Lithium question/school suggestions

[Wonderful Family]

Hi everyone:

Been a while since I've been on since it's been so hectic at home and work. I thought the best way to do this would be an update and then list my questions.

Overall, difficult child continues to do "OK"; basically he stays away from anything that will remotely cause him stress or make him uneasy. School finished OK as well. He's still great about taking his medications himself with minimal reminders. However, he does still become unglued if you take him out of his comfort zone at all and he is still paranoid/anxious most of the time. He can just hide it now under "normal" home circumstances.

psychiatrist wants to add lithium to the medication mix and start decreasing/eliminate the Geodon starting in July. Although we have not had any problems with the Geodon, the concern is due to unknown long-term side effects and his still constant cycling - combined with the inability to increase the lamical anymore until he gains some significant weight.


Obviously, there's a good chance that the Geodon may not go away completely . . . but that was psychiatrist's stated goal. I think difficult child may stay on at least a low dose; but we have a great psychiatrist who will listen and work with us.

To make matter worse, difficult child will have to go back to public schools next year due to a pending job loss for husband. SD is extremely hard to work with; difficult child went to a private school for special needs kids the last couple of years. I had a child that would sit in a catatonic state and just wring his hands for hours on end; yet there was "nothing wrong with him" according to SD - when he wasn't raging. Of course, he was just extremely hyper at school when he was there and was constantly in trouble for dumb things.

We originally went back to the SD this past spring for evaluation just to keep his IEP active and try to get him into what is supposed to be a very good therapeutic school in the district. SD is going to put him directly back into mainstream with supports added "as needed", potentially behavioral intervention and speech testing. The evaluation they did had the psychiatrist and husband pretty upset. We were hoping to wait until HS to try to go back with hopefully better results (different caseworkers).

Fortunately, husband has decided he will handle everything with the SD.

My Questions:
1. What are the side effects associated with starting Lithium? How long before we hit therapeutic levels; difficult child is about 105 pounds.
2. Does anyone have any experience with the combination of lamictal and lithium (lamictal has been a bit of a god send for our son).
3. How does/will Lithium impact the anxiety levels? Or is this driven more by the bipolar not being stabilized (I know that the anxiety can be a separate component as well - just never sure how much is which).
4. The SD clearly accepts the medical diagnosis right now - but medications are supposed to fix everything. They cleary view difficult child's potential lack of cooperation with homework, etc as just that; not difficult child being unable to cope with day-to-day because he can't say why. Any suggestions on how to explain this so that they can witness it in an objective fashion for themselves? difficult child will sit in any meetings and definitely agree to do what they say; then can't.

Thanks!

 

[alongfortheride]

My son takes Lithium and Lamictal with Neuroton for social anxiety. The mix is the best we've had yet. I am very pleased but the anxiety component still keeps him from doing anything outside his comfort zone, like a job interview At least the mixed state he was in before this medication combo is stable. Mixed scares me the most. When he's low, he doesn't do anything but at least he's not out there putting himself at risk for arrest like when he's manic. The mixed however is the worst because I fear for his life. Good luck.

 

[BusynMember]

My son took Lithium for three years. I took it for a few months then I gave it up.

1/I have heard, although I'm not sure, that Lithium with Lamictal is not safe, but again NOT SURE.

2/Lithium takes up to EIGHT WEEKS for a therapeutic effect. The blood lithium level should be closely monitored and is important. My son gained so much on Lithium, and his thyroid was messed up. He is still obese after being off medications for four years. This is not a medication that will not cause weight gain. It often does cause weight gain, often a lot. My son also wet his bed every night that he was on it (never did it before or since). He was also very thirsty and had to have water at his desk at school, which they were very good about allowing. Ditto for sudden urges to go to the john.

3/I didn't care for Lithium and I have bipolar II. I'm sure it's a great medication--it is the golden standard for bipolar and has been for years. It has saved many lives. But for me it made me feel as if I was walking around in a dream state and it scared me. Of course, my fabulous psychiatrist (heavy sarcasm) never took blood draws and my level was 1.6 when another psychiatrist finally took it (this was three days after I'd tossed it in the trash).

