another new medication trial

[Jena]

hi...

so i went to difficult child's pyschdoc today, to see if we can find another medication. We had to pull the lamictal last week due to the burn/rash that appeared.

i went alone this time, so that him and i could have a more intelligent conversation, speaking very openly about the medications, approaches etc.

well i walked away as confused as usual. i'm still searching for a new pyschdoc, yet haven't had any luck. their hard to come by.

I began by stating that when i break it down i'm looking at mood swings the bipolar (severe highs, lows etc.), than lack of sleep issue and wetting bed, and Obsessive Compulsive Disorder (OCD)/anxiety is very bad.

i said we've tried this that the other..... where do we go from here?? i want to help relieve something for her. I told him she's set to return to school in September so we have to get the medication thing straightened out somewhat or at least the prevalent sleep and wetting bed issue.

he begins to throw out names of stuff, not explaining what it is while i'm there. I have to keep asking ok what category is that?? than i said well what do you think I should do.

well i don't know, what do you want to do? omg. same each time! so at the end of the day he suggested elavil..... it's a tricylic antidepressant.

i said why would we go there when every category of medications ssri's we've tried activate her? he said well we can try.......... wth

so i mentioned lithium, depakote....etc? he said no let's try this....he thinks it'll help sleep. My mom gut is thinking itl'l drive her nuts and activate her.

so here i sit script in hand, just as I knew I would confused about what to do. he doesn't listen to me, doesnt' give guidance. He acts like it's therapy..... I don't want you to mirror my concerns. I want some straight shooting answers, besides well she's a complicated case.

So, anyone have experience placing a bipolar child on this medication? if so how'd it go, did it activate?

we're keeping the zyprexa that I have now increased to 7mg. for the simple fact we're afraid shell stop eating again. Yet he said the weigh gain in concerning and leading to depressive episodes.... yes no duh...

 

[klmno]

well i don't know, what do you want to do?

I wouldn't give my son- or anyone's child- nor would I take any medication gotten that way.

Well, ok- I wouldn't after going thru drug treatment. Before that is a different story.

Just saying what I would do- I would never go back to the person.

 

[Jena]

ok i have no choice now..... my question isn't if he's not a great pyschiatrist, the question is have you had your child on that one?? it's easy to say that stuff yet when there are no other available pyschdoc's you would't trust me.

all my old clients go to him and love him! i don't get it.

i just need medication experience....... with this particular one. please...

 

[klmno]

I have no experience with that medication.

Are you saying you can't find another psychiatrist (psychiatrist) in your area or that there have been problems with ones you've seen in the past and now you can't find another one with openings who'll see you?

Is this the same psychiatrist rx'ing medications to your husband and you and older daughter?

 

[Jena]

no, and I don't get medications regularly, just have an old bottle of xanax medications. that I took in portland to help with sleep there. No, the other pyschiatrist are all varied reasons..... not the right age, do not take the insurance, do not have any openings, just are cash etc. we can't afford to pay cash at this time. her therapist is cash.

i just wanted to know if anyone did a run with this medication in particular. he tends to turn towards the older medications. he's old himself, been in the field since he was 30 he's now gotta be about 65 i'm guessing. he's very old school, likes all the older medications. Whereas I dont'.

easy child's had different pyschiatrist, yet he was same the same way, he was from the same office. my gut's telling me it'l activate her, after I took sometime and researched it. I just don't want to put her through another failed medication trial, after we just ran into problems with the lamictal. it's all a carpshoot as well all know. She is tough to medicate my little girl. So many disorders running at once and her reactions are opposite on alot of them.

so right now i'm holding as I said on the zyprexa still.

 

[HaoZi]

Shoot, I know the name but can't recall who I knew that took it.

 

[Josie]

My daughter was tough to medicate before, too. Elavil was the first one that helped her with sleep, anxiety, and headaches.

Her Obsessive Compulsive Disorder (OCD) got out of control and we tried medicating with SSRI's. She had side effects to all of them and had to be off her Elavil to do them.

Elavil did not work on her Obsessive Compulsive Disorder (OCD), but she didn't have problems with it and it was helpful for other reasons.

Anafranil is another tricyclic that is used for Obsessive Compulsive Disorder (OCD). It is what they used to use for Obsessive Compulsive Disorder (OCD) before SSRI's. That seemed to be a disaster for my daughter, too. In hindsight, I think what we thought were side effects were her chronic illness coming out.

A few years later, we went to a different psychiatrist and she has been able to take Lexapro now.

When she went into the hospital for her headache, the neurologist took her off the Lexapro and put her on 50 mg of Elavil. That was scary. I'm not sure if it was the higher dose of Elavil or the lack of Lexapro.

I would start low. When she took Elavil regularly, I think she started at 5 mg and worked her way up to 10 mg. I think she might have taken 15 mg at one point.

