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General Parenting
medication question and Tink update
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<blockquote data-quote="smallworld" data-source="post: 327557" data-attributes="member: 2423"><p>Hi, BBK. I'm sorry things have been so rough for Tink and for you.</p><p></p><p>If the psychiatrists at the hospital truly think Tink has bipolar disorder, they should forget about the ADHD medications, including Strattera. That means only first-line mood stabilizers (Lithium, Depakote, Lamictal, Trileptal, Tegretol) plus atypical antipsychotics (Risperdal, Seroquel, Abilify, Geodon, Zyprexa). If she did well on Abilify, I see no reason not to go back to that (or if Seroquel is working, stick with that) and trial a different mood stabilizer from Lithium since Tink didn't seem to do well with that one.</p><p></p><p>For what it's worth, Strattera is an antidepressant that is used for ADHD. It is only effective in 40 percent of ADHD cases, and side effects include anger and irritability. You may also know that kids with BiPolar (BP) tend not to do well with antidepressants, especially when they don't have a mood stabilizer on board (which Tink doesn't). by the way, Strattera typically takes 3 weeks or so to kick in so you shouldn't see immediate results.</p><p></p><p>The reason the psychiatrists aren't able to stabilize Tink is that they're concentrating on the ADHD part of the equation instead of the mood piece. When medicating kids with BiPolar (BP), you need to focus on mood stabilization first and then deal with residual symptoms afterwards. Sometimes what looks like ADHD clears up when mood stability is achieved.</p><p></p><p>You might want to take a look at the Treatment Guidelines on the Child and Adolescent Bipolar Foundation website at this link:</p><p></p><p><a href="http://www.thebalancedmind.org/sites/default/files/treatment_guidelines.pdf" target="_blank">http://www.thebalancedmind.org/sites/default/files/treatment_guidelines.pdf</a></p><p></p><p>This very helpful document, written by a consensus conference of child and adolescent psychiatrists, is based on medical literature and includes step-by-step strategies for treating mania and depression in young patients. Some parents find it helpful to print it out and bring it to appointments with their children's psychiatrists.</p><p></p><p>Hang in there, BBK, and let us know how today's family therapy session goes.</p></blockquote><p></p>
[QUOTE="smallworld, post: 327557, member: 2423"] Hi, BBK. I'm sorry things have been so rough for Tink and for you. If the psychiatrists at the hospital truly think Tink has bipolar disorder, they should forget about the ADHD medications, including Strattera. That means only first-line mood stabilizers (Lithium, Depakote, Lamictal, Trileptal, Tegretol) plus atypical antipsychotics (Risperdal, Seroquel, Abilify, Geodon, Zyprexa). If she did well on Abilify, I see no reason not to go back to that (or if Seroquel is working, stick with that) and trial a different mood stabilizer from Lithium since Tink didn't seem to do well with that one. For what it's worth, Strattera is an antidepressant that is used for ADHD. It is only effective in 40 percent of ADHD cases, and side effects include anger and irritability. You may also know that kids with BiPolar (BP) tend not to do well with antidepressants, especially when they don't have a mood stabilizer on board (which Tink doesn't). by the way, Strattera typically takes 3 weeks or so to kick in so you shouldn't see immediate results. The reason the psychiatrists aren't able to stabilize Tink is that they're concentrating on the ADHD part of the equation instead of the mood piece. When medicating kids with BiPolar (BP), you need to focus on mood stabilization first and then deal with residual symptoms afterwards. Sometimes what looks like ADHD clears up when mood stability is achieved. You might want to take a look at the Treatment Guidelines on the Child and Adolescent Bipolar Foundation website at this link: [url]http://www.thebalancedmind.org/sites/default/files/treatment_guidelines.pdf[/url] This very helpful document, written by a consensus conference of child and adolescent psychiatrists, is based on medical literature and includes step-by-step strategies for treating mania and depression in young patients. Some parents find it helpful to print it out and bring it to appointments with their children's psychiatrists. Hang in there, BBK, and let us know how today's family therapy session goes. [/QUOTE]
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