how long should a medication increase take to see an affect?

[Jena]

hi to everyone, i hope everyone's day was good. I know some of us have had very rough days' today. My thoughts were totally with you. so, i have a question....

i increased difficult child's medications about 5 days ago, i did it because i started to see the manic behaviors again, sleep disturbance or rather not falling asleep, extremely argumentative, wetting the bed again, etc.

So, she's struggling tonight. boyfriend's kids unfortunatley are really driving hard with the holidays this year, excited talkign about the "countdown", they were online tonight at toys r us writing their xmas lists. I can't control his kids, their just being kids. Yet difficult child can't handle this over stimulation right now.

So, i was wondering how long do you think it takes to see an affect of some type once dosage is increased?? i already back medication up now to 5 p.m., when i first started i gave it to her at 630.

I just want to try to navigate my ways thru the holidays with her with-o a crash of depression again or a continued manic episode.

sure if she was with-o a diagnosis of any type i'd say ok typical kid behavior she's excited, blah blah yet hmm she's her.

any thoughts???

 

[smallworld]

What dose Seroquel is she currently taking?

 

[klmno]

I think it depends on what the medication is. Anti-depressants can take some time- up to 6 weeks, I was told by psychiatrist. Mood stabilizers work quicker. It might take them 3 weeks to see a real change after an increase or intial start, but missing one dose can cause a change in mood the same day, and some medications are even quicker acting. This is just my understanding of it, but I'm no expert and others here can offer more experience on this topic than I can.

 

[Steely]

Is it the Seroquel you are increasing?
If so, there is an immediate affect of sedation and calming, but more of a long term affect of stopping the mania that can take a couple of weeks. It can definitely be used as a PRN to stop the mania, as well as a long term to keep the mania from coming on, if that makes any sense.
What dose is she on? And what is the doctor recommending you take it up to?

 

[Jena]

hi,

she's now on almost 40mg. of seroquel. we began at 12.5 mg. of it.

she's super sensitive to medications and they usually take affect pretty quick with her. Yet she's starting to climb again. What's very frustrating is that she is looking for an "easy" answer to this. She wants to pop a pill and be all good. I've been trying to explain to her lately and the therapist it requires effort and work on her part. To stay focused during day in school, to handle the anxiety attacks when they hit, to handle the jumpiness and nastiness when it hits, to try to use her "tools" meditations, breathing techniques when she's bouncing off the walls and not sleeping.

Yet she doesn't want to. She's so so thick headed she's like no i'm not doing it, that's it. LOL. I'm sitting here thinking oh man we have a lifetime ahead of this, hopefully i'll break the wild horse soon and she'll begin adhering and trying these things. When we do them together she's all pink and blue yet we are trying to break her of her overwhelming neediness of me as well. So, now I start her off on rough nights and she is supposed to continue on alone.

 

[Jena]

We're also trying to work on the physical stuff, hitting easy child, and pushing me when she's manic and totally i a different world. the therapist seems to think a behavioral chart will work. lol. i'm sorry yet when my little girl is off in that land of her's mentally there is no behavior chart in the world that will make a difference. She has to be medicated first, brought to a managable level than the behavior charts begin.

dr. and i are just taking it one day at a time, rather I am. He's i'll be honest a really nice guy. yet when i call him, he's like umm who, how old is she, what medication is she on?? LOL

 

[smallworld]

If your difficult child is truly experiencing mania, 40 mg Seroquel is not going to do it.

Mania is typically dosed at 300 to 600 mg Seroquel, with some people needing as high as 800 mg. I recommend reading about Seroquel dosing at www.crazymeds.us.

My son started Seroquel last winter when he was staying up all night for several days in a row and not feeling tired at all (this is truly a sx of mania). His psychiatrist started him at 100 mg Seroquel and went up in 100 mg increments every few days until he reached 800 mg. We have since been able to decrease his dose to 600 mg. We found if we didn't increase it quite rapidly, his sx started breaking through, rendering the Seroquel ineffective.

What is the psychiatrist's plan for your difficult child?

 

[Jena]

hi,

that's a huge difference from the almost 50 she's currently at. wow. i see your point.

His plan? I wish I could tell you what that was, I myself do not know. I know what my plan is. He's like well let's see how it goes. I'm there once a mos for a medication check and that's that. he really doesn't even know who i am when i talk to him the few times i've called.

i feel like a mix of the medications, combined with weekly therapy, i work with her at home also, her teacher Ms. herbal is finally on board with me and i'm awaiting the iep mtg.,alot of role playing and calming techniques as well as conflict resolution stuff to hopefully teach her to use instead of her hands (yet i know when manic it's not going to work), and then i brought in the violin thru school, as many play dates as i can grab, and also the play she'll be in, IF she gets on that stage come january.

 

[Jena]

It's going to be a long one. I took her out of her bedroom after 3 hours of unsuccessful attempts at calming down, she was bouncing off the walls in there. Now she's downstairs i put her in the recliner with her pillow and blanket and now she's jumping around in the chair fighting with the kitten. and here i sit with my candles lit and you guys wondering how long this will last tonight??

i have a long day tmrw also, i have to drive out far about 2 hours to pick up the recommendation letter from my old boss for the interview on wed.