 

[susiestar]

Elavil, aka amitryptiline, is one I have a lot of experience with. If it activates her, benadryl can help stop it. Benadryl will actually counteract some problems taht can be caused by elavil. Elavil is often used for migraine prevention and anxiety. It is also often used for insomnia. One reason he may like it is that it has been around forever, is cheap and the side effects are pretty well known. Not like some newer medications where in a couple years we may learn all sorts fo things to watch for. Wiz was on risperdal for years before anyone put guidelines out there for blood sugar monitoring, etc... He was actually off it for over a year before that came around. You won't find that there are unknown side effects for elavil.

It can be very sedating. I know ssri antidepressants have been bad for difficult child, but elavil is not that type of a/d. It is a tricyclic and some say is is not as activating for people with bipolar. It is very often used for anxiety, which is a huge part of difficult child's problems.

It is also fast in and fast out of the system. You should know in a few days if it is going to work, esp for sleep. I actually had it as a prn at one point for anxiety as I was dealing with some abuse issues. It is often sedating at first, but if taken during the day this can wear off after a couple of weeks.

Next time you go in, take a copy of the bipolar child with the medication protocol marked with a postit so you can find it. ask him why he doesn't want to follow that if she has a bipolar diagnosis. It is a valid question, esp if he wants to know what you think on every medication.

I know this isn't the best way for a psychiatrist to work, but if he is all you can find then you will have to take info with you to help try to figure this out by asking the right questions, like why not follow the protocol for treating bipolar that is approved by the board of psychiatrists?? that is the one in the bipolar child book. If you do not have this book, go and get it. It is a very valuabel resource.

 

[smallworld]

I myself have been on Amitripltyline (generic for Elavil) for 5 years. I don't have bipolar disorder. I take it for sleep, migraines, irritable bowel syndrome and stress. For a tiny pill, it hits all of my symptoms amazingly well. My son, who has a Mood Disorder-not otherwise specified diagnosis, took Amitriptyline for a short time for sleep. We have no idea whether it dysregulated him because it was soon after his manic reaction to Zoloft and his symptoms had not yet been brought under control.

Most of the research in The Bipolar Child book is outdated. If you want up-to-date medication protocols, you should look on the Child and Adolescent Bipolar Foundation website at http://www.thebalancedmind.org or look into research being conducted at the National Institute of Mental Health (NIMH) in Bethesda, Maryland. If you can't locate this information, just let me know and I'll point you in the right direction.

If you are going to give this medication a trial, I agree with starting low and going slow.

 

[Jena]

thanks small. i'm going to drop it off tmrw. at the pharmacy to be filled. he wrote a script for 10mg of it. he keeps doing that and than i have to cut them in half to start smaller.

i am giving it to her with the zyprexa. i suggested why not cut the zyprexa half in a.m. half p.m. he said no just give her all the medications at night? ok i said. i know he's been a pyschiatrist for many many years and i try desperately to respect him. yet to understand what a mtg. with him is like one would have to be there.

he speaks in riddles and puts it back on me time and time again. today i finally said hey im just a mom. thats' why i come to you your the expert. (in my head....... or supposed to be i thought)

 

[DammitJanet]

I know many people who have been on elavil for a long time with good results. I myself was on a cousin of it for years but had to come off of it.

If you are looking for a new psychiatrist and are trying to do it without added expense, I just googled "sliding scale mental health in your city" and came up with lots of hits. If they do sliding scale, I am sure they would take your insurance.

 

[Jena]

thanks janet i appreciate you trying and thanks for the info. i've decided to move forward with it. unfortunately i can't start it until sunday night. difficult child has big city wide tests tmrw and thursday and goes to her dad's on friday for the weekend. He never handles new medication trials well.

last time she was on lamictal i began at home she was on her 5th day by him. i told him do your usual yet i wouldn't be poppin her on anything crazy do the movies, park her bodies still adjusting... well ding dong put her on the cyclone roller coaster at coney island in brooklyn. it's the scariest most devastating roller coaster there is if you ask me. so needless to say this is why i've decided to do it upon return from her dad's lol.

i have called several of those docs also, and majority of them do not take insurance so that's why they do sliding scale. going rate right now fora therapist without insurance is 150. we lucked out with- husband's, difficult child's and easy child's. i was soo lucky difficult child's is the most expensive at 80 bucks a week. i'll try again though, our town's suffolk, long island is quite large. I owe for easy child's pysch evaluation still that was 450. so prices here are beyond insane.

still it's appreciated. i'll give it another shot yet won't be able to probably till monday. she has testing tmrw and thursday as i said i scheduled it at library it's too busy here with lawn mowers, dogs barking etc. and friday she has her last piece of the evaluation for the iep. we have our big iep mtg. first week in june.

trying to line it all up so ms. thing can return to school in september beautifully here's hoping