Zyprexa question

[HaoZi]

For those with experience with it, psychiatrist wants kiddo moved to once a day dosing instead of splitting the 10mg pill like I've been doing (since twice day dosing worked at psychiatric hospital I wanted to keep it that way). What I'm wondering is if I move her to once a day is it better to give it to her in the morning or at bedtime?

 

[crazymama30]

My guess would be the evening as zyprexa can be sedating. If she seems too wound up during the day, you could switch it to morning, maybe on a weekend and see if she is too sedated?

Fwiw, my difficult child was on 10mg of abilify in the morning and 5mg in the evening and all summer needed the higher dose in the morning. when he started school again, he was falling asleep in class. I think he was more wound up in the summer time due to less structure, and the structure of the school year helped him but then he needed the lower dose in the morning and the higher dose in the evening to help him calm down from the day and sleep as he also has trouble sleeping during the school year.

I would ask psychiatrist why they want to go with once a day dosing if twice a day dosing is working? If twice a day works for you I would be leery to change it

 

[HaoZi]

The second half of the pill degrades a bit, it's not meant to be split, but getting the insurance company to pay for two lower doses vs one a day dosing is such a PITA and takes up a lot of time and arguments with doctor's office about A) correctly writing the Rx in a way the insurance will accept and B) getting him to do the paperwork for the prior authorization. This is same psychiatrist that I'm having such an issue getting a referral to a specialist from because he wants justification beyond me asking for it.

 

[Farmwife]

My difficult child started zyrexa about 6 weeks ago. According to his psychiatrist it is in the same family of medications as his previous one, risperdal. He is not new to this kind of medication being my point. Anyway, he takes his dose at night. The split dose wasn't practical for him because he will be 18 and self managing soon enough. He is forgetful so the one pill routine offers stability. That being said, he has difficulty getting to and staying asleep and would struggle during school with lethargy an inattentiveness. Now he gets tired enough to go to bed on his own at a good time, huge difference from his previous stalling routines. He wakes up less troll-ish and reports a much improved ability to concentrate in school. Although all difficult child's are unique my guess from the response you got from crazymama and my own experience is that you should determine what end of the spectrum your difficult child is on as far as behavioral needs. Too high energy during day=dose in morning -or- trouble with sleep and dealing with life the next day=dose at night.

Hope that helps.

 

[smallworld]

Zyprexa is very sedating. I would think your difficult child would have to take a 10 mg tablet in the evening, or she would be snoozing all day.

Why can't you get the psychiatrist to write for Zyprexa Zydis, which comes in 5 mg oral disintegrating tablets? That way she could take one in the morning and one in the evening.

 

[HaoZi]

Kiddo is a strange one. I've seen her both sleepy from it and bouncy from it, she is an insomniac but also tends towards hyperactivity. She was on risperdal briefly (never again!). And she refuses to take anything that orally disintegrates or has to be chewed as far as medications go. She doesn't like liquid forms of medications, either. Looking like this will be a coin toss all the way, lol.

 

[smallworld]

Does your psychiatrist have any samples of Zyprexa Zydis? It's paper thin, has no taste and dissolves very quickly (according to my very picky daughter, who has taken it for 4 years). You might want to give it a try with your daughter if your psychiatrist will throw some samples your way.

 

[HaoZi]

The insurance still won't go for the twice a day dosing, no sense fighting kiddo and the company to get the *&^%$ Rx filled and taken. The office he sees her at here isn't his office, they don't have samples down here, and apparently psychiatrist is on vacation until the 20th anyway.
Thanks for the input everyone, going to try her on the full pill tonight and see how it goes, will let you know.

 

[Jena]

good luck with that medication. we are starting on it on friday night. pharmacy messed up again. it's from what small told me is similar to seroquel yet much more effective. does your daughter have any anxiety also? that's what we're looking to combat so that she may begin to eat again someday!??

 

[HaoZi]

She's been on it since psychiatric hospital and it's been upped once already. She has anxiety, aggression issues, etc etc etc. She took it about an hour ago. No sign of sleepiness yet, we're sitting here watching The Little Mermaid. Hope it helps yours Jen, mine been eating til her stomach hurts. Doesn't matter how many times she does it, she repeats it daily.

 

[Jena]

it could take a bit to kick in. hope she sleeps well tonight. little mermaid that's cute! i got a reprieve tonight my step daughter is here sitting on floor with difficult child playing barbies so i get to go online and clean up dog's puke lol!!! yay me!!

i know what you mean about the medications and food. difficult child also used to be beyond starving all the time on seroquel.

