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Ready to see him go off medications ...
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<blockquote data-quote="katya02" data-source="post: 213588" data-attributes="member: 2884"><p>Thanks for your comments and suggestions; it's really good to get info from those who have practical experience with Lamictal. It came out after I stopped practice and I only have academic info on it, which is helpful but never provides the clinical context. I think it could be a good possibility for difficult child.</p><p></p><p>I know lithium is still used but it has such a small window of efficacy between no effect and toxicity, and that window can be affected by so many things, that it's not as frequently used anymore. It was common when I trained and we saw the toxicity and problems - I think most docs were very relieved to have other options once they were available. Still, it's definitely an effective mood stabilizer. I think difficult child would balk at it because of the potential for toxicity, but you never know. He'll have to be willing to try something if it turns out he can't manage off medications. We just wonder if he might manage as long as he has no antidepressants and no stimulants. I think he has a bipolar element to his clinical 'picture' that tends toward hypomania, given his reaction to antidepressants, but I suspect that personality and substance abuse issues are more significant aspects. If he needs a mood stabilizer I guess we'll continue to try, but he could use a washout period at the moment. Just in time for the holidays, but timing is never perfect, is it?</p></blockquote><p></p>
[QUOTE="katya02, post: 213588, member: 2884"] Thanks for your comments and suggestions; it's really good to get info from those who have practical experience with Lamictal. It came out after I stopped practice and I only have academic info on it, which is helpful but never provides the clinical context. I think it could be a good possibility for difficult child. I know lithium is still used but it has such a small window of efficacy between no effect and toxicity, and that window can be affected by so many things, that it's not as frequently used anymore. It was common when I trained and we saw the toxicity and problems - I think most docs were very relieved to have other options once they were available. Still, it's definitely an effective mood stabilizer. I think difficult child would balk at it because of the potential for toxicity, but you never know. He'll have to be willing to try something if it turns out he can't manage off medications. We just wonder if he might manage as long as he has no antidepressants and no stimulants. I think he has a bipolar element to his clinical 'picture' that tends toward hypomania, given his reaction to antidepressants, but I suspect that personality and substance abuse issues are more significant aspects. If he needs a mood stabilizer I guess we'll continue to try, but he could use a washout period at the moment. Just in time for the holidays, but timing is never perfect, is it? [/QUOTE]
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