difficult child in the hospital/new diagnosis

Discussion in 'General Parenting' started by Jody, Jul 9, 2010.

  1. Jody

    Jody Active Member

    difficult child is in the psychiatric hospital again. 4th time this year. Her Dr, who I am told is very very good and was assigned difficult child because she has had so many numerous hospitalizations. She is taking her off the Abilify all together, and they are putting her on Trileptil. Is this good news? She has gained 40 lbs since January. She has diagnosed her as Bi-polar. Everyone knew that she was bi-polar or were pretty sure but didn't want to label her at such a young age. I am bi-polar. You can watch her rapid cycle. I am hoping that this is the last time she has to go in and that somehow that this is the miracle drug for her. She takes Wellbuterin XL 300 mgs and Adderall Xr 40 mgs. Please send some prayers and happy thoughts difficult child's way. She's such a terror and so hard to live with, but I still miss her. I so want to see her happy like other kids, even if it's just a little bit here and there. it's better than unhappy all the time.
  2. smallworld

    smallworld Moderator

    Jody, hugs.

    Are the psychiatric hospital psychiatrists going to take her off Wellbutrin and Adderall as well? It can be very hard to stabilize a child with BiPolar (BP) while she's taking antidepressants and stimulants, even with a mood stabilizer in the mix.

    I'm glad your making headway. I hope she improves soon.
  3. susiestar

    susiestar Roll With It

    I hope the hospital is able to help her. I am glad you are getting a few days to recharge your batteries, if possible.

    Have you read "The Bipolar Child"? It is an excellent resource, esp with regards to medications. Bipolar can be very different in children.

    It would be a miracle if your daughter was able to get better while still on Adderal and Welbutrin. It is RARE for a child with bipolar to be able to take stimulants OR antidepressants with-o them causing cycling and other problems. The trileptal is a good choice for antipsychotic as it seems to also have some mood stabilizing properties. While difficult child is still in the psychiatric hospital please ask the doctor about weaning her off of the adderal and welbutrin and getting her on a first line mood stabilizer.

    Often a child with bipolar will have to be taken off all medications except a mood stabilizer and an antipsychotic. Sometimes they even need 2 mood stabilizers to become stable. Once their moods are stable then SMALL amounts of stims or antidepressants can be tried. It is not uncommon for them not to be needed because the symptoms that were thought to be adhd and depression were actually being caused by the bipolar. Until she has been off of them, and on the right combo of mood stabilizers and antipsychotics for 6-8 weeks, you won't know if she will really NEED the adderal and welbutrin.

    For some reason many docs need to be pushed to follow this. It is the formal medication protocol for treating bipolar patients (children and adults) established by the boards of psychiatry. It is in the medication section of the Bipolar Child, and is also on the web. Ask the doctor to follow this to see if it will help. You may find that the welbutrin and adderal are causing far more problems than they are helping.

    Several of the adults on the site who have bipolar have said that changing to this protocol made a HUGE difference, better than they ever thought could happen. It is one reason that many of us suggest pushing the doctor to try it. It will take 6 to 8 weeks after difficult child is at a therapeutic level to know how well the medications are going to work. It can be HARD to get to that level and then wait so long, but it can be worth the effort in the long run.

    I hope that this helps. Now that she has the formal diagnosis it is time to push for the right treatment. When other disorders are comorbid, it is important to treat the bipolar first because many medications cause cycling. Until the moods are stable the other problems cannot be fixed no matter what you do.
  4. smallworld

    smallworld Moderator

    Trileptal is a first-line mood stabilizer, NOT an antipsychotic.
  5. TerryJ2

    TerryJ2 Well-Known Member

    I hope it works. I don't know anything about it other than what I read here.
    I do know that bipolar people do not do well on Adderal or other stims.
    She must be miserable. I hope this helps!
    And I hope you trust the hospital enough that you can get some sleep and peace while she's in there.
    I had mixed feelings when my son was there.
  6. DDD

    DDD Well-Known Member

    Sending caring thoughts your way....with fingers crossed, too. DDD
  7. susiestar

    susiestar Roll With It

    Sorry for the mistake on trileptal. I googled it and misunderstood the article I pulled up. Now I am confused as to why Wiz was put on it to help with aggression when they took him off of geodon. It happened years ago so it doesn't really matter anymore.

    Hopefully the docs will still wean her off the adderal and welbutrin.

    Keeping your family in my prayers!
  8. Wiped Out

    Wiped Out Well-Known Member Staff Member

    First off, hugs and I am praying that your difficult child will start to improve. My difficult child who is both bipolar and ADHD cannot take any stims because it brings on so much raging in his case. Sometimes once a person is stabilized they can do well on stims but not for my difficult child.
  9. Jody

    Jody Active Member

    Dr. just called and she said difficult child is going to be there the rest of the week and maybe will get out sometime next week, if all goes well. I talked to her about what I have been told regarding the mixing of the stimulants and depression medicine with the mood stabilizer and anti-psychotic. She is tapering her adderall xr down to 35 or 30 mgs a day. She says she is very depressed and doesn't realy have the mania type bi-polar. More of the depressive state and she wants to keep trying her on the trileptal and see if she can get some relief, but she needs her depression medication and if her mood improves she might not need it, but for right now she does. I am so hoping this works. She said she normally would have tried Lithium first but since I have had success with trileptal she wants to start her on that. I hope this goes better than the rest of the hospitalizations.
  10. CrazyinVA

    CrazyinVA Well-Known Member Staff Member

    FYI, Lamictal is a mood stabilizer than can be very helpful with depression. Just another option; it does have to be titrated up slowly, however. It takes about 4 weeks to get up to the minimum therapeutic dosage, and Youngest ended up being on about 3 times that eventually.

    I know you must miss her terribly, but I'm glad they are not in a rush to discharge her, so that hopefully she will be stable once she's home. Sounds like the doctor actually listens, too, which is huge in my book.
  11. shellyd67

    shellyd67 Active Member

    Jody, I am sending good thoughts your way .... I hope all works out for difficult child and your family !
  12. Wiped Out

    Wiped Out Well-Known Member Staff Member

    I'm so glad they don't seem to be rushing her out! Hugs.
  13. Jody

    Jody Active Member

    I talked with difficult child this morning and she was very calm and get this she was AGREEABLE. I wanted to talk to her forever. Those moments mean a lot, I hope that we have some more of that when she is out. It sure would be nice to spend some time with her that isn't all bad. Thank you for all the good thoughts!!!!
  14. Jody

    Jody Active Member

    It is best not to say anything good, because I jinx it everytime. She called on her lunch talk time. I couldn't stand to even talk to her. She was being manipulative. She was telling me she might get to come home on Friday if she was good for the rest of the week, and that as soon as she got home she was going to relax. Knowing full well that her room is a mess and you cannot walk in it. But she is laying out on the line and telling me what she is going to do once she walks in the house. I said well after you get in and have a little rest it will be time to get going on that room, you have been refusing to work on. Here comes the whine, "won't you even help me on it". Ugh. just started to cringe, same old, tired whining and manipulation. Drives me nuts. I didn't make the mess but of course she wants me to help (do the majority of the cleaning) while she moves as slow as she can and acts like she's not understanding the words, pick up all the papers, get all the plates/dishes/cups out of here and take to the kitchen sink. Ugh, i am so not ready to do this again. It's like vacations, by the time I start to relax and feel like I should on a vacation, it's time to go back. I am starting to feel halfway decent and then she comes right back again and the peace and happiness I have found is gone. I do miss her sometimes, but then I think of something that she says a lot of, and it cures me, instantly.