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Ready to see him go off medications ...
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<blockquote data-quote="flutterbee" data-source="post: 213524"><p>I wonder why they're going to topomax next. I know for Janet it's been the only thing that works for her, but for most people I've talked to/heard/read about the cognitive dulling was just too much and the benefits not so great. </p><p></p><p>Lamictal works more on the depressive side of bipolar, but it's worth a try ('m not sure where he's at on the BiPolar (BP) spectrum - more manic or more depressive). I'm taking it now for treatment resistant depression and I *love* it. No side effects at all. None. And I've had doctors and pharmacists tell me that I'm that less than 1% that has the weird side effects. It's also one that doesn't require blood work to monitor. I don't have bipolar disorder, but do have severe depression and I started to notice results quickly - while I was still titrating up. It took 4 weeks to get to my dose (therapeutic dose is 200mg, but I am holding at 100mg because it's working). It would be another 2 weeks to go from 100mg to 200mg, I believe. It goes 25mg for 2 weeks, 50mg for 2 weeks, then 100mg. I didn't go any further, so I'm not sure, but the next step is either 150mg or 200mg. You just have to watch for the Stevens-Johnson rash. I don't split my dose as it can cause some insomnia - I take it all in the morning, but I know others split their dose. An important thing to note about lamictal: You cannot stop it cold turkey or it can cause seizures. While Janet was in the drug-induced coma and had 2 seizures, it was determined they were caused from withdrawal from the lamictal cause the doctor's didn't continue her medications. If I miss one dose, I can tell, but it's not a very different feeling from if I miss a dose of lexapro.</p><p></p><p>Have they tried good old-fashioned lithium? I don't know why psychiatrists shy away from that just because they have newer drugs. It's the most studied. It does require blood work to monitor because the line between efficacy and toxicity isn't too large, but it's an effective mood stabilizer. Does he have a health condition that contraindicates lithium?</p><p></p><p>We've seen a lot of psychiatrists of kids on the board try to stabilize with atypical AP's and I can't think of a single member who has had success that route (doesn't mean they're aren't any, but none come to mind). The most success seems to be with first line mood stabilizer then add in an atypical AP if needed for acute mania or impulsivity, etc. </p><p></p><p>Going back and re-reading was a great suggestion, Susie. Occassionally, I do that and it's amazing how much you forget. We so much live in the moment with our difficult child's and it's easy to forget where we've been.</p></blockquote><p></p>
[QUOTE="flutterbee, post: 213524"] I wonder why they're going to topomax next. I know for Janet it's been the only thing that works for her, but for most people I've talked to/heard/read about the cognitive dulling was just too much and the benefits not so great. Lamictal works more on the depressive side of bipolar, but it's worth a try ('m not sure where he's at on the BiPolar (BP) spectrum - more manic or more depressive). I'm taking it now for treatment resistant depression and I *love* it. No side effects at all. None. And I've had doctors and pharmacists tell me that I'm that less than 1% that has the weird side effects. It's also one that doesn't require blood work to monitor. I don't have bipolar disorder, but do have severe depression and I started to notice results quickly - while I was still titrating up. It took 4 weeks to get to my dose (therapeutic dose is 200mg, but I am holding at 100mg because it's working). It would be another 2 weeks to go from 100mg to 200mg, I believe. It goes 25mg for 2 weeks, 50mg for 2 weeks, then 100mg. I didn't go any further, so I'm not sure, but the next step is either 150mg or 200mg. You just have to watch for the Stevens-Johnson rash. I don't split my dose as it can cause some insomnia - I take it all in the morning, but I know others split their dose. An important thing to note about lamictal: You cannot stop it cold turkey or it can cause seizures. While Janet was in the drug-induced coma and had 2 seizures, it was determined they were caused from withdrawal from the lamictal cause the doctor's didn't continue her medications. If I miss one dose, I can tell, but it's not a very different feeling from if I miss a dose of lexapro. Have they tried good old-fashioned lithium? I don't know why psychiatrists shy away from that just because they have newer drugs. It's the most studied. It does require blood work to monitor because the line between efficacy and toxicity isn't too large, but it's an effective mood stabilizer. Does he have a health condition that contraindicates lithium? We've seen a lot of psychiatrists of kids on the board try to stabilize with atypical AP's and I can't think of a single member who has had success that route (doesn't mean they're aren't any, but none come to mind). The most success seems to be with first line mood stabilizer then add in an atypical AP if needed for acute mania or impulsivity, etc. Going back and re-reading was a great suggestion, Susie. Occassionally, I do that and it's amazing how much you forget. We so much live in the moment with our difficult child's and it's easy to forget where we've been. [/QUOTE]
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