Discussion in 'General Parenting' started by YoursMineAndOurs, Jun 5, 2009.

  1. YoursMineAndOurs

    YoursMineAndOurs Momof4gurlz

    Its a long story but I will get straight to the point. My boyfriend's niece is a difficult child, she is 14 years old and has showed signs of being bi-polar since shes a young child. Her parents had her on a low dose of prozac and she seemed to be doing great. 4 years ago she was taken from the parents and placed in foster care. Her parents are suppose to have say over her therapy and medications but they have never been involved. She is getting worse and is highly medicated. She becomes very agitated, aggressive, curses, she shuts down, she will just sit there with her arms crossed and not say a word, she than passes out cold and when she awakes she all confused and disoriented. She remembers the episodes in pieces and over several days.

    Her medications are -

    8AM Daily
    Zoloft 75mg
    Strattera 40 mg

    8PM Daily
    Seroquel 50mg
    Trazodone 50mg
    Strattera 80mg

    She has about 20 to 30 minutes at night to get to bed or she will pass out where ever she is. I read up on her medications and most of them arent even approved for children under the age of 18. My questions are -

    Is she overmedicated?

    Are any of the medications a mood stabilizer? Because I read that is what she would need in addition to any bi-polar medications.

    What kind of doctor should she be seeing?

    Her parents want to help her but like I said at this point they have no say even though there is a court order saying they are to be involved.

    Any information will help
  2. smallworld

    smallworld Moderator

    Welcome! I'm glad you found us, but sorry you needed to.

    About the medications: Your difficult child is on NO medications for bipolar disorder (except for Seroquel, but she is not taking a mood-stabilizing dose). In fact, she is on medications that can make kids with BiPolar (BP) more angry, aggressive and agitated.

    Zoloft is an SSRI antidepressant that is typically used to treat anxiety and unipolar depression. Only 25 mg of Zoloft made my son, who has BiPolar (BP), violent, angry and aggressive.

    Strattera is an SNRI antidepressant that is used to treat ADHD. It is dosed by weight. If you can provide her weight, I can tell you if the dose is too high.

    Trazadone is also an antidpressant that is used for sleep problems. It is probably why she falls asleep so quickly after taking her medications.

    Seroquel is an atypical antipsychotic that is used to treat hallucinations and mania. She is on the sleep dosage, not the mood-stabilizaing dosage -- again, why she falls asleep so quickly after taking her medications.

    I would be very concerned about a child with potential BiPolar (BP) being on three antidepressants.

    She needs to be treated by a board-certified child/adolescent psychiatrist. She would also benefit from a neuropsychological evaluation to make sure you are dealing with BiPolar (BP) and not something else entirely. Neuropsychologists can be found at children's and university teaching hospitals.

    Again, welcome.
  3. mstang67chic

    mstang67chic Going Green

    I would suggest a medication wash for this girl. I'm assuming she's still in foster care and I don't know what kind of acess you have but they need to do something.

    I don't have much faith in the foster system when it comes to psychiatric medications. We got our difficult child as a foster son when he was 9. At the time, he was on Tenex, Adderall and Zoloft and had a diagnosis of ADHD and depression. We found out within a year that yes he is ADHD but was also Bipolar. That medication combo wasn't doing squat for the BiPolar (BP). He was hospitalized, taken off all medications and they started over. It didn't fix everything but it definately made a difference in his overall health. I also later found out that he had already been diagnosis'd with BiPolar (BP) but NO ONE KEPT UP ON IT. At one time, he had been on the CORRECT medications but for whatever reason (I was never able to find out) he was taken off and put on stuff that made him rage. No wonder previous foster/pre-adoptive parents couldn't control him.

    I'm not as up as some of the others here on the various medications/interractions/uses but yeah, personally I think she needs a medication wash and a good psychiatrist.
  4. YoursMineAndOurs

    YoursMineAndOurs Momof4gurlz

    Shes about a size 5 in womans so about 120 lbs.

    She has been diagnosed with possible everything. they use the word possible because she is a child. She is far from ADHD so I dont know why they have her on medications for that. Like I said before when she was home her parents had her on a low dose of prozac and she was doing very well. They had a feeling she was bi-polar so they took the next step in helping their child.

