someone clairify please

Discussion in 'General Parenting' started by totiredtofight, Jan 15, 2012.

  1. totiredtofight

    totiredtofight New Member

    the psychiatric hospital called early this morning to say that difficult child 2 had to be restrained and put in to the quiet room because she had attacked peers and staff .. about 30 mins ago the psychiatrist called
    to get the ok to give difficult child 2 zyprexa ( may have spelled it wrong) on an as needed basis but also wants to start the ablify tonight .. when i asked about the diagnosis i was told that all of the results from the nueropsych tests were not in and he hopes to have them by the middle of the week however he does think that she does have adhd.odd,cd but also may have either mood disorder not otherwise specified or bipolar not otherwise specified .. when i looked up the two the sites say they are the same thing .. Is there a difference or is mood disorder not otherwise specified just another term for bipolar not otherwise specified ??? and why are the test results taking so long as they were done the last part of december????
  2. zaftigmama

    zaftigmama New Member

    Not *exactly* the same thing--both depression and bipolar come under the heading of mood disorders--a "mood disorder not otherwise specified" would mean they weren't sure if it was depression or bipolar disorder or some of both; "bipolar not otherwise specified" means they're not sure if it's bipolar I or II or a combination of symptoms from both. I think. I'm no expert. :doctor:
  3. JJJ

    JJJ Active Member

    Chances are that the person who did the testing isn't qualified to finalize the results. At least in our experience, person A would do the testing and preliminary results, then person B would review the results and finally doctor C would sign off on them -- then we would get them.
  4. klmno

    klmno Active Member

    Based on what psychiatrists have told me in the past, these two previous responses are correct. They aren't sure what the exact diagnosis is yet but they have it narrowed down a little and are suggesting a medication that should help- there are several medications that can be used and not all work the same on everyone so don't be surprised if it takes a few trials with different ones. The mmood disorders cover depression (unipolar) and the various Bipolars. Some would say anxiety is in there too although I don't think it officially does, it just goes hand-in-hand with mood disorders many times.
  5. susiestar

    susiestar Roll With It

    I think the difference between mood disorder not otherwise specified and bipolar not otherwise specified depends on the edition of the DSM you are looking at. Older ones called it one thing, newer another. He may be using those words to try to help you understand what is going on, not saying it is this or that. Of course I could be totally wrong.

    I thought abilify and zyprexa were the same kind of medicine. If he is thinking of mood disorders, those NEED the be the first condition treated. OFTEN if a patient is treated properly for bipolar the symptoms that look like adhd and many other things go away. But if they treat the adhd first, the adhd medications will actually CAUSE the mood disorder to spin out of control and there will be no way to stabilize the moods.

    Go and get a copy of The Bipolar Child by Papalous TODAY. It is excellent and will help you make sure she is getting what she needs. THe medication protocol is in the book and is what the Academy of Child and Adolescent psychiatrists approves, but for some reason that makes NO SENSE to me and that NO psychiatrist has EVER been able to explain, the psychiatrists want to use antidepressants and stimulants first and NOT work to stabilize the moods first. I have asked a LOT of docs about this because every time we had to change doctors for Wiz they wanted to give him a different diagnosis. Not so much because the diagnosis he had wasn't right, but more because they wanted to do something different (I call it reinventing the wheel and it drives me absolutely crazy in this situation!). Every one wanted to say Wiz is bipolar, which he just isn't and never has been, but they don't want to treat the bipolar, they wanted to give him medications that would make bipolar worse. Often they made notes saying I was a difficult parent to work with because I just don't bend on this issue. Goody for them - a few showed me where they wrote it in Wiz' chart, somehow thinking that it would make me let them do what they wanted and mess up my kid jsut to do it. Now I think it was funny, at the time I thought they were idiots (well, I still think that about a few of them,lol).

    Anyway, with a mood disorder suspected, medications are now a HUGE issue. YOU have to be super educated on this. You MUST know the medication protocol and you MUST know the names of the medications and what type of medication they are. You have to be willing to ask for time to look up a medication and get back to them. They will NOT like it, but it is better to wait a few hours or a day to start a medication than to end up spending precious days or weeks trying to undo the chaos the wrong medication can cause.

    A LOT of medications can cause moods to cycle for someone with bipolar/mood disorder not otherwise specified. The medication protocol calls for first using a mood stabilizer and an atypical antipsychotic to stabilize moods. TWO mood stabilizers can be used together if needed to achieve this goal (along with the atypical antipsychotic). Once moods are stabilized, if symptoms of adhd, depression, or other things still persist, LOW doses of stimulants, antidepressants, antianxiety medications etc... can be added in carefully.

    One of the big problems is that mood stabilizers don't work quickly. They take time, weeks usually, to get to therapeutic levels. They have to be at therapeutic levels for 6 weeks to get the full effects. So you have to work up to the therapeutic level and then wait 4-6 weeks to know how well a medication will work. It is incredibly frustrating but when you find the right medication combo it is very very helpful.

    I know this medication combo is the right way to handle medications because a lot of parents have told us about what a HUGE change it makes when you finally find the right combo and wait it out until it works. MANY of these parents previously had said how great an antidepressant helped but their child had huge mood swings and often ended up in a major crisis because what the antidepressant did was make them cycle and esp trigger the manic states. We also have parents here who are bipolar and went through this all. One in particular spoke with me about how she knew of the protocol with the stabilizers but for her an ssri antidepressant made her feel SOOOO much better and was just waht she needed and that protocol wasn't for everyone with bipolar. Not long after that she had a crisis and she returned to us a year or so later and posted about the experience. The antidepressant she thought was helping was actually hurting her, but in a manic state you don't know it. You also don't have to be in the stereotypical manic state or stay manic for days/weeks at a time. Some people, and esp kids, can cycle much much MUCH faster than that (I know a little girl who cycles about every ten to fifteen minutes when unmedicated, more on mds for adhd!! It is exhausting for everyone around her and she has NO control over herself.)

    PLEASE get the book I suggested. Educate yourself about bipolar. If you push for mood stabilizers and atyp antipsychotics, it won't be a quick fix, but it can be a way to get help that lasts, and that will then let her use the tools she can learn in therapy.
  6. InsaneCdn

    InsaneCdn Well-Known Member

    Its not unusual for a formal report to take 2-4 weeks to write up... add in the "down time" of the recent holiday season... I don't think the timeframe is unreasonable. It takes time to "score" the results, then analyze, cross-compare, etc. all of which take time, and THEN they can draw conclusions and write the report.
  7. crazymama30

    crazymama30 Active Member

    Abilify and zyprexa are the same class of medication, however I think zyprexa had a version that melts in the mouth and acts quicker. That may be why they want to start both on the same day, a the abilify takes a few days to work
  8. DammitJanet

    DammitJanet Well-Known Member Staff Member

    I would assume they want permission to use zyprexa immediately for the reasons crazymama said above. It is a really fast acting medication that can be used for a chemical sedation effect which helps. The abilify will take a bit longer to get into the system and work. Lots of times they keep zyprexa around for the chemical restraint use.