The only advice I have for a unhelpful school district is to get an Advocate to go with you and talk to them. You can find one by calling your Dept. of Public Education, and I highly advise doing it. We got nowhere without one. They don't cost anything and are available to all. Of course, SD's never tell you about them because they don't like them--they actually force them to follow the law.

Lithium can be very useful for bipolar, substance abuse and to stem off suicide. I hope it helps your ds. Prayers and hugs!

 

[Wiped Out]

My difficult child didn't do well on Lithium but he didn't do well on much for a long time. The biggest side effects for him were constantly being thirsty and using the bathroom. Along with that it affected his thyroid gland which I believe is not that uncommon.

The school district needs to get a clue. I hate when teachers expect medications to be a cure all. One thing that has been helpful for us is we have copies of difficult child's neuropsychologist report along with a letter from his psychiatrist on file with his school.

 

[Wonderful Family]

Thanks for the responses. We'll see how it goes with the lithium.


Can you tell me more about the Advocate?

 

[jcox]

My E is on Lithium Extended Release or Eskalith CR the name brand is. He is doing very well on it, actually better with this medication combo of Abilify-Lithium-Clonidine then he ever has been in his life. This is the first time that I can say he has been mostly st*ble. The extended release versions work better for him. When E first started Lithium he had stomach aches, and he still gets headaches from it sometimes. His anxiety is very very high and the Lithium seems to do nothing for this.

 

[totoro]

I know of a few who are on the Lithium and Lamictal combo AND are doing quite well.

Weight gain can be controlled, it sounds like your difficult child is not having weight issues to begin with, by drinking non-sugar drinks. This is a huge one!
No sodas, no sugar added to fruit juices.

Increased bedwetting happens to some, not all. Usually it happens to kids who have had this problem in the past.

We have not had a problem at all. Statistically it happens more to boys than girls though.


Bad things can happen with any of the medications our kids are taking.
Lithium actually helps the brain recover from serious manic attacks. There is proof that instability without medications can cause slight brain damage, Lithium has been shown to help the brain form reconnections to the damaged areas. No other medication does this.
(I am sure I am not wording scientifically correct but this is the basics of it)

Lithium results can show up in a matter of a few weeks for some, not a therapeutic level but improvements for your difficult child.

My difficult child was showing improvements in 2 weeks, small things but better.

Her anxiety is still a problem, but we are using therapy for this.

She is on a small does of Abilify with the Lithium. We use Ativan as our PRN.

The huge thing is is to drink tons of water! We use rewards for this.
She has not gained a pound so far, but we are watching what she eats and controlling portions.

We are doing this because the AP's caused a lot of weight gain. Much more than the Lithium will.
Our psychiatrist has found that her patients when they follow these steps for the most part and stay active don't gain too much weight.
But for some it is just a fact with medications. Like K with her AP's.

We are going to cut her Abilify in half once she has been on Lithium a bit longer.

Good luck, I hope it works. Not all of these medications work for each of us. Some do some don't.
Doesn't mean it won't work for you.

Also we do blood draws every 3 weeks and then space it out once at Therapeutic level.
But we went very slow in the beginning, to avoid any stomach issues and intense side affects.
K has had none.
Other medications have been a nightmare for here... but one never knows.

Lithium may not be our answer, I hope it works for you!

 

[wakeupcall]

M\y difficult child, 13, has been on Lithium for about two years. He has blood draws every 6 mo or so to make sure all is well. His level had been staying at 1.9 and it dropped to 1.7. The psychiatrist increased it and the symptoms he had had breaking through went right away. He has a diagnosis of mood disorder, but no one (yet) is calling it bipolar. He takes Lithium, Focalin XR, and Strattera. So far, the combo is working well. The only thing I've noticed of late is non-stop talking.

 

[susiestar]

No real info, but I hope you can find that "magic" level of the right medications to give him his life back.