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General Parenting
Developed Tolerance to Stimulant, Now What?
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<blockquote data-quote="pepperidge" data-source="post: 16866" data-attributes="member: 2322"><p>Hi, </p><p></p><p>Welcome to the board. All I can say is that it sounds like where my youngest son (the almost ten year old) is at right now (on Abilfy , now trialing Focalin), you have described him to a T. </p><p></p><p>Also somewhat where my oldest one was before we got on mood stabilizers. He started off pretty well on just Adderall (had more inattentive type of ADHD), but it seemed to lead to very angry episodes, particularly on the rebound. He was irritable/depressed all the time. We added in Prozac, but then he became very impulsive. We needed more stimulants just to deal with the side effects of the Prozac. Needless to say, we ditched the Prozac pretty quickly. It wasn't until we got to the combination of the stimulants with Lamictal and Risperdal that we have achieved some stability. </p><p></p><p>Have you seen the thread on severe mood dysregulation of about a week or so ago? That seems to describe my kids pretty well, much better than bipolar, since they don't seem to cycle at all. </p><p></p><p>Is there anything that would make one think of more classic childhood bipolar (Have you read The Bipolar child?)</p><p></p><p>Have you discussed trialing a mood stabilizer with you psychiatrist?</p><p></p><p>One thing I don't understand very well is the interaction between Abilify (which acts on dopamine) and stimulants (which also act on dopamine.) I wonder if the abilify dampens the impact of the stimulants. But haven't found a psychiatrist yet who could give me a satisfactory answer to that question.</p><p></p><p>We haven't had good luck with yet with my youngest. While the Focalin seems to be helping a bit with the frustration intolerance, I am not sure it is the total answer. Abilify worked great for a few months, but then pooped out on the mood front, though I think it helps the impulsiveness a bit. So we too are wondering where to go. We trialed Lamictal for him, but didn't seem much of a difference it seemed (though maybe a little more than we thought). </p><p></p><p>All this to say that it sure is complicated. I would look at reducing the Focalin (maybe some of the anger and frustration are due to that) and maybe think about a mood stabilizer of some sort. </p><p></p><p>Don't know if this helps. I guess I would research more bipolar/severe mood dysregulation and familiarize yourself with mood stablizer drugs if you are not already familiar. Is your psychiatrist sympathetic to the notion that it might be a mood disorder? </p><p></p><p>And many of us think that the Explosive Child is very useful, too, if you haven't read it already.</p><p></p><p>welcome and hope you can get things straigtened out.</p></blockquote><p></p>
[QUOTE="pepperidge, post: 16866, member: 2322"] Hi, Welcome to the board. All I can say is that it sounds like where my youngest son (the almost ten year old) is at right now (on Abilfy , now trialing Focalin), you have described him to a T. Also somewhat where my oldest one was before we got on mood stabilizers. He started off pretty well on just Adderall (had more inattentive type of ADHD), but it seemed to lead to very angry episodes, particularly on the rebound. He was irritable/depressed all the time. We added in Prozac, but then he became very impulsive. We needed more stimulants just to deal with the side effects of the Prozac. Needless to say, we ditched the Prozac pretty quickly. It wasn't until we got to the combination of the stimulants with Lamictal and Risperdal that we have achieved some stability. Have you seen the thread on severe mood dysregulation of about a week or so ago? That seems to describe my kids pretty well, much better than bipolar, since they don't seem to cycle at all. Is there anything that would make one think of more classic childhood bipolar (Have you read The Bipolar child?) Have you discussed trialing a mood stabilizer with you psychiatrist? One thing I don't understand very well is the interaction between Abilify (which acts on dopamine) and stimulants (which also act on dopamine.) I wonder if the abilify dampens the impact of the stimulants. But haven't found a psychiatrist yet who could give me a satisfactory answer to that question. We haven't had good luck with yet with my youngest. While the Focalin seems to be helping a bit with the frustration intolerance, I am not sure it is the total answer. Abilify worked great for a few months, but then pooped out on the mood front, though I think it helps the impulsiveness a bit. So we too are wondering where to go. We trialed Lamictal for him, but didn't seem much of a difference it seemed (though maybe a little more than we thought). All this to say that it sure is complicated. I would look at reducing the Focalin (maybe some of the anger and frustration are due to that) and maybe think about a mood stabilizer of some sort. Don't know if this helps. I guess I would research more bipolar/severe mood dysregulation and familiarize yourself with mood stablizer drugs if you are not already familiar. Is your psychiatrist sympathetic to the notion that it might be a mood disorder? And many of us think that the Explosive Child is very useful, too, if you haven't read it already. welcome and hope you can get things straigtened out. [/QUOTE]
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