Nuerontin time...

[totoro]

So we start Nuerontin tommorow... we are increasing K's Lamictal 100mg a.m. and 100mg p.m. That will be ther maximum amount. We are also starting Nuerontin 100mg a.m. and 100mg p.m. hoping to help with anxiety... we shall see. I found this on the Bipolar Child under treating Anxiety, it made me feel a bit better:

We asked Dr. Janet Wozniak from the Harvard Medical School some questions about the treatment of bipolar disorder and anxiety in youngsters and she replied:

In the cases of pediatric bipolar disorder, our rule of thumb is to stabilize the manic mood prior to addressing issues of comorbidity with depression, ADHD and anxiety. Sometimes when the manic mood state is treated the anxiety symptoms also improve. Sometimes the opposite is observed: after the mood is stabilized the anxiety “comes front and center”. We have no way of predicting who will fall in which category. But the idea that mood stabilizers "cause" anxiety may be erroneous. It may be that the comorbid anxiety is more obvious when the mood is stabilized, given that reports suggest anxiety occurs comorbidly with Borderline (BPD) in many adults, children and adolescents.

There are no studies to inform us which agents are best to use when we add an anti-anxiety agent for this population. In practice, we make use of all the possible treatments including Gabatril, Neurontin (which may be less likely to destabilize mood or in some small number of cases might help mood), benzodiazepines (which unfortunately could be sedating, cognitively clouding, or have a paradoxical effect), buspirone, and antidepressants (which of course carry the risk of exacerbating mania).

Neurontin and Gabitril (two anticonvulsant drugs) both increase the neurotransmitter GABA transynaptically, which is where benzodiazepines such as Klonopin and Ativan work against anxiety.



This is basically what psychiatrist3 wants to do. He feels K is pretty stable as far as the Lamictal, we have tried Buspar and it didn't touch it.

We shall see... I had to have the talk with husband about too many medications tonight... explaining that if K had a headache and an infection you wouldn't treat them both with Ibuprofin, right? Well why do we feel pressure to do that with mental illness and mood disorders? I think mostly because (for me at least) the media, the stigma, the off-label prescribing, all of that and the media never mentions that they just act like you should be able to give every kid one medication and fix them, one medication fixes all. Don't we wish...
I said just because she is on a MS doesn't mean it fixes everything, for her. For some maybe.
Unfortunately age doesn't matter, sex doesn't matter... the severity of the symptoms and the diagnosis do. Not what others think... he sighed and agreed.

No-one wants their baby on medications... I'll never enjoy going to the Pharmacy, I may like the effect, but I wont like the trip.

 

[pepperidge]

hi totoro,

medications are a drag...but if and when you find one that really helps, you will begin to like the trip to the pharmacy!

Have you noticed any positive effects from the Lamictal yet?

My son was on Neurontin for awhile for anxiety. It didn't seem to help, but that was before we went on Lamictal. Maybe if he went on after Lamictal, I might have noticed a difference, but I think it is perhaps hard to treat anxiety if there are other major things going on.

I believe that when my son was on Neurotin, he was supposed to take it three times a day--it has a pretty short half life. So that might be something to research.

Anyway, I am wishing you luck. Seems like you are due some good news on the medication front pretty soon.

hOpe school is going ok.

P.

 

[totoro]

P-
Thanks, psychiatrist only wants to go with 2x a day due to the no nurse availability at school!?!?!?! He feels we can work with it and he has done this before... she is more stable than ever before... that kind of statement would only make sense to those of us with G'sFG. LOL

K is actually doing really well at school. I feel like she could be doing better academically... and also that she is SO happy because she has her first friend and it is a boy... he is as touchy as her and they basically hug each other every 5 to 10 minutes!!! No-one stops them or interferes. I don't mind so much but realize this can lead to some issues in the future, and I know she is placing all of her happiness on this boy... which is scary. The hugs help calm and center her... but once in 1st grade, is that appropriate? Will another teacher allow it, and how loong will he allow it???

So while she is "stable" it is all very shaky... as always. I like our Pharmacists, i just hate feeling like I am always going in there... Ya Know???

 

[DammitJanet]

Hey girl...

I take a cousin of Neurontin, Lyrica, for fibro and it does seem to help with anxiety too. In fact, I have only had to use my klonopin rarely as a prn.

