Mom? What's a difficult child?
So, husband called Dr. P. our old psychiatrist. Who is the greatest psychiatrist in my opinion!!! (Why do we have her direct #?, and why is a woman this important able pick it up on the 3rd ring and talk to my husband???) Yet the rest of the darn psychiatrist'S in this country can't figure it out???
Back to my confusion, so she informed husband that she is now at this point so heavy into her research for kids and working on possibilities for our kids that she is in the lab every day except Tuesday's... and on Tuesday's she is only updating.
So husband filled her in. She said, she doesn't think Lamictal is a good medication for difficult child 1, and with her symptoms she thinks she needs to be on Lithium. She feels until we can get her on that to go with a higher dose of Abilify add back the Cogentin and move to Tucson...
She loves Tucson, feels they have a wonderful medical system in place and available. Also gave us a name of someone... She does not like Pheonix... LOL
So now I don't know what to do with this? We can not just up and move, we are working on it.
Do I tell new we Difficult Child Lamictal, I didn't understand why she didn't like the Lamictal? difficult child 1 was like this prior to starting the Lamictal... I think maybe she doesn't think Lamictal is "right" for her symptoms?
Oh what to do... I just want to get the stupid IEP started and find a Pre-school for difficult child 2 and a babysitter... oh the list!


Active Member
I don't think you could very easily work your old psychiatrist's treatment plan in with your current one. You pretty much have to go with the doctor you have or get your kids to the doctor you want.

Could you move back to the apartment in Chicago for the summer? At least you'd be able to find psychiatric care.


New Member
Could you somehow get the two Dr's to speak to each other? I would think that would be the best and most efficient way of handling the situation. Of course not all psychiatrists would be willing to listen, since they all seem to have their own ideas. Just a thought.


Active Member
I would share with your current psychiatrist what the other one said and see what he says. I got a second opinion for my difficult child, actually at her psychiatrist's suggestion, and there was a difference of opinion. difficult child's psychiatrist would have gone either way but did tell me why he thought what he did. Having that whole conversation increased my trust in him. Maybe your new psychiatrist will tell you more about why he is doing what he is and/or why he doesn't think her approach is better.


Well-Known Member
I know why the old psychiatrist is saying what she is saying about the lithium vs the lamictal.

Maybe I can explain it in some semblance of ways someone can understand considering I just woke up and my fingers arent cooperating!

Ok...Lithium works much better on certain neurotransmitters and chemicals in the brain than lamictal does. It is a salt instead of a neuroleptic. Lamictal works more on the depression side of things and lithium works more on the mania side of things. While they are both mood stabilizers they work on slightly different neurotransmitters.

In the future there will be some sort of blood test or something that they can do so they can say...oh...he/she needs this drug because this is missing. Wont that be nice? That gets into genetics.


Mom? What's a difficult child?
Well Dr. P. told my husband that she is basically done working with patients right now... she just researching. She also told him we need a new psychiatrist. She was very blunt. If you can't get ahold of her, well...

I called the Hospital and set up a plan for difficult child 1 on my own... they were very helpful and liked the idea.

I also got ahold of a number for a psychiatrist who has been out of the country for a year here in town... he is expected back, soon? SO who knows.

I left a brief message for psychiatrist here letting her know that no-one ever returned my call for the prescription or returned my e-mail... and that I talked to psychiatrist in Chi. So we shall see. I also said that that I did not feel comfortable with difficult child 1 symptoms and the fact that I had no-one to call.

Of course then mother in law talked to difficult child 1 and let her know that they are coming to visit at the end of June, which is a big NO-NO!!! We have asked her not to do that before... SHe did that just last month and didn't show for difficult child 2 b-day.
This will be for difficult child 1 early b-day, so now difficult child 1 will perseverate on this and get worked up for 3 weeks, and if they have to cancel... mother in law thinks if she tells her it will make difficult child 1 feel better. She just doesn't get it. We have tried to explain nicely how it affects the girls...


Unfortunately, some people just don't "get" nice. Sorry things are so chaotic. Good luck with the other psychiatrist.


Active Member
It sounds to me like old psychiatrist is dealing with some of her own personal issues right now. If that's the case, she might not be able to give the most objective feedback at this time.


Mom? What's a difficult child?
klmno- Sorry I don't understand your comment? My old psychiatrist was/is the only person who took the time to talk to us, she was in the middle of the lab researching and answered her personal line to talk to husband!!! Maybe I didn't make it all clear? I would fly to Chicago now if Dr. P. was not tied up in research... she is one of the best in the country!!! All she does is work on helping solve the BiPolar (BP) problem. She really is quite amazing!!! I wish all of our kids with Mood Disorders could see her!

My writing and thinking don't always make sense though!!! LOL


T, this is how I read it: Lithium works well for mania, and according to emerging research, Lithium has a strong and possibly unique effect against suicidal behavior in people with BiPolar (BP). Apparently this is not true for other mood stabilizers. I'm guessing Dr. P was concerned your difficult child 1 sounded suicidal and thought Lithium was the best medication to help her. In addition, only Lithium has been approved for the treatment of mania in children under age 16. Although many anticonvulsants are being evaluated in the treatment of BiPolar (BP), only Depakote has been approved for the treatment of mania in adults (however, Depakote and other anticonvulsants are used quite frequently in the pediatric population for the treatment of seizures). My understanding is that a lot of the research around the country (and certainly at NIMH in Bethesda, MD) is evaluating the efficacy of Lithium for the treatment of pediatric BiPolar (BP). That may be why Dr. P felt comfortable recommending it.

Having said all that, I do know that every psychiatrist has "favorites" that he/she likes to prescribe based on clinical experience. I have a personal affinity for Lamictal because it's worked well for two of my three kids, and it has a low side-effect profile. There is no way you can judge the efficacy of Lamictal for your difficult child 1 at this point because she's on such a low dose.

My recommendation is to find a psychiatrist -- either where you are, in Chicago or where you end up moving -- schedule frequent medication checks and follow one doctor's plan. It's fine to get a second opinion, but you need to have regular ongoing care with one psychiatrist. Otherwise, you end up with a mish-mash of care that won't in the end benefit your difficult child.

Sending hugs your way.