Lithium

[Bugsy]

I am wondering about lithium. My son has tried so many medications and is currently on 700 mg seroquel, 100mg lamictal and 6mg invega (started 2 weeks ago). It has been an extremely difficult spring. Since the end of February there have been daily meltdowns, more panicking, constantly impulsive, rages, violent behavior and so on. We considered hospitalizing him but really can't see how it would be better for him considering there really is not a solid children's psychiatric hospital/floor. I went to a support group and the therapist and moms kept saying they don't know why the doctor has not tried lithium yet for my son considering his list of medications tried and the severity of his moods.
The word lithium seems to be scary but yet with all of the reading I have done ALL of the drugs have unpleasant side effects but I keep reading that lithium is still one of, if not, the best help for many people.

Should I be more afraid of lithium? I understand the blood being drawn , but a weekly needle seems managable compared to out of control behavior and being hospitalized without your parents.
Are there topical analgesics that make the needle less painful?
The doctor did say it would probably be the next drug to try.

I'd appreciate feedback on lithium.

Thanks,
bugsy's mom

 

[BusynMember]

How long has he been on Lamictal and at what dose? You have to give a mood stabilizer eight weeks at a therapeutic dosage.
Lithium is known as the Gold Standard for bipolar, however, it also takes at least eight weeks to kick in and must be at a therapeutic dose. After a child is on a stable dose, you don't need weekly blood draws, but you do at first.

 

[smallworld]

I have no experience with Lithium, but I did want you to know there's a numbing cream called Emla (by prescription only) that is put on the inside arm 45 minutes before the blood draw. My daughters have used Emla with good results.

How much does your difficult child weigh? Is the Lamictal as high as it can be?

 

[Bugsy]

He weighs 62lbs. He is on 100mg lamictal and started slowly titrating it up to 100mg a number of months ago. He has been at 100 for atleast 2 months. What would be considered a therapeutic dosage for a 6 year old boy weighing 62 lbs?

 

[smallworld]

My daughter weighs 57 pounds, and she's on 125 mg. My son weighs 120 pounds, and he's on 200 mg. I think your son's therapeutic dose lies close to where my daughter's dose is, but maybe even could go higher. But you'll have to ask your son's psychiatrist. If you don't get a satisfactory answer, ask for a neurologist's opinion. Neurologists have much more experience with Lamictal and kids because they use it for epilepsy.

 

[crazymama30]

in my humble opinion, all the medications are a bit scarey. What to remember is just because one drug worked for one person or did horrible things for someone, holds no prediction on what it may do for another. Side effects do not happen in everyone, and can occur by degrees. My son is on 75 mg of Lamictal, and I can see the light. :smile:

He has been on many other medications that either did nothing or he could not tolerate. Talk to your psychiatrist. Good luck and good vibes coming your way.

 

[jannie]

Based on observations made from reading this website, I feel that many people have been extremely satisfied with the results from Lithium. Also, NIMH is doing a huge lithium study on kids with mood disorders. I definately think it is a mood stablizer to consider. Although blood draws can be a negative, at least you know when your child is at a therapeutic level. With tripleptal and lamictil, you don't really know if you are at a therapeutic level. Lithium has been around for many many years. We definately know more about long term use and side effects of lithium compared to the newer atypical aps....

 

[BusynMember]

Wow! I just noticed...700 mgs. Seroquel? I've never heard of any kid on that high a dose. THAT would cause me concern. My son was up to 500 mgs. and I made him bring it down to 300 mgs. because my son was dopey all the time. Why is he on so much? Does anyone know if that is over the limit? I thought 500 mgs. was tops for a child. I do know Seroquel doesn't go by weight and I'm thinking that Lamictal doesn't either. As far as I know, the only one weight-related is Trileptal. Also, what type of medication is invega? You'd be amazed at what can destabilize a mood disordered kid!

 

[smallworld]

Invega is a new long-acting Risperdal.

According to The Bipolar Child, Seroquel can be dosed up to 600 mg a day.

 

[Bugsy]

I am very concerned about the amount of seroquel and did much research and found there are kids on it past 800mg. It seemed that when he was on 300mg/400mg we saw a good effect. It made the appearance of hyperactivity decline but it kept getting raised to help with the mood and I do not see that help happening. That's when we started adding lamictal. Still no better mood regualtion. Since this spring has been SOO bad with increased rages and much more anger the psychiatrist wanted to try invega. It is a new form of respiradol. The idea is that it can be as effective without the side effects because it is in a purer metabolized form. Who knows? All I do know is I am sick of my soon to be 6 year old hitting me, saying g-d aweful things, and being distructive every time he does not get what he wants at that second.

Opinions on lithium for a 6 year old?

Thanks again,
Bugsy's mom

 

[timer lady]

kt is & has been on a high dose of seroquel for a few years now. For her, it's been the most consistent medication & doesn't have the sedating side effects. More mood regulation.

Having said that, lithium is said to be the gold standard for treating bipolar. And lamictal has been very successful for many here. It really depends on the individual.

I'd like to add that your little guy is pretty young & going through many growth spurts & changes. Our worse time medication wise was the ages of 7 through 11 or so. By 11 years of age we had our diagnosis down & the medications pretty much figured out.

I expect a small period of calm before the hormones totally take that out of the picture. :hammer: :smile:

 

[BusynMember]

In my experience, I've seen Lithium work when nothing else did. The biggest problems I've heard of (I took it a while) are possible weight gain, thirst, and it's common to get thyroid issues with Lithium. Many kids have to take thyroid medications with the Lithium. As far as what it does for moods, the last word I heard on this from my Psychiatrist is that Lithium has a higher success rate for bipolar than any other medication, at about 70-80%. The others are in the 60's, although I don't know about Lamictal.