she's on lamictal finally

[Jena]

so i began it tonight with her, super low dosage i cut the 25mg pill in half. she was hypomanic, couldn't sit still, aggitated, been this way for past 4 days now leading up to holidays is a trigger for her. she was restless miserable and said mom when am i starting that new medication??

i was waiting for existing rash to go away, we had gotten cream from dr. so i said ok i guess tonights' the night.

she said this is my bipolar isnt' it, the way i get too excited over stuff that i feel like i'm going to explode. i said yes it is.

anyway i gave her half of the 25mg sat with her as i do when i give her new medication. only ten minutes rubbed her head. she stopped being aggitated, got calm and fell asleep peacefully.

i was so nervous to try this medication. hoping for good things with it. so now she's on zyprexa and lamictal. first time on two medications at once. i'm thinking in a week or so dropping the zyprexa

 

[pepperidge]

how much are you going up a week? 25 mg? It will probably take at least a month before you begin to see anything significant, if even then. But worth it to go slow. It was a godsend for my difficult child's depression.

 

[smallworld]

I know we're not doctors, but we have a lot of collective wisdom when it comes to medications. Lamictal typically doesn't become fully effective until it reaches a therapeutic dose of 200 mg. If you are going up in 12.5 mg or 25 mg increments every two weeks, it is going to take a while to get there. I'm not sure why you would drop the Zyprexa until you are at a higher dose of Lamictal in her blood stream. Furthermore, many kids with bipolar disorder need both a mood stabilizer like Lamictal plus an atypical anitpsychotic like Zyprexa to achieve stability (you can read the Treatment Guidelines writen by child psychiatrists on the Child and Adolescent Bipolar Foundation website at http://www.thebalancedmind.org/ ) so I'm not even sure why you are dropping the Zyprexa altogether. There's a good chance your daughter needs both Lamictal AND Zyprexa to become fully stabilized.

 

[rlsnights]

I agree with smallworld. What is her psychiatrist saying to do???

Patricia

 

[crazymama30]

I agree. Why would you drop the zyprexa? Lamictal takes a long time to get to the correct dose, can be a month or more. Stopping after a week would not be a wise choice at all, in my humble opinion. Also, why would you drop it period? Many kiddos (and adults, fwiw) need a mood stabilizer and an ap. My difficult child takes 4 different medications now, not at all what I want but if it helps him function and makes life easier for him (and us) then that is what we do. I would not play doctor with all your difficult child has been through. It is just not a good idea.

 

[Wiped Out]

Ditto what the others are saying. It took about 3 months to build up to a therapeutic level in my difficult child. Even with all of that difficult child needed a combination of medications. If the psychiatrist is saying to do that then, of course, I would follow his/her directions.

 

[Steely]

Jena - with kiddos like ours - you are gonna to have to accept that she may be on two or more medications at any given time to achieve stability. It is OK. I know it is hard, I felt the same way - yet I had doctors telling me a kid like Matt needs 2 mood stabs plus an antiopsychotic to be stable, and I wanted the best for him, so I did it.
I know it is hard, and you want balance - but the doctors also know what they are talking about.
Even at 20 Matt is still on 2 mood stabs - and he needs to be on an AP, believe me, but he refuses.
Listen to the Dr., and try and accept that she may be highly medicated to get through this period of time.

 

[Jena]

hi

yup half 25mg i'm starting. we gotta drop the zyprexa her weight's off the charts to the unhealthy point now. plus doctor wants to add in ssri ontop of the lamictal. we're trying to use an ssri without her swinging. she isn't showing signs of depression we're trying to stabilize the mood first than add the ssri as an antiobsessional medication so the cbt works which isn't really working right now.

i'm still holding at 5mg on zyprexa though. does lamictal require blood draws?

 

[DammitJanet]

Ok, I am going to say this as a bipolar person and as the mother of a bipolar child one time and then I am never going to say anything else about the medication of your daughter again.

Your psychiatrist has placed your daughter on two medications: Lamicatal- a mood stabilizer and Zyprexa- an anti-psychotic. I have no idea if your doctor advised you to start her at the 12.5 mgs or not but I hope you are following his advice. Is he advising you to stop the Zyprexa next week? Is he going to recommend another more weight neutral AP? There are two new ones that just came out. I am on one of them.

Lamictal will not work in one day or one week. It will take at least a month to six weeks for you to see any effects. You cant just start and stop these medications. Weight is something that people with our issues struggle with because these medications tend to cause weight gain but the positive effects vs the negatives have to be weighed and sometimes we just have to deal with it.

