The medication Road, Yet Again

Discussion in 'General Parenting' started by Janna, Jul 31, 2007.

  1. Janna

    Janna New Member

    After almost 17 very good, almost miraculous months, the realization that the medicine is no longer working for Dylan has hit us head on. He is hypomanic. Eyes bugging. Loud. The giddy, "I can't help it" laugh. It's beyond annoying. Truthfully, I saw what I thought was mania before, but within the last 2 months, it has become very, very clear to us what a manic episode looks like. Unfortunately, it seems to be Dylan is a rapid cycler. Could it get any better?

    So, the Abilify had to be cut. The Geodon was a disaster. The Depakote caused stomache problems. Now, he waits, alone on Lithium, up to 1050 mg a day, and it's doing nothing but messing with his thyroid (and he is on the Synthroid still).

    At this point I guess I'm thinking I'd like to wean him off the Lithium once he goes into the Residential Treatment Facility (RTF) and try something else. Maybe his thyroid can stabilize too, and he can get off the Synthroid.

    I hate the thought of having to think of medications again. I don't know if his metabolism is soaking up the Lithium, if he's going through puberty or what, but he is definately in need of something else.

    So sad to see my son be so out of control of his own emotions. Thank goodness, he is still compliant, not defiant, and being good. I don't think the defiance stuff will be a problem with him again, at least until the teenager years lol, but he's so out of whack.

    I've talked to several parents in the last couple of weeks who's kids have tried Lamictal and it made their outbursts much worse. The psychiatrist had mentioned that to me prior, and I didn't believe him, and now I've talked to parents who say yes LOL! EEK! I thought that may be a route, but now, hmm, I dunno.

    I'll take thoughts, maybe there are medications that are new that I'm not aware of yet. I'll give you the run down of what he's been on:


    As far as mood stabilizers go, I was seeing improvement with the Depakote, but with him already having past problems with encopresis, I'm not interested in a drug that is going to cause tummy issues. He was becoming very constipated and gassy.

    Any thoughts are appreciated. Thanks for at least reading the whine lol.
  2. smallworld

    smallworld Moderator

    Janna, I see you've tried Seroquel, but was it ever in conjunction with Lithium? How about trying Zyprexa in conjunction with Lithium? My daughter has had a very good result from that.

    Another thought: Maybe if you go slower on the Depakote titration, the tummy troubles will resolve.

    For what it's worth, we've had not one bit of activation from Lamictal, but quite frankly, my kids lie more on the depressive end of BiPolar (BP) rather than the manic.

    Sorry you're strugging. Hope you make some progress soon. Hugs, my friend.
  3. crazymama30

    crazymama30 Active Member

    The medication road is not a fun one. Gentle hugs and prayers your way.
  4. Marguerite

    Marguerite Active Member

    I'm sorry I'm fairly useless on this topic, Janna. Other than having medication reactions in general, that is. I have no personal understanding of BiPolar (BP) (thank goodness) and I really don't know if I would cope as well as you seem to do.

    All I can do is offer support. I'm so glad for you that at least he is compliant. I hope you can find something he can tolerate, that can also help him.

  5. jamrobmic

    jamrobmic New Member

    From what I've read, Lamictal works on depression, and it works to reduce cycling, but it doesn't work well on active mania. In my son's case, when he started Lamictal, he was also on Seroquel (had started it a few months before starting Lamictal). For several months, when he didn't take the Seroquel along with the Lamictal (he hated taking Seroquel and would spit it out if we didn't watch him), we knew it by the next evening because he would be raging again. Finally he refused to take the Seroquel at all, but by that time, the Lamictal was working well by itself. He took it alone with good results for about a year until he refused all medications (with not so great results, I might add).
  6. crazymama30

    crazymama30 Active Member


    I think Neurontin is used as a mood stabilizer, but I am not sure. Maybe research it.
  7. Janna

    Janna New Member

    No, SW, never used the Seroquel in conjunction with the Lithium. Truthfully, our current psychiatrist had suggested it, and I was willing, and then he switched his mind to Geodon. Then somewhere between then and now, Seroquel left his mind, and he was thinking the Klonopin/Ativan line, which I don't know if I'm 100% comfy with (I don't like the word addictive for a 10 year old).

    When he tried Seroquel, it was around age 4. The psychiatrist said "ADHD/ODD", tried Tenex, then Clonodine, then Ritalin, then Metadate, and mumbled "hmm, maybe he's manic" (I had NO clue what manic was then). We tried Seroquel, can't recall the dose, and it helped Dylan sleep, but didn't seem to do much else, and was d/c within a week. LOL! Truthfully, back then, I was looking for "the magic pill", and I'm sure my patience/tolerance level was very low. So, yes, that may be a good reconsideration. Thank you.

