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<blockquote data-quote="susiestar" data-source="post: 234814" data-attributes="member: 1233"><p>Welcome! I am so glad you found us, but sorry you need us, Know what I mean??? </p><p></p><p>anyway, my first question is have you read The Bipolar Child by Papalous? It is considered the "bible" for children with bipolar or other mood disorders.</p><p></p><p>One thing that stands out is that he is on Abilify, Lithium and Vyvanse. Many times children with bipolar cannot handle stimulants such as vyvanse. The American Academy of Child and Adolescent Psychiatrists has a protocol for treating children with bipolar. Sadly, many docs forget about it or don't know it.</p><p></p><p>the protocol calls for using a mood stabilizer FIRST. Sometimes a second mood stabilizer must be added. Once moods are stable, then other things can be addressed very slowly. Often an atypical antipsychotic like Abilify is used with the mood stabilizers because the aggression and violence our kids can show.</p><p></p><p>After moods are stable and aggression dealt with, THEN if ADHD symptoms or anxiety symptoms are there they can be addressed. But often even very small doses of stimulants (like vyvanse, ritalin, adderall, concerta, etc...) will send the child cycling. So sometimes antidepressants like strattera are used (strattera is effective on ADHD but is an antidepressant). Often this also sends the child cycling. Many children with bipolar cannot tolerate antidepressants either.</p><p></p><p>All of this is in the Bipolar Child book. It is explained very well in there, but you will want to read the book a bit at a time, it can get very technical.</p><p></p><p>From what we learned when my son was younger, you address teh Bipolar first because so many medications (including cold medications) can send the child cycling. Then, once the child is stable you address the Aspergers, ADHD (which often can disappear if the child is stable - mania can look like ADHD as can mixed states and ultra rapid cyclers). </p><p></p><p>I would ask his doctor about removing the vyvanse and adding a second mood stabilizer. You may find that is helpful. But I am NOT a doctor, so don't make medication changes based on what I am saying!!!!</p><p></p><p>The Explosive Child is an Excellent book - it really helps you look at parenting in a new way, a way that works better with our children.</p><p></p><p>A medication wash is where they slowly wean the child off ALL medications to see what is really going on versus what is a side effect of a medication or of medications interacting. I TOTALLY recommend trying to have this done in the hospital, many kids have real problems while the medications work their way out of their system.</p><p></p><p>Not sure if medicaid will cover it, but I do know that when we were on the state medicaid for kids it covered a LOT more than our private insurance does, including a 4 month psychiatric hospital stay for my son that didn't cost us anything!</p><p></p><p>Sending gentle hugs, and with any advice you get here, take what works for you and ignore the rest.</p><p></p><p>Susie</p></blockquote><p></p>
[QUOTE="susiestar, post: 234814, member: 1233"] Welcome! I am so glad you found us, but sorry you need us, Know what I mean??? anyway, my first question is have you read The Bipolar Child by Papalous? It is considered the "bible" for children with bipolar or other mood disorders. One thing that stands out is that he is on Abilify, Lithium and Vyvanse. Many times children with bipolar cannot handle stimulants such as vyvanse. The American Academy of Child and Adolescent Psychiatrists has a protocol for treating children with bipolar. Sadly, many docs forget about it or don't know it. the protocol calls for using a mood stabilizer FIRST. Sometimes a second mood stabilizer must be added. Once moods are stable, then other things can be addressed very slowly. Often an atypical antipsychotic like Abilify is used with the mood stabilizers because the aggression and violence our kids can show. After moods are stable and aggression dealt with, THEN if ADHD symptoms or anxiety symptoms are there they can be addressed. But often even very small doses of stimulants (like vyvanse, ritalin, adderall, concerta, etc...) will send the child cycling. So sometimes antidepressants like strattera are used (strattera is effective on ADHD but is an antidepressant). Often this also sends the child cycling. Many children with bipolar cannot tolerate antidepressants either. All of this is in the Bipolar Child book. It is explained very well in there, but you will want to read the book a bit at a time, it can get very technical. From what we learned when my son was younger, you address teh Bipolar first because so many medications (including cold medications) can send the child cycling. Then, once the child is stable you address the Aspergers, ADHD (which often can disappear if the child is stable - mania can look like ADHD as can mixed states and ultra rapid cyclers). I would ask his doctor about removing the vyvanse and adding a second mood stabilizer. You may find that is helpful. But I am NOT a doctor, so don't make medication changes based on what I am saying!!!! The Explosive Child is an Excellent book - it really helps you look at parenting in a new way, a way that works better with our children. A medication wash is where they slowly wean the child off ALL medications to see what is really going on versus what is a side effect of a medication or of medications interacting. I TOTALLY recommend trying to have this done in the hospital, many kids have real problems while the medications work their way out of their system. Not sure if medicaid will cover it, but I do know that when we were on the state medicaid for kids it covered a LOT more than our private insurance does, including a 4 month psychiatric hospital stay for my son that didn't cost us anything! Sending gentle hugs, and with any advice you get here, take what works for you and ignore the rest. Susie [/QUOTE]
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