new medication schedule, anyone tried this before???

neednewtechnique

New Member
Somehow, I managed to land our 13 year old and our 5 year old at their psychiatrist appointments on the SAME DAY, and only had to take ONE day off work this month!!! Luck of the draw, yes!!! Anyway, so I already posted about my 5 year old's first appointment with her psychiatrist, and now to talk about our 13 year old.....

She started the Lamictal a while ago, with GREAT results as I have already mentioned, but psychiatrist still wanted to try to increase, at least to try to even her out a little more. She said if not much changes, we can go back to the 25, and both difficult child and I were fine with trying it out to see what happens.

The strange thing was, I thought that Lamictal was to be a 1x/day thing, and she wants us to try to stay with 25mg in the morning, and then have her take the other 25mg after school...

Have any of you ever heard of this?? Splitting up the Lamictal dosages to two different parts of the day?? Since I thought this medication lasted ALL DAY, I was wondering if any of you know WHAT this is supposed to help with, and if I should have any concerns about sleep, etc... I know, I should have asked these questions when we were there, but somehow I managed to draw a COMPLETE blank in her office and couldn't think of anything at all to say!!!!

Other than that, I guess all good things to report, except for the things going on with her bio mom right now, everything else is going well for her. She has been almost an entire month without cutting herself, which is a GREAT accomplishment for her. ESPECIALLY considering everything going on with bio mom right now. She is convinced that her mom doesn't love her anymore. I just tried to explain that with mom JUST getting out of rehab, that if things might be different this time, mom probably just needs some time. She has been through a lot, and although it :censored2: for her now, it might be better in the long run, because if things are so different this time, maybe that means she is taking steps in the RIGHT direction, and hopefully rehab will STICK this time, and she will keep herself clean...I told difficult child to just try to give her some time and see what happens. Also tried to re-assure difficult child that her mom DOES love her, she is just going through a lot right now and maybe she just needs to focus on her for a while.

I don't really know at all ANYTHING about what it's like to be in prison, jail, or drug rehab, so maybe that is all a pile of cr@%, but it sounded good, and without making any promises as to the future of their relationship, was able to help difficult child feel better. Hopefully I did the right thing there??? Only time will tell...
 

timer lady

Queen of Hearts
NNT,

I'm glad the appointment went well. I'm an epileptic & have taken lamictal & other types of medications that are commonly prescribed for mood stability.

I take my medications (keppra, neurontin) twice a day; even though keppra is supposed to last all day it's been broken into 2 doses with no negative effects.

As to bio mom - I wouldn't reassure difficult child the biomom does love her. Right now, she doesn't - the drug comes first. She's in love with her drug of choice & her child is the last thing on her mind. Even having been through rehab - given her hx - I assume that if biomom isn't using, she's either fighting a huge fight with her addiction, OR looking for a way to start up again.

I've been through this with the tweedles. Our therapist was blunt when he told kt & wm that biomom loved her drugs before she loved them. While it was a horrid moment - it helped the tweedles to make sense of why a mother, who loved them, would allow them to be taken away; would allow & be involved in the abuse/neglect that the tweedles survived.

Take this for what it is - a word of caution. Use it if you can.
 

Marguerite

Active Member
Hi, NNT. Getting the appointments on the same day - we try to do that. It's getting more difficult for us because as the kids get older, the older two are more independent and trying to organise their schedules as well is tricky. But I deliberately chose a pediatrician (who is the doctor who looks after this sort of thing in Australia) who could see all three kids at the same time.

Getting a joint appointment means we take up an hour or more of the doctor's time, and to book a solid hour means plenty of advance warning, but I book appointments several at a time, in advance. For example, I know he wants to see difficult child 3's half-yearly and yearly school reports, so I make two of the year's appointments to correspond with that. And since he wants to see difficult child 3 at 3 month intervals, and the other two at six month intervals, I book the other two kids in to coincide with school reports also. Then I book just for difficult child 3 in the midpoint of the other appointments. This also means that if one of the other kids is having trouble, I can get them squeezed in on the same day as a difficult child 3 appointment, or if difficult child 3 is going well I will swap the kids around.

A short while ago we were having trouble with difficult child 1 and his suddenly increased Obsessive Compulsive Disorder (OCD)/compulsive behaviour in general. HE was even commenting on it, it was bothering him, so I was able to get him seen on an emergency basis. But generally, the doctor gets the whole family all on the one session. It can get very lively indeed, but he learns a lot watching all the interactions, as well as hearing them 'dob in' each other for any weirdness they've been doing lately.

As for the change in medication schedule - I can't help you there, except to say - if it works, then keep it. If it makes things worse, go back to what was better. Just because the rules say we should do things a certain way - sometimes our kids break the rules just because they are different. Trust your own instincts and observations.

As for her mother - poor kid! "Loving the drug first" may be the only way to explain it. A lot of parents are like this unfortunately - and it's not always the drug they love first. For some, it's themselves they put first. This doesn't mean they don't love their kids - it's just that they don't know how to be parents and simply can't cope with the reality of parenthood. Instead, they love the IDEA of being parents, of having a kid somewhere they can put up on a pedestal and dream about when they are getting their next high. But those drams are really like the dreams we maybe had as youngsters of one day having our own house to look after, and a husband to care for - a vast difference from the reality.
A mother like this is more like a relative you might visit, if they are available and have the time. You might take a tea cake, or a packet of biscuits, but you're always glad to go home to your own space again. No matter how much you enjoy spending time with that relative (or not) it is more a duty than something you throw heart and soul into. A part of yourself always knows that home is where you have been living. It's being able to emotionally detach like this, when in y our heart you feel there should be more - that hurts. She needs to know she is loved and wanted - by her father, by you. And in a weird way, maybe by her biological mother, who simply doesn't know HOW to be a proper mother, she has become the relative you visit. Or maybe talk about visiting, when she is available and you can handle it.

And most of all, she needs to learn to value and love herself. That's very difficult, with all the mixed signals her bio-mum is sending her. But those mixed signals are because drugs are her top priority, and NOBODY can compete with the emotional lure of a drug.

Marg
 

smallworld

Moderator
I have two kids on Lamictal, and for both, we have always split the dose -- half in the morning and half in the evening. Even though Lamictal lasts all day, this dosing keeps the blood levels more even over a 24-hour period. You should be aware that at each medication increase, there can be a burst of increased energy, which does seem to settle down as the body adjusts after several days.
 

Sara PA

New Member
Both my son and a friend who takes Lamictal for seizures have said that Lamictal can interfere with sleep for a few hours after taking it. For seizures, the recommendation is that it be taken once a day. My friend needed to take it twice a day to keep the levels as even as possible. As a mood stabilizer, though, the recommendation is for once a day. My son took all his (he was on 400 mg/day for quite a while) when he awoke. He said it helped him out of the sleep fog more quickly. What he didn't want at night was exactly what worked great in the morning.

The prescribing information instruction for dosing children are specific to seizure disorders, not bipolar, and recommend split doses.
 
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