As far as the doctor suggesting a SSRI for a child that anyone is saying is bipolar? Especially one who is already bouncing off the walls in as manic a state as you describe....I would refuse emphatically. SSRI's are renowned for causing mania in anyone who has bipolar. Why would you even chance it? Whatever symptom you are trying to control there are other ways to do it.

 

[Jena]

Janet,


hi, i have no clue why your being nasty to me. Yet i'll say this I dont' just start and stop medications. Not sure impression i'm giving you yet lamictal was on table fora while yet difficult child had an existing rash i had to get rid of first, being the side effects of lamictal etc.

as far as the ssri goes, the doctor and therapist wanted me to add in the ssri once the lamictal was in place and remove the zyprexa. i am nota dr. either and am listening to her therapist and her pyschiatrist. so what you are saying is ssri isnt' good? we all know she flies on it, yet they felt with the lamictal in place the ssri would be able to work. she wouldn't fly becuase the lamictal would level the mood.

again i'm nota dr. didn't even want to start lamictal was nervous about it. came here to share i worked thru my fear nad her rash and started it. wish i didnt' have to put her on any medications, yet i tried that before and lead to an eating disorder for a year.

the zyprexa isnt' doing anything anymore, so that's another reason they want to remove it. yes i come here for medication advice like other's and for experience's had with a particular medication. also f.y.i. i was supposed to pull zyprexa according to portland hospital 2 mos ago and i said no way i was scared the eating disorder would return and i spoke to difficult child's doctor and he said no let's leave it so we have now since i've been home.

as many other's parents i try medications, they work for a while than they stop working. the reason the weight is an issue is because it causes her to get depressed, self image etc. and we dont' want her to swing into another eating disorder one in which is a true one and she starts limiting food to reduce her weight gain. which by the way last week she started and i put a prompt stop to.

 

[smallworld]

Lamictal does not require blood draws to test the level of the medication in the blood stream (the way Lithium or Depakote is tested, for example). However, it is always a good idea to have blood drawn every 6 months or so to make sure liver enzymes and thyroid function are fine while taking an anticonvulsant.

Lamictal is better for the depressive end of the mood spectrum than it is for the manic end of the mood spectrum. So if an SSRI is added and makes a child manic, it is unlikely that Lamictal will help all that much with mania. But I'm not a doctor, just a mom whose 3 kids have been on Lamictal at various times. My son, for example, failed 3 trials of antidepressants while taking Lamictal.

 

[Steely]

You know the thing is about being a parent of a difficult child is that sometimes we ARE the experts. These kids are rare, and most doctors do not have a true grasp of how to treat them. I always did a ton of research on every medication out there, and there were times I refused a medication, suggested a medication, or pushed a medication, because of what I knew from my grass roots research. doctors are certainly to be respected, but as parents, our intuitive knowledge and research is also to be respected.

So, as you go down this journey, you will see it is trial and error. I had many docs suggest what your doctor did, and tried them with Matt - sometimes the SSRI worked if he was already on 2 mood stabs and an AP. On the flip side I had an AP send him into a manic episode of gigantic proportions. Each time I went to the Dr and said - "here is the deal" - and in the end I am the Mom and they had to respect what I witnessed, saw, or felt imperative - even though they said "it was impossible that Matt could have that kind of reaction". You will have to do the same.

The research shows that if your kid really is bi-polar, putting her on one mood stab and adding an SSRI is kinda like neutralizing the entire deal. She might as well be on nothing. At that point the mood stab is just controlling the mania the SSRI is trying to induce.

Just really read the posts on here, and read the sigs to see what each kid is on, and research all medications - then go informed to these Dr meetings. It is your prerogative to not only refuse the SSRI but also demand they switch her from Zyprexa to a less weight inducing AP. You are her only advocate - the doctors certainly won't be - so be empowered with information as you go on this journey with her.

Hugs.

 

[Steely]

PS - remove all sugar from your kitchen cabinets and replace it with only healthy food. She may binge on Zyprexa, but at least she is not binging on high caloric foods. Fortunately she is young enough that you still have this control.

 

[Jena]

i have done that with the foods..... i wonder why both the therapist and the psychiatrist would say add in an ssri. i also said wait a second she went crazy on a ssri years ago........

right now i'm holding at zyprexa 5mg and the lamictal at only half of the 25mg. she's still slightly manic yet was triggered tonight by something that occured.

it's sooo odd both these guys would say to do this. tha'Tourette's Syndrome why i posted about it. anyway day 3 no rash so far. yet i just noticed he gave me the generic which i hear doesn't work for everyone. we needa good mix, the mos are flying by and she has got to go back into that school biulding come september and me back to work.