 

[smallworld]

Do you have permission from the psychiatrist to use Seroquel PRN? Or melatonin?

 

[Jena]

no i don't. i'm def going to have to put call in tmrw. to him so he calls me back in a few days. than i'll get to see if we are in pattern mode again, or this is a fluke of sorts. She once went literally a mos. with basically endless days and nights. sleeping on average 3 hours per night if that and functioning everyday at a very high level. i just want her to have a good holiday this year, and make it thru calmly.

 

[smallworld]

How high did she get on Seroquel the last time she trialed it?

 

[Jena]

we got to 50 mg. and she seemed very very different. and she broke out with a rash, she gained a ton of weight and we had to pull her off of it. ? i'd like to try the melatonin with it. i won't do it tonight with-o his ok, so i'll wait

 

[Jena]

when she used to go thru this in the summer i'd let her draw, she'd sit up for hours writing random recipes, making books, fascinating stuff. i'm just wondering if i should let her do that now. i hate to do stuff like that becuase it also becomes habit forming for her. she is a little creature of habit. she's soo needing some type of soemthing to do tonight though.

 

[susiestar]

I don't have seroquel answers, though her dose does seem to be VERY low. I think you may need to add a mood stabilizer to it in order for it to be the most help. But you can only change 1 thing at a time, so it will take a while.

Did you ever get a full, PRIVATE Occupational Therapist (OT) evaluation for sensory issues? I can honestly say it may be the most helpful thing you can find. Rin seems to have a lot of sensory things going on, from what you have told me, and addressing these can have a HUGE effect. If I hadn't seen the changes in thank you I would never have believed it. You really almost HAVE to see it to believe it, in my humble opinion.

I DO recommend, STRONGLY, getting the book "The Out of Sync Child Has FUn" by Carol Kranowitz. It is activities that you can do at home to provide various types of sensory input. I let thank you lead me in what he needs. Even before the Occupational Therapist (OT) assessment we had done I would look at what he really liked and disliked and let that lead us through activities. Even food.

for example, he has the food allergies. And from early babyfood, before we picked up on the food allergies, he HATED anything with pineapple or orange or strawberry. So we didn't force those things.

He HATED certain activities on the playground and LOVED others. The ones he loved were providing the types of stimulation he needed. He was a bed bouncer - no matter WHAT I did, he jumped on that dang bed. So I moved the mattress to the floor and let him bounce. He needed that to calm himself down at times. He freaked, totally bonkers, at this indoor gym designed for kids. It was the ONLY time I saw him hit another child on purpose (by age 4). He was just so totally overwhelmed sensory-wise that he couldn't cope. We tried it a second time and haven't gone back.

Anyway, those are just examples. If you get the book, you can go through activities and TRY them. If you keep track of what she does and doesn't like you may be able to figure out some of her sensory needs and look up other ways to help them.

Holidays are hard for any kid, but esp for ours. Sorry it is too much for her.

 

[lizzie09]

Oh Jennifer, I am so sorry you daughter is going through this not to mention you.

As you know my 22yr old son approx 12st weight was put last week on Seroquel and Epilim. The seroquel is 3 doses 25mg each which seems small but is helping things greatly. Is there weight gain even with that amount?
The stabilizer at night is good too at the moment so maybe that might be a consideration for you

I am so new to this medication thing I cant offer you anything but a big thanks for always supporting me and wishing you well and your little girl

 

[BusynMember]

My son took Seroquel for three years. in my opinion if she is bipolar that isn't the best medication for her. It's an antipsychotic and doesn't work that well as a mood stabilizer (I think you are seeing that). My son would be sleepier right away on a dose increase. Why isn't she on a mood stabilizer??? If she is prone to depression, have you ever had her on Lamictal? The only thing is did for my son was make him tired and cognitively dull. To be fair to the medication, my son was misdiagnosed. He didn't HAVE bipolar. He is on the Autism Spectrum Disorders (ASD) spectrum. I don't know if that makes a difference.

 

[smallworld]

Actually, in 2004 the FDA approved Seroquel as monotherapy for the treatment of bipolar mania (you can get to a link to the published study on www.crazymeds.us). Seroquel is also used off-label on its own for the treatment of anxiety and insomnia and augmenting an SSRI for Obsessive Compulsive Disorder (OCD) and treatment-resistant major depressive disorder. So you don't necessarily need a mood stabilizer, but you do need a hefty enough dose to do the job.

And yes, Seroquel can cause weight gain at any dose. It's one of the listed side effects.

 

[BusynMember]

SW, even if it's FDA approved, that doesn't mean it's the best treatment. It doesn't seem to be working for this particular child. I was wondering why no mood stabilizer is in place...

 

[smallworld]

It doesn't seem to be working for this child because it's at such a low dose. Under 50 mg Seroquel isn't going to do much for bipolar mania (if indeed that's what's going on with Jen's difficult child -- she doesn't have a firm diagnosis). Seroquel on its own at a good therapeutic dose seems a reasonable option to try before adding other medications to the mix.