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Input on Mood Stabilizers
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<blockquote data-quote="smallworld" data-source="post: 39869" data-attributes="member: 2423"><p>Hi Alison, me again. You're going to get sick of hearing from me.</p><p></p><p>Anxiety can lie at the heart of bipolar disorder. But it can also go hand-in-hand with unipolar depression, be a part of Autism Spectrum Disorders and even be a diagnosis unto itslf. My easy child's only diagnosis is anxiety, and it has manifested itself over the years as selective mutism, a choking phobia and Obsessive Compulsive Disorder (OCD) tendencies. Figuring out where your difficult child's anxiety emanates from will determine in part how you decide to treat him. With anxiety on its own or even part of certain other disorders, SSRIs like Zoloft are appropriate choices. But if anxiety is part of bipolar diosrder, Zoloft could send a child into mania. And even if the child does not have bipolar disorder, there is still a risk of antidepressant-induced mania. Unless you have more concrete diagnostic information, there is absolutely no way of predicting how your son will respond to Zoloft. </p><p></p><p>In my many years of dealing with medications and my own kids, I have found that psychiatrists seem to readily prescribe stimulants and antidepressants, but tend to go to mood stabilizers as a last resort. That is what happened with my two older kids. Their psychiatrists prescribed mood stabilizers only after they had bad reactions to SSRIs, which were originally prescribed for anxiety and depression. And I don't fault the psychiatrists in any way. We don't have a family history of bipolar disorder (do you?), and their symptoms seemed to merit treatment with SSRIs. I'm not saying that this should happen in your case, but I think you have to get a firmer grip on diagnosis before the psychiatrist determines course of treatment. Can you have your difficult child evaluated elsewhere before you decide to go ahead with any more medications? </p><p></p><p>The first-line mood stabilizers are Lithium and the anticonvulsants Lamictal, Depakote, Trileptal and Tegretol. Just like any psychotropic medications, they are not without risks. In my experience, their best use is not for alleviating anxiety, but rather for smoothing out the ups and downs in mood. Depakote was very good at containing my son's agression and agitation. Lamictal has been very good at lifting my son and daughter's moods and generally making them more stable. We have never used Trileptal because our psychiatrists have been underwhelmed at its efficacy for adolescents. And even when we contemplated a mood stabilizer for easy child earlier this year, her psychiatrist said she wouldn't choose Trileptal because it had mixed clinical reviews. But this is just the opinion of three psychiatrists. What matters is the opinion of the psychiatrist treating your son. And if you don't think she's doing a good job, you need to find someone better.</p></blockquote><p></p>
[QUOTE="smallworld, post: 39869, member: 2423"] Hi Alison, me again. You're going to get sick of hearing from me. Anxiety can lie at the heart of bipolar disorder. But it can also go hand-in-hand with unipolar depression, be a part of Autism Spectrum Disorders and even be a diagnosis unto itslf. My easy child's only diagnosis is anxiety, and it has manifested itself over the years as selective mutism, a choking phobia and Obsessive Compulsive Disorder (OCD) tendencies. Figuring out where your difficult child's anxiety emanates from will determine in part how you decide to treat him. With anxiety on its own or even part of certain other disorders, SSRIs like Zoloft are appropriate choices. But if anxiety is part of bipolar diosrder, Zoloft could send a child into mania. And even if the child does not have bipolar disorder, there is still a risk of antidepressant-induced mania. Unless you have more concrete diagnostic information, there is absolutely no way of predicting how your son will respond to Zoloft. In my many years of dealing with medications and my own kids, I have found that psychiatrists seem to readily prescribe stimulants and antidepressants, but tend to go to mood stabilizers as a last resort. That is what happened with my two older kids. Their psychiatrists prescribed mood stabilizers only after they had bad reactions to SSRIs, which were originally prescribed for anxiety and depression. And I don't fault the psychiatrists in any way. We don't have a family history of bipolar disorder (do you?), and their symptoms seemed to merit treatment with SSRIs. I'm not saying that this should happen in your case, but I think you have to get a firmer grip on diagnosis before the psychiatrist determines course of treatment. Can you have your difficult child evaluated elsewhere before you decide to go ahead with any more medications? The first-line mood stabilizers are Lithium and the anticonvulsants Lamictal, Depakote, Trileptal and Tegretol. Just like any psychotropic medications, they are not without risks. In my experience, their best use is not for alleviating anxiety, but rather for smoothing out the ups and downs in mood. Depakote was very good at containing my son's agression and agitation. Lamictal has been very good at lifting my son and daughter's moods and generally making them more stable. We have never used Trileptal because our psychiatrists have been underwhelmed at its efficacy for adolescents. And even when we contemplated a mood stabilizer for easy child earlier this year, her psychiatrist said she wouldn't choose Trileptal because it had mixed clinical reviews. But this is just the opinion of three psychiatrists. What matters is the opinion of the psychiatrist treating your son. And if you don't think she's doing a good job, you need to find someone better. [/QUOTE]
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