 

[Jena]

well she has a rash a new one. her skin tends to be rash anyway. yet this one's kinda large and she pointed it out to me. i don't know if it's due to medication, i dont' wanna give up on this medication. so i gotta call doctor get her in for him to look at it. just looks red and she said it's itchy. i def. started the medication low enough i think.


its' odd, it activates her at night past 3 nights and during day she's sluggish and tired. told her to hold on we gotta ride out the side effects. her T doesnt' think she's bipolar I. he thinks sh'es bipolar II. he also thinks if she applies herself with the cbt stuff it'll knock alot of bipolar symptoms out and she wont' fit the criteria for bipolar anymore. we'll c......... soundsa little too perfect to me!

 

[Steely]

Well the therapist truly has no business giving you medication advice. It is not his expertise! And it verges on unethical.

As for the Dr., believe me, I have had doctors tell me so many things that I know don't sync up with my own common sense or experience - or sync up with what some of the research says - that is makes me wonder too. All I can say is that our difficult children are not within the bell shaped curve of the kids they usually help, so they don't really have a lot of experience. Most of these doctors are used to giving hyper kids Rhitalin, and depressed kids Prozac, and they are not experienced with trying to create a balanced multiple medication mix with an out of control child.

So I always made it more my role (helpful or not) to question every thing, every decision, do my own research, and then once a medication was chosen go with my gut on how it was helping. For instance they gave Matt Abilify and he was up three whole days in a state of mania. The Dr told me that was impossible, that medication doesn't do that. Whatever - it evidently DID - so we can't take it. Choose another one.

The turning point for me was when I found a Dr who wanted my input, listened to me, and did not dismiss my intuition. She got us through the roughest of times - and was amazing. She was always on call, and if there was an emergency I could call her anytime. We truly collaborated on getting his medications straight - and I think that made a huge difference.

Good luck.

 

[Jena]

do you really think so?? see i like him, he's informal i can say just about anything to him. he runs out each time before difficult child's appointment to buy her chocolate as a reward for doing the cbt work. really nice i think. he knows i have a very weak pyschdoc so he tries to give me his thoughts off the record. we talk about his son at times as well, he shares with difficult child he has asperger's.

i dont' know i feel like it's a very relaxed atmosphere, he's not stuffy he's totally laid back treats her i think as he would one of his kids. he's very warm with her. she responds to that well, she's just ina funk right now.

him and i agreed we have to get her walking into school building soon. show her the light sort of thing at the end of the tunnel. maybe it'll wake her up make her want to work at this. keep telling her you'll get back to school do the work first etc. seh's like yea ok sure i will than back to avoidance........ make sense??

 

[Steely]

Jena I am not saying that your therapist is bad or wrong - at all.....giving medication advice it is just not something that therapists are ever supposed to do. He did not go to school for that, he has no credentials for that, and he can really confuse his patients if he is handing out medical advice that does not coincide with a your chosen Dr. After seeing many doctors and therapists I have been told that it is unthical for a therapist to give medication advice. However - keep seeing him -just sounds more like you need a new psychiatrist.

 

[crazymama30]

Jena, call the doctor about the rash. If it were the Lamictal rash, she would have a very high fever and be very very ill. My difficult child developed a rash when we started Lamictal, and we stopped it and restarted it and have been fine ever since.

And I do have to agree. If the kiddo is bipolar, or anyone, many times they cannot tolerate and AD. Sometimes they can, but if they are not perfectly stable and have not been so for awhile? I don't know if I would even try. First I would want to see if the Lamictal was even enough to stabilize her, and if she runs more manicky than depressed? I would think it may not be enough to hold her.

 

[Jena]

hey thanks........

no it's just a rash no fever no sickness nada...... so going to doctor is overkill i guess.

we're on a super low dose and just began i wont' be able to tell what this medication can do for a while yet. she's still on the zyprexa for now although id like to pull in time. i'm battling huge depression and weight issues with her now due to the other medication. yes my pyshcdoc bites he always has. yet i cant' find anyone new who takes our insurance around here. their all the same they sit and play a guessing game regarding medications, either way its' a **** shoot to me. she is very sleepy and achey during day though on it, shes kinda loopy at times. not totally out of it yet wacked out a bit. i told her to hang on it'll get better we gotta ride out the side effects to get to the true benefit of it. shes in i hate myself mood as of late. her clothes dont' fit at all none of them, shes' very large and she feels ugly and friendless my poor little peanut.

why would you think she'd be more manicky on lamictal? i'm new to this category of medications. i hate that. i got ok with the ap's and i know the benzo and ssri's fairly well. now i'm in new unchartered territory. i hate medications period lol can you tell? i wish there was a way to solve this holistically for her. yet i tried and she refused herbals and supplements and boom eating disorder. so not going there again