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OK Now I am confused...
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<blockquote data-quote="smallworld" data-source="post: 47163" data-attributes="member: 2423"><p>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.</p><p></p><p>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. </p><p></p><p>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. </p><p></p><p>Sending hugs your way.</p></blockquote><p></p>
[QUOTE="smallworld, post: 47163, member: 2423"] 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. [/QUOTE]
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