Another Risperdal ?

[totoro]

So I am trying to be patient here... ha ha. But, difficult child increased her Risperdal from
.25mg bid to .50mg bid as of last Thursday. So it has been 5 actual days (complete doses) She wet her bed last night, did not wake up. Has gained another pound, this is now 6 pounds in 8 weeks. With heavy duty food monitoring and an increase in exercise.
She is still a wreck since the increase... up and down all day, anxious, depressed, aggitated, worried, having weird thoughts, everything scares her, hyper, hungry, very labile, everything just seems to have increased in the past 2+ weeks and this medication increase hasn't affected her yet.

Should it have??? I am trying to give it some time before we call her psychiatrist, I just don't know when is it time to try something else. I know when you first start the Risperdal you need to give it 6 to 8 weeks to really balance them out, but what about an increase???
husband is out of town working and I have 2 kids who are so emotional right now I feel really bad for them. But difficult child is just struggling, she does really well with husband working back and forth so far, because she gets so much special time from him when he is here that she kind of likes it now.
I am trying to keep her busy so her little mind won't run amock... but she gets so overwhelmed so easy. Again it is like back to before the Riperdal with a decrease in the violence still.
Thanks guy's

 

[smallworld]

Totoro, sorry you're struggling. Not sure where you got the idea that APs like Risperdal take 6 to 8 weeks to work like mood stabilizers. They generally work very quickly. If you haven't seen much improvement in 5 days, I'd recommend a call to the psychiatrist. It may be that Risperdal is not the right medication for your difficult child.

In terms of the weight gain, it happens on APs in spite of how much you watch food intake. My son gained 12 pounds in a month on Risperdal. I've heard of some kids who take Metformin (a diabetes medication) to counteract the weight gain, but I don't know if that would be recommended for a child as young as yours.

Hang in there. We're here for you.

 

[Nancy]

I'm sorry I didn't see your previous post but I will tell you that Risperdal caused a big weight gain very quickly in my difficult child. I think we only had her stay on it for about 6 weeks before deciding the benefits were not worth the weight gain and other side effects.

We were lucky because we found other medications that helped much better and did not cause weight gain. If it were me I would be seriously questioning the benefits of this medication.

Nancy

 

[flutterbee]

I've not heard of AP's taking so long to take effect either. Risperdal, I know for sure, is often prescribed PRN. It's effects are immediate...but maybe not the effect your psychiatrist is looking for.

I think a phone call to the psychiatrist is in order.

Good luck. I'm sorry you and difficult child are struggling so much. Hugs...

 

[totoro]

Smallworld I guess I didn't word my post very well duh??? I am not comparing ap's to mood stabilizer's, I was going with the "start low and go slow" theory. That they do indeed take time to fully get into the childs system, not that I didn't see any effect, I saw an effect the next day when she first started taking them. I was going with my psychiatrist's and others suggestions that by around 6 to 8 weeks you will see the full effect of what the AP is doing for your child, or not doing. Thus then you increase or stop the medication.

My question was should the increase be helping more dramatically by now??? But I do see you point that it should be doing something by now. I just didn't know with an increase if it was so noticable in past experiences or what???
I don't know why but because this is our first medication trial it is hard to know when to give up and how hard to push the psychiatrist. I always feel like I am bugging them!!!
Thanks Nancy

 

[Janna]

Dylan's been on Risperdal 3 different times over many years (funny, each psychiatrist really liked that drug, and each time, it made him worse).

We saw results (although negative) every time within a couple of days.

Additionally, we increased him in 2003 from .25 (and it made him crazy) to .50 (why did he increase it if it was making him crazy, I don't know) and he got even worse, immediately, when we increased it.

It does not take time to "build up" from what I understand. As with the Abilify Dylan is currently on, when we increase the dose, we see positive results within 48 hours I'd say, if not sooner.

Janna

 

[totoro]

Janna
thanks
Her psychiatrist had said just give it some time... but my gosh she is driving me crazy... I know the Risperdal is not suposed to fix all of her problems, It doesn't even seem to be curbing the agitation and violence as well either...
hmmm.

 

[Janna]

Well, I'm no doctor by any means, totoro, but I can tell ya that we have gone through so many medications because ones that were supposed to work quickly just didn't.

I think (and I'm only going by my own, non doctoral experience here) I'd call the psychiatrist and tell him/her difficult child is not calming down on the Risperdal if this was my kid.

No, it shouldn't be a fix all, but the antipsychotics SHOULD at least, if nothing else, CALM your difficult child down some. If you're saying your difficult child is more wound up, that's a problem.

Janna

 

[totoro]

Has anyone had hiccups??? difficult child has been getting hiccups for the past couple of days off and on all day!!! It is driving her crazy! Poor thing. Can the medication increase do this?


Thanks Janna-
I think I am going to call in the am... this is just so scary. I know I will get used to this but a small part of me was hoping this would really help her at least for awhile...

 

[pepperidge]

Sounds like a call to the psychiatrist is in order, if you are really not seeing a noticeable improvement. I wouldn't hestitate to call. (Does she do email?)

One thing you might think about is giving her .25 at one point in the day, and .5 at the other time (if I understood you correctly to be giving .5 twice a day). Maybe the jump was just too much.

We saw a pretty immediate effect with Risperdal and Abilify.

By the way, my son had problems with daytime accidents when we upped his Abilify. Something about what is does to the autonomic (?) nervous system. Perhaps a smaller dose would help.

Sorry it didn't work its magic.

 

[dreamer]

when we had elderly patients in the nursing home who had alzheimers or dementias, and they would get all wired and wound up, respirdal was the medication we used most often for a "quick get them calm" medication for the moment. We gave one dose at the time we needed them to calm down and we saw result in minutes. (for the record, we only gave it to people who had an order for the use of it prn)
BUT for some people, it is NOT effective and for some people it makes them act out worse. even "start low go slow" you should not see an increase in undesireable behaviors.

 

[Janna]

That's a good idea, too, splitting it up.

One other thing, too, dont get discouraged because one antipsychotic didn't work (or doesn't seem to be).

Dylan did awful on the Risperdal. I mean, the kid was on all fours in the classroom, barking like a dog, hallucinating, thinking he was a canine. He was having a conversation with the wall one day. He spurted out "are you drunk"??. Who was he talking to??? OMG, he didn't shut up for TWO SECONDS on that drug. He was FLYING OFF THE SOFA! Argh. But the Abilify has been great. Down side - the weight gain, on all the antipsychotics he's been on (he was on Seroquel at one time too). Some kids just react so funny to some of the medications.

I know you want the first pill to work. I'll tell you, at 5.5 years old, you're pretty lucky to have that BiPolar (BP)-not otherwise specified diagnosis. I had to wait until Dylan was 9 years old to be told that was going to be our "optimistic diagnosis" and boy, I had no clue. So, at least you're getting it early.

Stay tough. The BiPolar (BP) is very hard to try to figure out. If I put the list of all the drugs Dylan's been on, your mouth would drop to the ground. 17 medications. 7 years. That's how long it took for us to get it right. But you know what? When we did find the right mix, it was great. And it's been over a year, and he's been great.

The BiPolar (BP) still presents, but it's nowhere what it was. He's such a happy kid. Just try to hang in there.

Janna

 

[dreamer]

totoro- I think the doctor does do email......

 

[smallworld]

Now that you mention it, my easy child got hiccups on and off for an entire day. I think it may have been around the time we increased her Zyprexa (another AP), but I never connected the two events until now.

FWIW, easy child has been taking Zyprexa for mood stabilization and anxiety (choking phobia that led to a feeding disorder) since July. She was making very slow progress with eating, seemingly stuck at just eating very soft foods, when we increased her Zyprexa. Within days she was eating almost everything again. It was that dramatic. So yes, I do think you can see improvement very quickly with APs.

On the other hand, difficult child 1 took Risperdal for one month total, and within that time, we were able to determine it was not the right medication for him. He took .25 mg BID for 2 weeks, and when that wasn't effective in calming his mania, we raised it to .50 mg BID. Within days he had a dystonic reaction (uncontrollable mouth opening, lip licking and tongue thrusting) and akathisia (internal and external restlessness that can look like agitation and anxiety). If you think your difficult child may be experiencing that, it is definitely time to check in with the psychiatrist.

 

[dreamer]

And Janna? may I say------you were one of he lucky ones?
You were able to get the diagnosis sooner, and find medications that did work faster.
I mean that in a positive way. From 1989 till 1999 they kept saying well yeah it LOOKS idetical to bpolar BUT children cannot have bipolar.
and the medications? We hit 17 medications so many years ago, bypassed 17 medications.and were still going strong somewhere towards 30 or so medications...... when psychiatrist decided enough was enough.

100 extra pounds (APs) later combined with a full 6 inches shorter (stims) than the next shortest person in our family and blood pressure problems thru the roof from APs (irreversible)
and Lupus like symptoms (also irreversale) from- I forget which medication it was? Tregetol, Trileptal? Seroquel? I do not remember.
Yes, the symptoms of bipolar will stretch and try your patience and the treatment will stretch and try your patience.
Hang in there. Someone here always posts "it is a marathon, not a sprint" and they are right. Pae yourself, and keep your eyes open and keep an open mind. The trial and error, hit or miss of the drugs is not always easy. ANd....well-----nevermind. I won't say what I was oing to say.
Hang in there. This is notfor the weak of heart.

 

[Janna]

Yeah, Dreamer, I feel lucky, but know we have a life long battle ahead.

And for now, the Lithium/Abilify is a great mix, but I see changes coming soon. We are discussing removing the Abilify. We are discussing replacing that with a stimulant.

So, things may be fun soon LOL!

I wish I could tell everyone with a BiPolar (BP) kid to try the Lithium/Abilify mix, haha. Too bad we all know it doesn't work that way :frown:

Was alot more than the medications, though - but you know that too :smile:

 

[smallworld]

Janna, why removing the Abilify and replacing it with a stimulant? What's going on with Dylan?

T, sorry to hijack your thread.

 

[dreamer]

Janna....I am glad you do not seem to have taken hat wrong.
Yes, I do know it has been hard for you.......and a loot of work etc. LOL, some days I do get jealous when I hear tho, how well DYlan is doing.
I CAN say over the years "I" have changed. My outlook, our priorities etc have changed and how we handle things.....and while we do have difficult times, there is seldom anger in our house, even with all our diagnosis'es.
To my delight I took oldest difficult child with to eye surgeons for son this week and oldest difficult child did GREAT and was helpful. things at home did not run so great with busy easy child and gfgdh......BUT-------I expected that.....so at least it was not a surprise.

Nah, we did not find a medication or medication combo that worked but there are 3 of us bipolars living here and life is not so bad.

ALso I also apologize for hijacking the post a little------BUT have hope.....hang on to hope. and do something nice for yourself!

 

[totoro]

Well I am so glad I asked because my husband is very hesitant on changing he wants it to work and I felt like it should be working... she has had an increase in toungue thrust,drooling and lip licking... she did it before but it has kicked up a notch...

Janna I like the visual of Dylan... I think difficult child is a bit like that latley!!!

Maybe I will e-mail the psychiatrist tonight and see if she responds...

I feel better believe it or not!!!

 

[smallworld]

T, my son has tics so when he started in with an increase in mouth opening and lip licking, we thought it was just his tics kicking up. But then the lip licking became so uncontrollable that the skin around his mouth became irritated, and he developed a serious staph infection. Our pediatrician, who treated the staph infection, said he was very glad we had pulled difficult child 1 off Risperdal. This is definitely a side effect that needs attention.