    When she has an episode during the day she literally passes out from exhaustion and sleeps for at least a hour.
  5. smallworld

    smallworld Moderator

    Her Strattera dose of 120 mg/day exceeds the maximum FDA-approved dose for her weight. Her dose is typically for a person who weighs 190 pounds.

    Bipolar disorder is generally treated with a first-line mood stabilizer or sometimes two (Lithium, Depakote, Lamictal, Trileptal, Tegretol) plus an atypical antipsychotic (Risperdal, Seroquel, Abilify, Geodon, Zyprexa). Check out for treatment guidelines. Antidepressants generally make kids with BiPolar (BP) worse.

    She shouldn't be on two medications for sleep -- Trazadone and Seroquel. One should suffice.

    If she's passing out after "episodes," she needs to be checked by a neurologist for seizures.
  6. susiestar

    susiestar Roll With It

    Hi! Welcome to our little safe haven on the web.

    Your difficult child is on a whole ton of medications. It sounds like she may need a medication wash (time where she takes no medications) so that you can see what is her and what is the medication.

    smallworld gave excellent advice. You may need a court order to see her, but it would be well worth the effort. If for nothing else she may one day remember that you did everything possible to help her learn to handle life.

    I am so very sorry.
  7. YoursMineAndOurs

    YoursMineAndOurs Momof4gurlz

    Today her father had court in hopes of having her returned home at least on a weekend basis and it was denied and further more all visits have been stopped.

    When he brought up the medicine the judge just said " who are you to say what and how much medicine she should be on" he was like, I am her father. The judge didnt want to hear it so his lawyer told him to get as many professional opinions as he can and have them right a report about what they think about the combinations of the medicines and just the medicines in general for a child. For example, therapist, pediatrician, neurologist etc....

    They also told him that he is the cause of her behavoir not the medication. This is a child we are talking about. I dont get how anyone can just disregard the welfare of a child especially when CPS/DYFS is suppose to be protecting them and they are the ones destroying most of them. Her in NJ the system *****!
  8. SomewhereOutThere

    SomewhereOutThere Well-Known Member

    I'm on medications for bipolar, which I have had since very young too. I have been since age 23 and now I"m 55. In my opinion, she is grossly overmedicated. I would be a nutcase and a zombie on all those medications. There are times when one medication made me a zombie OR made me so manic I couldn't sit still or control myself. She's on a slew of them.
    I have a rule. Two psychiatric medications at a time. Believe me, after being on the same two for almost twenty years, I still pass out after taking them. I need them to function, and they do a good job, but if I had to add any, I don't think my mind would be clear. Everyone is different, but I wouldn't want any kid of mine on all those medications. My eyes got wide looking at the list. I'm aware of what they are--I've taken some of them. 100 mgs. of Straterra alone would make me a basket case. That's a lot of antidepressant along with the others...blehhhhhhh. The psychiatrist in my opinion is really pushing it. I think she needs to see a teenage Psychiatrist, but not the one she's currently seeing. And I've been to a lot of psychiatrists in my day. Not all of them are good, so you kind of have to be picky. Unfortunately, as one who also did foster care at one time, I know how bad the system is and how they often blame the parents for a child's illness, even though in my opinion it's ridiculous. Sadly, parents don't understand that they do lose their rights when they put kids in foster care, and the foster parents are usually no better able to deal with the kids then the parents are. There is no special training. I was shocked. We quit--we couldn't handle the way the kids were treated.
    I sympathize with your niece in the care of NJ's foster care system. We adopted a child from NJ and were told he was a nice kid, but cognitively delayed. Well, he was probably brilliant, but he was a budding psychopath who hurt my kids and killed my animals. The Child Welfare System of NJ had no idea what their own child was like and they certainly didn't help him. And they didn't want to hear about it after we told them that he had to be removed from our house. I hope the child is returned to her parents soon!
    Last edited: Jun 5, 2009
  9. YoursMineAndOurs

    YoursMineAndOurs Momof4gurlz

    Her parents are filing a motion to have her evaluated by their doctors and to do a medication wash. Hopefully they will get a court date sooner than later. Family court is so backed up in NJ its not even funny. Thats one of the reasons so many children get lost in the system like my boyfriend's niece.

    Thanks for all the responses so far, keep them coming!