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Just read something here that has me worried
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<blockquote data-quote="slsh" data-source="post: 589207" data-attributes="member: 8"><p>IT1967 - the usual order of medications when bipolar is suspected is a mood stabilizer first. Lithium used to be the gold standard, but in kids a lot of times they use the antiepileptic medications that also work as mood stabilizers - Tegretol, Depakote. A lot more data on use of these medications in children because they are used for epilepsy as well. There are newer ones which I'm not familiar with because we were going thru this about 15 years ago, but really the rule of thumb is mood stabilizer first, then move on from there. After getting the mood stabilizer on board, some kids do well with stims, some flip out (mine). Some do well on SSRIs, some don't. Some do really well on the antipsychotics (Risperdal was a *huge* blessing for us, but other antipsychotics either did nothing or actually *made* my kid psychotic - go figure). There's more trial and error involved than science, because it's impossible to predict what anyone's reaction to a medication will be. </p><p></p><p>Blood tests depend on the medications. Some require routine checks of medication levels. Some require liver function tests and CBCs routinely. Some (lithium especially) should have thyroid functions checked. </p><p></p><p>I really wish there were an easy answer for you on this. I remember well how horrible it was to be playing pharmacologic roulette. I couldn't understand why there wasn't a tried and true medication or combo of medications that would help my kid out enough long enough so he could start learning how to cope with his illness - medication management is really an art.</p><p></p><p>ETA: The one thing that is an absolute, in my humble opinion, is that medications should *never* be continued if they are making behaviors worse or causing unacceptable side effects. My difficult child did gain a lot of weight on Risperdal, but at the time the behavioral benefits far outweighed that side effect.</p></blockquote><p></p>
[QUOTE="slsh, post: 589207, member: 8"] IT1967 - the usual order of medications when bipolar is suspected is a mood stabilizer first. Lithium used to be the gold standard, but in kids a lot of times they use the antiepileptic medications that also work as mood stabilizers - Tegretol, Depakote. A lot more data on use of these medications in children because they are used for epilepsy as well. There are newer ones which I'm not familiar with because we were going thru this about 15 years ago, but really the rule of thumb is mood stabilizer first, then move on from there. After getting the mood stabilizer on board, some kids do well with stims, some flip out (mine). Some do well on SSRIs, some don't. Some do really well on the antipsychotics (Risperdal was a *huge* blessing for us, but other antipsychotics either did nothing or actually *made* my kid psychotic - go figure). There's more trial and error involved than science, because it's impossible to predict what anyone's reaction to a medication will be. Blood tests depend on the medications. Some require routine checks of medication levels. Some require liver function tests and CBCs routinely. Some (lithium especially) should have thyroid functions checked. I really wish there were an easy answer for you on this. I remember well how horrible it was to be playing pharmacologic roulette. I couldn't understand why there wasn't a tried and true medication or combo of medications that would help my kid out enough long enough so he could start learning how to cope with his illness - medication management is really an art. ETA: The one thing that is an absolute, in my humble opinion, is that medications should *never* be continued if they are making behaviors worse or causing unacceptable side effects. My difficult child did gain a lot of weight on Risperdal, but at the time the behavioral benefits far outweighed that side effect. [/QUOTE]
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