstable, prone to "bad behavior".
2. These occasional meltdowns are symptoms of the more pervasive condition his brain is in and he needs the experience of a healthy brain in order to properly develop. I have observed older family members with the same symptoms who have gone untreated and I can see how this condition, with early onset, has stunted and distorted development -- cognitive (hard to carry a logical train, a lot of "magical thinking") and emotional (no empathic imagination, narcissistic personality, etc).
Hence his psychiatrist's attitude to up the dosage until symptoms are reduced to none.
The only side effect so far has been weight gain, which is a drag, but when the medication works we have our sweet and intelligent boy with us who has really just started developing when he started Abilify.
Comments?
Me -- almost 50 y.o. married dad
difficult child boy 7y.o. BiPolar (BP), on Abilify
 

flutterby

Fly away!
When you have a condition like BiPolar (BP), medications are necessary. I have my doubts about Abilify being used as bipolar monotherapy, though. The studies to get FDA approval as use for monotherapy were short - even more so for kids (and those were aged 10-17). I believe the studies were 4 weeks long and a lot can happen after that.

The standard treatment for bipolar has always been first line mood stabilizer (lithium, lamictal, depakote, etc) and an antipsychotic (abilify, risperdal, seroquel, etc) as adjunctive therapy. Abilify is new. Until further studies show that it is as effective as the treatment above, I personally would be leary of trying it as monotherapy.

As far as doses, I personally don't think it's enough to just get by. I think it needs to be enough where the child is stable.

You're correct about the stunted emotional and cognitive growth for those with this disorder. difficult child 2 is 16, but emotionally is about 12...but he thinks he's 25. :hammer: Reaching and maintaining stability are very important.

ETA: I guess I shouldn't say "always been" above. But, it has been for a long time.
 
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earthprowler

New Member
Things have been so far so good on 5mg of Abilify although the allergy season now seems to get things into a tired and cranky mode more often, with the far-out behavior more likely.
Also, what kind of weight gain do people here experience with Abilify? His appetite is strong and he's beginning to "fill in" -- no alarm yet I thing, but am curious as to the statistics on this.


my son was on abilify last year. stock the fridge and cubbards because his appetite will become ferocious. watch his weight and sleep patterns. it really helped my difficult child, his teacher and the principal at school couldn't have been happier when he was on it, but nothing lasted more than two months with him until his current medications (and they don't always work!). but his attitude greatly improved at home and all around, people let him start coming back to their houses to play with their kids because they weren't afraid of the "mouth from hell, or their kid ending up getting hurt or beat up".
 

miles2go

Member
Thank you, flutterby and earthprowler.
Earthprowler -- difficult child has been on ablfy for about 6 months now, and yes, his appetite has been prodigious.
Flutterby -- thanks for the medication tip. As I understand BiPolar (BP) now, it's a syndrome that covers a wide range of conditions. While his older relatives swing into depression, he never does -- he goes into an obsessive, controlling (ordering teachers around) and manic mode. The psychologist who spent most time with him and who was the first to insist that he is NOT adhd diagnosed his disorder as obsessive (which I understand is a wider condition than just Obsessive Compulsive Disorder (OCD) -- he has no Obsessive Compulsive Disorder (OCD)-type ideations) and suggested ablfy with later transitioning to (or adding) zoloft type medications.
So I don't see "mood swings" as such without medications, just his brain crowded with thoughts and then switching to a crazy zone either from some irritant or fatigue/allergy etc.
What dosages of ablfy have you seen/used ?
 

susiestar

Roll With It
Hi, and if I didn't welcome you already, Welcome!! And if I did welcome you already, Great to see you again!!!

I would personally push for as much mood stability as possible. The brain goes through changes when it cycles. Chemicals are released in the brain during manic stages that are addictive. The more a person cycles, the more likely they are to be medication resistant as adults. Or this is what I understand from the psychiatrists we have seen, the developmental pediatrican Wiz saw, and from the book "The Bipolar Child". If you don't have the book - go and get one!!! It truly is an amazing resource.

There is some thought that the mood cycles are caused by a type of seizure activity. in my opinion this is supported by the success of many anti-seizure medications as mood stabilizers (topomax, depakote, trileptal, and more). It can't be measured on an EEG (brain wave test), but only a small fraction of seizures can be detected this way. Not only is our equipment not capable of catching many types of seizures, but also because the patient has to have a seizure at the exact time of the test.

With the type of seizure that are thought to be part of bipolar, they actually build pathways through the brain. The more seizures a person has, the more seizures they are likely to have. So it is crucial to have the child be as stable as possible, simply because you want them to develop healthy pathways and not become "addicted" to the chemicals given off by the cycling.

You state you don't see clear highs and lows in your difficult child's behavior. This may mean he is in a "mixed" state, where he has both manic traits and depressive traits. This can be one of the toughest things to treat from what the docs told us. This is explained very well in The Bipolar Child, far better than I could explain it.

I realize that minimizing the amount of medications a child takes is important, but so is ensuring that their brain develops in a healthy way.

Doesn't it hoover to be caught up on this highwire? At least now you have us to talk to about things!

First and foremost in your treatment decisions should be getting all the info you can. Then you have to weight the info and figure out the options. When choosing an option ALWAYS ALWAYS ALWAYS follow your instincts. If something feels very wrong, then it IS.

I hope this helps some.
 

flutterby

Fly away!
We're not using abilify, although I have inside information that is what difficult child 2's psychiatrist will put him on. His mother and I have already talked about it and neither one of us thinks it's a good option. Everyone that I have known on it has been more on the depressive end and, from the studies I've read, abilify tends to exacerbate depression. I don't know what doses they were on.

I did want to point out that depression in children is vastly different from depression in adults.

I'm wondering why they are wanting to add an SSRI if he doesn't have depression.
 

miles2go

Member
Thanks, susiestar, I have the book but I didn't read it all the way through. Does it talk about "addiction" to mania chemicals (dopamine level?) and the seizure theory?
In the morning I was going to describe his non-medicated state from memory, also wondering whether his "speediness" was due to recent Concerta experience, but tonight I come home and see the same thing -- he is talking through clenched teeth, anything his little brother says winds him up, got into a hitting fight with older sister etc. Ask how are you -- "great", and he is, not insisting much on "his way" while I am around, though without medications he'd be screaming at teachers to go to Target and get him toys. He did score high-ish on some depression questionnaire his psychiatrist gave him maybe a year ago, saying that he feels "sad because so often he can't get his way". However, I think, the psychologist was talking Zoloft later as some newer way, from his and others experience, of treating this sort of obsessive disorder. In his ancestry I certainly see more depression/mania cycles, but I think depression comes later in life. Or is it just manifested differently? do you have any references on this different manifestation or can you describe, flutterby?
Again, I thank you so much for support, I feel bad that I dont have any time to offer support to others on this forum.
 

totoro

Mom? What's a difficult child?
Hey and welcome! I did not welcome you before.

He is not on Concerta now right? This should not have any affect on him if he is no longer on it.

My daughter K is pretty classic BiPolar (BP) 7yo. She is on 5mg abilify as well.
We have lots of therapy and tons of support in place right now. Just so we do not have to add more medications at the time.
I know we will, but we are working with her psychiatrist and Psychologist, and therapist as well as a lot of people in her School to keep her stable.
Unfortunately if you want to keep the medications at a minimum you need lots of people in the picture which means you have to be very open about the diagnosis and you have to be pretty sure about the diagnosis.
Both me and my husband stay home a lot to help both of my kids.
Otherwise K would be on a lot more medications right now.

I would highly suggest a Nuero-psychiatric evaluation if you have not done so already.

I have a heavy family history of mental illness, feel free to PM me if you have any questions.

Also under the Social Groups I think under communities? We have a list and links to tons of sites about BiPolar (BP) and other issues regarding our kids and their needs.

I myself have had great luck with Lamictal and Topamax which are both Mood Stabilizers, also Trazadone which is an AD. I also use Valium for anxiety.
I do not get depressed either, very rarely. The Trazadone I use for sleep and it seems to help over all?

My daughter K also has bad Anxiety, she uses Ativan PRN.
I am not overly drugged out. I really have no side affects.
K does have the weight gain and tics associated with AP's. I honestly do not like AP's, but K has to take them due to her Psychotic Episodes and tendency to hallucinate.
But AP's have saved her and they truly have helped so many of our kids.

I personally would prefer to just have her on a MS.

Good luck keep up the good work!
 

totoro

Mom? What's a difficult child?
by the way, K has the same afternoon thing- she gets very agitated and worked up from keeping it together all day at School. or at least trying to hold it together at School.
She comes home and by early evening she is just falling apart.
She will start screaming and fall apart over nothing.
Trash her room, slamming things...
We don't get a lot of homework done. i have given up on it a lot of nights it is not worth the fight.

When do you give him his Abilify? Is it all in one dose?

I have found for us that splitting the 5mg is more affective for K. We do 2.5mg in the a.m. and 2.5 mg at dinner.

Could also be that he is an ultra-rapid cycler. K cycles very quickly, which means at times you can't see the switch from normal to ramping up and then bam, they are in a hypo state or manic and then it ramps down quickly. They can ramp up and down all day long. For K her depression is very short and is more of her anxiety.

Once you tune into them you get real good at seeing the change. I can watch K's breathing and eyes and see her changes and know when to anticipate her moods. For the most part... sometimes. :)
 

gcvmom

Here we go again!
Depression in kids can appear as irritability.

FWIW, my husband's depression also manifested as irritability, short fuse, etc. He also sought to self medicate with excessive spending, gambling, food and sex.
 

susiestar

Roll With It
The Bipolar Child is where I got the info on seizures and bipolar, also on the body becoming "hooked" on the high produced by chemicals during mania.

I had many docs tell us my oldest was bipolar. He is just a complicated Aspie though. I did read the book because it gave some insight when we were figuring things out. The seizures creating pathways and then the body getting hooked on the mania from the chemical changes made a lot of sense to me.

I think a neuropsychologist evaluation would be an EXCELLENT idea. it would give you more of an idea of what needs to be done, would give suggestions to help him, and suggestions for his IEP.
 
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