I hope it works for K. Neurontin was one of the first MS we tried for me and it didnt work well as a stand alone but then topamax did for a couple of years before we had to add lamictal to the mix. Its all so iffy this medication management...lol.

 

[smallworld]

Hi T, Neurontin is definitely worth a try. My son has extreme anxiety, too, and it's been difficult to get under control (even with a low dose of Lexapro). I may have to ask our psychiatrist about Neurontin . . .

Having said that, I would seriously caution about making two medication changes at once, even though K is already on Lamictal. K appears to be sensitive to medications, and if something spins out of control, you're not going to know what caused it. medication changes should always be done one at a time.

Good luck. Let us know how it goes.

 

[jannie]

Hi--

I must agree with Smallworld. I would not be comfortable increasing one medication and starting a new one the same day. Did the doctor want both changes to happen at once?

in my humble opinion, I'd increase the Lamictil for a week or twp so to see benefits and then add the Nuerontin--but--heck, I'm not a doctor-

Fingers crossed all goes well--I'm so glad you are seeing positive results with the Lamictil. Good Luck

 

[totoro]

Thanks ladies... I did ask about the 2 changes at once, he was also cautious, which is why we are still on Abilify. He feels we know what the Lamictal does at 25mg increases and we have been on it long it enough to know what it is going to do, I hope! Having said that he feels we can add the lowest does of Neurontin safely. It is said to have few side affects... I hope.

So who knows if this thinking is logical or not... he also said if I don't feel good about it I can wait.
I am going to pick it up this a.m. but do not have to start, he is also happy we are doing light therapy for her!!! But like everythign I have read cautioned against any nighttime therapy... may induce mania, for anyone...

I will think about this today and see how she is doing when I pick her up, maybe give her a couple of days???

 

[smallworld]

T, it's Tuesday. You could start the Lamictal increase today. And then add in Neurontin this Saturday. We always make major changes on the weekend so the kids are not in school and we can personally watch them. Just a thought . . .

 

[totoro]

I think I am going to do that... we did the Lamictal increase this a.m. So I think I will go until Saturday or Friday p.m. See how she is doing at that point.

When I picked up the medications at the pharmacy I asked the Pharmacist for some info on Nuerontin, he wouldn't budge, so I had to speak loudly over the tall counter... I told him what other medications K is on and he said "She is on <span style='font-family: Comic Sans MS'>ALL</span> of those medications?" Loudly... :frown: I just looked at him and said, yes...

I should have known, husband calls this guy, muscle head, he said when he used to go out drinking he would always be out. Loud macho ego type... All of the rest of the Pharmacists are very nice... I will avoid him from now on... jerk!

 

[flutterbee]

What a jerk!

I'm sure you know about the HIPPA laws and all...yelling over the tall counter doesn't seem to insure much confidentiality. I think you would do best to avoid him.

Was this a chain pharmacy that has commercials bragging about how compassionate and concerned their pharmacists are? I might be contacting a regional manager or looking up a customer service input online if that's the case.

Our pharmacists are great...all of them at all of the various pharmacies in town. Although, I usually wait until I get home and then call the pharmacist with questions. You then have their undivided attention on the phone and no one around to hear what questions you're asking. But, that's just me. I'm one of those that prefers to blend into the scenery and am very uncomfortable with strangers hearing anything - even if it's completely innocuous - about my private life, Know what I mean?? I'm a very, very private person.

But, that doesn't really matter. You should be able to talk to the pharmacist about any concerns without being made into a circus act.

 

[pepperidge]

T-

lost my earlier response.

glad that you are going to take things slowly.

On the 3 times a day, you might want to try sometime on the weekend to see if 3 is better than 2.

IF it is, then the school will need to find a way to administer I believe. Here we fill out a form, bring in the bottle, and the school has to find someone to adminster. This is a good topic for an IEP. But I think even if she didn't have an IEP, under 504 regs they would still need to find a way to accommodate need for medication. You might ask a bit more at your school...

P.

 

[blb]

My husband takes Neurontin, along with Buspar and Adderall, and from his experience, Neurontin made a huge difference as an add-on, it just took off the edge.

husband is diagnosed with adhd and anxiety, but for years I believe it may actually be BiPolar (BP) II. Unfortunately with his job, most of the mood stabilizers were off limits, so he's on this mix, which for the most part (as long as he's not under a lot of stress :hammer: ) works well for him.

Good luck!