 

[HaoZi]

She was naturally a picky eater (and like most prefers junk food). She ate enough for her size and would stop eating when she was full. Now she can be full AND be hungry at the same time. Drives us both batty.

 

[Jena]

shes bipolar right? sounds so similar to my difficult child. when did you feel that things were let's say a bit different? just out of curiousity? i kinda felt it from time i was pregnant with-her.

 

[HaoZi]

I'm still not convinced she is bi-polar, but after a convo with her case manager today we seem to be a bit closer to netting that referral to a specialist. As to different... well, she is my kid, I expected it! A lot of her issues are the same ones I dealt with, she just doesn't have the parental and peer support system I did so that changes things and adds to her issues making everything more complicated.

 

[Jena]

bipolar is super hard to diagnosis in kids without having same dr. on board for a while to watch their behaviors and log it for patterns etc. what type of specialist?? yup i know bad memory i'm sorry. she has you though and that's huge!

alot of what my difficult child goes thru i found out my ex went thru. yet he doesn't share with-her or look to say hey you aren't alone he just often makes things worse because he never got help for who he is.

 

[HaoZi]

They didn't have all these diagnosis's when I was little, I was diagnosis'd as "borderline hyperactive" whatever that meant. What else is anyone's guess. Some stuff like the marine biology and dinosaur thing I totally get because I loved those thing at her age (and still do) so never considered it unusual. Many of the Aspie traits are common in gifted people, and since we're gifted I never considered them much beyond just being part of that. Ditto Sensory Integration Disorder (SID). If I had insurance I'd go to a neurologist or neuropsychologist myself for a full evaluation. I think the one they're looking at is a neurologist that has a neuropsychologist in the office, but not sure. I mentioned a doctor that specializes in autism here that I've heard good things about in the hope that they'll refer her to that doctor.
Her psychiatrist sees her for 15-30 minutes every 1-3 months, I don't think that's enough time to make a proper judgment even with input from her weekly therapist, and I don't feel he takes me seriously (you can imagine how well I take that).
ATM she's hyper and a bit angry, not wanting to sleep and working herself up over it. Oy.

 

[Jena]

therapist is new, right? i got several diagnosis's of bipolar and switched doctor's several times when they'd diagnosis difficult child in ten minutes after speaking to me. I said no way! so i found a guy years ago that stuck with-us for a bit of a prolonged period of time he said possible bipolar. only because she did tend to cycle. so many days up and go go go than she'd crash, alot of seperation anxiety, didn't do well in school with-peers at all, didnt' handle open ended activities well at all. a bunch of junk. she didn't have any sexual hyperactivity fixation on that though, thank goodness!

so i met a woman going back who was difficult child's therapist she went on leave in june and she worked with difficult child intensly for about two years and same pyschiatrist that i have back now with her in conjunction and we tried so many diagnosis's and evaluations and medications we just had to conceed bipolar was the ticket.

once you get someone on board for a while, and it's hard to trust someone speaking to your child yet i let go of the reigns and made difficult child go in alone each week and i'd do a parent mtg. once a mos. to see what things were being targeted, goals and how she felt difficult child was doing what i could do at home. long story short that's how our diagnosis fell into place.

it's a puzzle for many of us. i got away from the diagnosis a while back and now just look to treat the symptoms, my daughter also could not sleep. i tried absolutely everything and this was from birth literally with sleep,, not being able to soothe herself, etc. i got an evaluation for bipolar trying to understand her. i didnt' have it. i have Sensory Integration Disorder (SID) it winds up, ptsd from my wonderful past and obsessive thinking patterns.

you can't get any insurance from this new bill the president signed ???

 

[HaoZi]

She's been seeing the same therapist over a year. Normal psychiatrist didn't think bi-polar, he went with ADHD and ODD. psychiatric hospital doctor slapped on the bi-polar label. I never considered her hyperactivity to be a manic phase, it was just normal for her. Clinical depression would fit, and she's quite capable of being hyper and depressed at the same time. But she's complicated, you know how it goes.

Zyprexa night dose is a FAIL. Not doing that again. The nightly foot pains became leg pains and she was pretty much up until midnight with those even after some benedryl. So it's back to either splitting pills or going to morning dosing, because it certainly didn't knock her out and the whole restless leg thing doesn't happen until bedtime, so maybe a morning dose where she can run off the worst of it will be better.

As to the health bill, that's also complicated and doesn't extend to people like me until 2014 (provided it doesn't get appealed or something in the mean time, which also wouldn't surprise me). As soon as I can get more printer ink I'm going to try to figure out the state sliding-scale insurance forms, but they mostly confuse me.