psychiatrist responded...


Mom? What's a difficult child?
I just got off the phone with the Pediatrician, she wanted me to e-mail psychiatrist back and ask her about Trileptal... ( whta do you all think?)
psychiatrist e-mailed me back she wants difficult child back down to .25mg bid Risperdal with cogentin, and she said she loves Trileptal... she said she wants a max dose of 600mg.

Then I called and cried to new psychiatrist and they have a cancellation on the 5th of March!!! So I would only have to wait 2 weeks...

So do I wait to start Mood stabilizer until we see new psychiatrist???
I am more than happy only having to travel 2 hours...


Well-Known Member
Honestly...want my opinion?

I would start the trileptal now. It will take awhile to get in her system so you are ahead of the game.

Wonderful that you got bumped up with the new psychiatrist.


Mom? What's a difficult child?
Yes DJ, I do want your opinion!!! Always... Thank you.

My pediatrician. is calling in the scrip right now...

Any opinions on Trileptal would be appreciated.


New Member
I think Trileptal is one of those hit or miss drugs. It works for some, not for others. It made my son extremely aggressive, badly so. But it works for others. It has a number of advantages (no blood draws, tolerable side effects). It can be used with Risperdal.

Just be sure to start real low and go slow. And if your daughter's behavior really escalate, then rethink it.

I guess I would think about starting it. The only disadvantage is that if you start and new psychiatrist wants you to d/c it, it will take a week or so to probably titrate back down. What you don't want to do if you can help it, is start one drug while you are withdrawing another. It makes it hard to tell what's going on.

I am sure you are, but also start keeping records of when you start stop change dosages etc. side effects you see. Doesn't need to be elaborate, but believe me in five years you won't remember any of it.


trying to survive....
I am not a doctor, but your child does not seem to be getting any benefit with the risperdal. If your gut says to stop then stop.

My child was on .25 twice a day and we cut the day time dosage out for about three days and then I cut the evening dosage to half of one pill and then three days later we stopped. I am not suggesting this, but I am telling you what we did.

I don't even remember the order of when we began trileptal (before or after the risperdal), but I do know that it took 6-8 LONG weeks until we saw a benefit from the trileptal. I do remember we started slowly and increased dosage every few days or so and each time we increased the dosage he seemed to get worse before better.

I do remember wanting so very much to stop the trileptal because it seemed to make it worse, but everyone at this forum kept telling me it takes awhile until benefit. I remember Janna also really complaining as she was getting Dylan up to a therapuetic dosage /forums/images/%%GRAEMLIN_URL%%/tired.gif I remember so many others also complaining, but I decided it was worth the try. It has helped. I sometimes wonder if it is doing enough, but I clearly remember when he was not functioniong and now he is.

So..if the pediatrician says to try it, I would start the trileptal...I will say that 600 mg is a fine dosage. I believe Bi-Polar Child states that some kids need as much of 900-1200 mg in order to be stable with trileptal.

Good luck--I am so sorry you are feeling stressed and overwhelmed. Sending cyber hugs.


New Member
my dtr used trileptal for a few years. one psychiatrist started her on 150 mgs and then he quit working at the agency we were going to and none of the other psychiatrists would up the dose......we saw no benefit at 150 mg. eventually the dose was upped and eventually it went as high as 2400 mgs. BUT we did not see much benefit. Then psychiatrist added seroquel to the trileptal, started at 25 mgs, eventually went up to 300 mgs, but then we stopped both as either seemed to make much difference. (and the seroquel was causeing a large number
of serious adverse reactions)


Mom? What's a difficult child?
So for now we are going with .25mg risperdal bid starting tonight the cogentin is to be taken as needed... with hope that with the lower dose of Risperdal she wont be as bad, and to add the Trileptal
150mg at bedtime for 3 days; then 1 tab twice daily for 3 days; then 2 tabs at bedtime and 1 tab in the morning for 3 days; then 2 tabs twice daily for a total of 600mg. pediatrician is willing to go slower also. psychiatrist gave us this dosage based on weight. 52 pounds.

I am trying to chart everything... some days are better than others...

But let me tell you just going to pick up these medications and run to get milk and cereal today was like a marathon with these 2!!! difficult child is such a wreck... I am willing to try anything at this point!!!

I asked about stopping the Risperdal and said how I feel like it isn't helping, pediatrician. would like to keep going with it until our new psychiatrist apt, just so we know all reactions and to get her adjusted to the Trileptal. She also said difficult child may adjust to the lower dose and do well with the combo... hmmm I have my doubts. But maybe.


T, sounds like a plan. So glad you were able to get an appointment with the new psychiatrist on March 5. Way To Go, warrior mom!

Please keep us posted on how it's going.


New Member
I am so glad that you have a plan in place. That sounds so hopeful! It is worth giving the Trileptal a try. It takes such a long time for it to reach therapeutic levels, that it is good to start. As long as there are no bad side effects, the new psychiatrist will most likely see it through to at least see if it helps. Good luck!

timer lady

Queen of Hearts
I'm glad that you have, at the very least, a working plan in place. Your little difficult child is, in my humble opinion, at such a trying medication wise. There are growth spurts, independence issues (in a difficult child very very magnified), & of course school demands starting to hit.

Keeping fingers crossed that you & difficult child hang in there until psychiatrist appointment.

Remember, what doesn't kills tends to cripple! :rofl: :surprise: :rofl:

Sending positive thoughts your way. :flower: