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.