vyvanse increase

Discussion in 'General Parenting' started by crazymama30, Oct 10, 2010.

  1. crazymama30

    crazymama30 Active Member

    difficult child was having a hard time at the end of summer, beginning of school year. We increased his abilify, then he was falling asleep in class. We put the higher dose of abilify at night (he takes it twice a day) and he quit falling asleep in class and starting sleeping at night! Woo Hoo.

    But he is still having some issues at school. One teacher described him as very up and down, and that he explodes at the drop of a hat. At home he has either been an angel or a devil, you really never know what you are going to get.

    So psychiatrist suggested we increase his vyvanse by 10mg a day. So far we are on day 3, the first day was ok, the 2nd day was horrible, and so far today is great. I know stims are a quick in and out drug, but with him if they are not going to to work we will not see it for a week or two and then things will hit the fan. I so hope this helps and we don't explode, I so hate the guesswork involved with medications, but I do really like new psychiatrist and trust her more than old psychiatrist. I just wished she billed insurance.
  2. gcvmom

    gcvmom Here we go again!

    Hope it works for him. The guesswork is hard, I agree. Do you think the Lamictal is at the right level?
  3. Jena

    Jena New Member

    it's great and huge to feel that trust and confidence in the dr. and the medication game i know is absolute torture. what will i get today, like mixing a bunch of junk in a pot and seeing what it comes out like. just log the behaviors at night in your easy child on word or something just a quick jot down this way you can go back and look and reassess when you need to.

    i wish you luck. i have no experience with-that medication though so i cant offer experience :)

    hang in there!!
  4. crazymama30

    crazymama30 Active Member

    I think psychiatrist (and I know I am) is leery of increasing the lamictal as he is already on 250mg at night. I know we could go higher, but would rather not. He is up to 10mg of abilify at night and 5mg in the morning, and this will make 50mg of vyvanse. I am going to take the wait and see approach on this one, many times things will look good but go south about week 2 or so of the medication change. I hate stims, I really do but difficult child without a stimulant is like a computer without a hard drive. Not good at all.
  5. gcvmom

    gcvmom Here we go again!

    I know you've heard people here say this a bazillion times about stims being bad for bipolar -- and I know he doesn't have that as his diagnosis, but with his dad's history, there's a pretty good chance it could be headed that way. I don't remember, but did you ever try Intuniv for his ADHD symptoms? It's helped my difficult child 2 alot. And FWIW, difficult child 2 starts looking horribly ADHD-ish in the middle of the day, so he gets another Seroquel dose and it works for him.

    You've got so much on your plate -- I hope you get some positive results soon for difficult child so you can breathe easy for a little while.
  6. crazymama30

    crazymama30 Active Member

    I have no doubt that difficult child is bipolar, no matter what his diagnosis says. How else would the medication mix he is on be so helpful? I know that stims are not good for bipolar people, and I am leery of this increase, but at the same time I know that difficult child is intolerable without the stimulant. If it is too much we will know soon, and there will be no doubt.

    With my difficult child? If he does not have a stimulant on board he is adhd'ish all day, it does not wax and wane, but will get worse as he gets frustrated due to other people's reactions to him. The morning abilify dose will not cut it for him. Abilify really does seem to be the ap that helps him, it helped his dad too but it activated the tardive in dad that geodon caused. I have moments where I get worried that difficult child will get tardive, but we have seen no sign at all of it and new psychiatrist is very thorough about checking him. I really really like her.

    The last time I billed the insurance company for her visit? They sent me $1.49 back on a $150 visist. It is hard to come up with the money for her, but she only sees him once every 3 months unless we ask to see her sooner and we do most changes over the phone. I have been at this that I am ok with this, and if I am not comfortable I have no problem saying so and asking for an appointment.
  7. gcvmom

    gcvmom Here we go again!

    I wonder why your insurance is paying so little? I thought the parity law passed for mental health? Is it just not covered under your policy? The rate she's charging is certainly not excessive. That's comparable to what we pay for a 30 minute visit for one person -- $175 if it's both difficult child's.

    Hang in there!
  8. crazymama30

    crazymama30 Active Member

    The insurance pays so little because she is not a preferred provider on our plan, and I bill the insurance myself, she does not bill insurance
  9. gcvmom

    gcvmom Here we go again!

    So if she's out of network, they only pay 1%??? Our psychiatrist is not in network either, nor does he take insurance and I bill insurance the same way you do. But we still get 80% of usual and customary yada yada yada (minus our copay) -- vs. 90% if he were in network. The option you're left with just doesn't seem right. I'm not trying to argue -- I'm just amazed. :( I can appreciate how you feel about finally finding someone you can work with and trust. Good psychiatrists are worth their weight in gold, and I'd do the same if I was in your position.
  10. crazymama30

    crazymama30 Active Member

    G---I think it has to do with meeting the deductible on the policy for providers not on the preferred list.