    I do not THINK Dylan is depressive at all. He loves to get up in the morning, go to school, go to camp, play with friends. Very rarely, even when raging, does he cry. He doesn't seem to be a depressed person, or have that type of personality. I think psychiatrist is leaning toward hypomanic. Mixed states. I dunno what the !??! Maybe Lamictal isn't what we should be thinking of. Blah.

    Never heard of Neurontin, will check into that one.

    Thank you for the support. And Marg, I appreciate you taking time to be here, you've given me more words of wisdom and advice than I'm sure you know.

    Thanks you guys.

  8. Sara PA

    Sara PA New Member

    Neurontin is not nor ever has been a mood stabilizer. It is an anticonvulsant which is rarely used for children because it causes aggressive behavior for too many of them. The urban legend that it was a mood stabilizer was part of the fraudulant and illegal marketing done by drug reps at the direction of the manufacturer for which they paid the highest fine in history (until this past week or so when another corporation was fined for something).

    Janna, what's his lithium level? Had it checked lately?
  9. totoro

    totoro Mom? What's a GFG?

    Sorry you are still searching... I know all about the feeling of impatience with the medications!
    We are still trying to reach therapeutic levels with the Lamictal, but have not seen any adverse reactions...
    It is so hard, K is the depressive type, very rapid cycler. It is 8:40 at night she is racing still, the silly voices wont stop in her head...
    She can't stop!!! Some nights she is asleep by 7:00-7:30!!!

    Our psychiatrist has mentioned Neurontin a couple of times as an add on... who knows?

    I wish you could find an answer for poor Dylan. SOON

    Hang in there
  10. Janna

    Janna New Member

    Holy moly, Sara! :smile: Thanks for the info on that. Whoa!!!!!!!! I would have looked it up prior to giving it to Dylan anyway, that's the rule, 48 hours for me to do research before writing the script, but OMG!

    Yeah, we did a blood draw about 3 weeks ago. psychiatrist was hoping the thyroid would be the one way that would be making Dylan hyper (I forget high low or low high or whatever it is) so he could drop the Synthroid down (he's on .75 mcg), but it wasn't, it was perfect, so we had to leave it. His Lithium level was .79 on 900 mg. (300 AM, 600 PM). I know the levels go up and down, but we had been checking it very frequently for a while there, and Dylan had done best around 1.0 or even a tad higher at 1.1, so we upped his Lithium another 150 mg. I guess we need another blood draw. He goes to the doctor next week, we can do it then. Even at .79 though, he is theraputic. I know the book says .8 - but through the hospital, their theraputic is .6. I would think even at .79, it should be doing SOMETHING lol.

    I appreciate all the good thoughts and such. This, too, shall pass, and we will find a good mix again, I just know it. If you guys knew him personally, you would fall in love. So heartbreaking, because he really wants to be perfect, so bad. He doesn't want to be hyper, doesn't want to be manic, doesn't want to do the things he does. He knows we get frustrated, and that in turn frustrates him, because he WANTS to stop, and can't. I think the Residential Treatment Facility (RTF) is going to be good for him.

    Thanks again :smile:
  11. Wiped Out

    Wiped Out Well-Known Member Staff Member

    My difficult child isn't able to use the anti-psychotics that are often prescribed-abilify, seroquel, and repirdal. The one that has helped the most for us is Loxapine-it's not a newer medication but an older one. I'm no doctor but just thought I would throw it out there because I saw it was one he hasn't been on.
  12. Lothlorien

    Lothlorien Active Member Staff Member

    When is he going to Residential Treatment Facility (RTF)? Has that been set up yet? Perhaps they can do the medication wash there, so you aren't having to deal with that. Perhaps the docs can figure something out there. I hope so. This poor kid has been through the gammut ( and so have you and your family).
  13. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    Janna, Lithium's therapeutic range is different for every individual. No matter what the book says, some kids do not do well on .8 and need it higher. You have to watch Dylan to see which level works best for him. Also, some kids need more than one mood stabilizer---like Lithium/Depakote. When I used to chat with bipolar moms, MANY of the kids were on two mood stabilizers and an antipsychotic--their medications would look like this (an example): Lithium/Depakote/Risperdal.
    Seroquel is an antipsychotic, but if your psychiatrist only gives your kid .25 mg. or even 100 mg. it could be way too low.When they trialed Lucas on it, back in his hyper days when they thought he had bipolar, he was on 500 mgs. He didn't have side effects on Seroquel, like he did on Riserdal and Zyprexa. He did gain a ton of weight on Lithium/Seroquel. He's still obese, even over three years after medications...grrrrrrrrrrr.
    I wish you luck, and write me! Heck, call me if you like--I'll tell ya my medication experiences. Oh, the fun of it!!! (((Hugs)))
  14. Janna

    Janna New Member

    He goes into the Residential Treatment Facility (RTF) on the 13th of August, Loth. Coming up soon :frown:

    MWM I owe you a phone call, I know this, really. I will make time this week, miss you.

    Thanks ladies ~ I'll check into that medication, Sharon!