moms of bp kids or.....

oh i am so sorry momof....

doc called in risperdal - we will see - we have an appt right now (on my way out) and one next week with seperate docs. todays seems like a farce to me it is nothing like what you all have described in the past - the one next week sounds more like the indepth screening we are looking for - thanks guys gotta go will check in and let you know how it goes.

This is my personal opinion:  Just because your son didn't react well to one stimulant and one AD, you can't assume he has BP.  He could be dx with ADHD and anxiety, for example, which would cause irritable behavior.  You certainly have to consider BP, but I think your son needs a thorough evaluation -- with a good child psychiatrist well-versed in mood disorders as well as a neuropsychologist, who can evaluate for many childhood disorders.  Neuropsychologists give you all kinds of helpful information about your child's cognitive and psychological functioning that you can't get anywhere else.  Psychiatrists with their background in mind-body connection have a unique perspective.  My daughter, who has suspected BP, is clearly working with a psychiatrist who is doing therapy with her, meeting with us bi-monthly, managing her meds, and in the process working on the dx.  My DD also had a neuropsych evaluation that uncovered a language disorder the psychiatrist feels could affect self-esteem if not addressed.  So we are getting valuable information from both evaluations.    

I sincerely believe you will be far happier if you nail the dx down now than flounder around for years wondering what the heck is going on (and trying all kinds of interventions that don't work because you don't have the right dx).  Although I think trying Risperdal in the short term is fine, I personally would not try any other interventions like talk therapy until you know the official dx.  That's like setting the cart before the horse. 

I know this is tough time for you.  We're all pulling for you.

thanks psm i was hoping i would hear from you as well knowing your history, as little as i do.

The woman today was a big fan of talking, not so sure based on my initial conversation that we aren't just dealing with a kid who has had some anxietiies over recent changes in his life. Several moves, new schools, new sibling (Blah blah blah) - she said they could do the neuropsych assessment but recommmends I do the therapy in conjunction b/c she is not sure she has the whole picture yet (uh duh - we met for 45 minutes and you did not talk to my kid yet - you definitely dont have the whole picture), I think they should warn you pre-appointment if they aren't gonna talk to your kid - I would not have taken him in that case. "We ran out of time...." She is an MD psychologist but there are Psychiatrists on staff at this office so she has someone she can work with if we get to the meds again (oh by the way we started risperdal - short term from my reg beh pdoc). I just dont know what she is gonna be able to tell me from talking to my kid - he is charming - yes, he is combative - probably not (it takes security for him to bring out himself). So I still have the intake phone call wiht the other office on thursday, they sounded like they were asessment driven, so I know that is what i will go there for. I did think of cancelling the (expensive) auditory processing screening for next month - may just see what the other assessments say.

I got the Explosive CHild from my mom (gee thanks) and am picking up the Bipolar Child tomorrow - guess i will go ahead and start reading it.

PSM - what should I be doing? Just seeing a psychiatrist? No neuropsych assessment? I knew what to do when I thought it was ADHD now I am not so sure...... 

I wont try any more stimulants and the strat was bad so no more antidepressants either. 

Sorry so long. thanks everyone

I have bipolar myself, and it does need to be treated with meds or you are at a high risk of s uicide. I'm not trying to be an alarmist. The stats say 1 in 5 with bipolar will commit suicide; 60% unmedicated with attempt it. I like the idea of going with a mood stabiliser. The only first line mood stabilizers at this point are: Lithium (the gold star standards), Depakote, Tegretal, Trileptal and Lamictal. Some pdocs try antipsychotics as mood stabilizers. They tend to work more short term and don't have the staying power like the first line mood stabilizers. They are Risperdal, Zyprexa, Abilify, Geodon and Seroquel. Again, these are NOT mood stabilizers and tend to wear out, sometimes rather quickly for mood stabilization. There are some second line mood stabilizers (not proven as effective): Topomax, Gabritral (maybe spelled wrong). Topomax has the side effect of cogntive dulling. It can truly make your child's IQ drop if not monitored or if raised too quickly. Lithium is the med that is most successful. It works in 80% of all cases. I believe Depakote is next. Tegretal is less successful. Trileptal can be "iffy" but has less side effects. Lamictal is a new promising mood stabilizer, but mostly given to older kids. Antidepressants are normally very bad for kids with bipolar as are any of the ADHD meds. Even Straterra, being an antidepressant, is a problem for these kids and causes moodswings. For three years my son had the wrong diagnosis of early onset bipolar and during those years I did tons of research on pediatric bipolar, as well as chatting on CABF, which is a forum (you need to pay $35 to join) for parents of bp kids. I learned a lot chatting with those moms, many who refused to medicate ADHD even if co-morbid with bipolar because the bipolar got so much worse. It is a good site and you can get a waiver and join for free if you dont have enough money and contact CABF by e-mail. I'll post a few links where parents have dealings with bipolar disorder. Because bipolar is a psychiatric disorder, I'm not sure a NeuroPsych is best for a bipolar child. A Child Psychiatrist to me would be best. I also do NOT recommend getting a diagnosis from any sort of talk therapist, including an MD Psycologist. NeuroPsychs are for neurological disorders. The one we saw had read about bipolar, was aware of it, but was far more proficient with neurological disorders.

www.bpkids.org

www.conductdisorders.com

who are Bipolar - i know you have probably said already but I keep getting my searches timed out -

What are you doing for treatment? My doc has a short term recommend that I am not sure about ( she feels like I need to do something b/c the process may be long) but also wants to see how our next appt goes....

We meet with a neuropsych (or at least a guy who says he does neuropsych assessments - can you tell i have become skeptical) today - I think this one is not what I am looking for just like the last one but I also have an intake appt on Thursday am w/a recommended neuropsych group (highly respected in the area) and they sound more like they are the correct path. Since all of this is out of pocket I am trying to find the best fit for me and my son...........

Thanks for any help or suggestions???

In general, when BP is suspected, a mood stabilizer is trialed, as atwork suggested.  These mood stabilizers include (but are not limited to) Lithium, Depakote, Trileptal, Tegetrol and Topamax.  All have pros and cons, and some like Depakote require frequent blood draws to monitor the drug level in the blood.  My daughter is on Depakote, and at the therapeutic blood level for BP, is doing well.

I know you were reluctant to read The Bipolar Child so as not to influence the diagnostic process for your son, but if you take a peek at the chapter on meds, you will get a good understanding of the rationale behind BP meds.  So I'm suggesting that you might want to read just that chapter.

Good luck with the diagnostic process.  It's never easy.

momoftwoboyz,

Still no mood stabilizer.  Wow!  Must be totally frustrating.

hello  my son dillon is bipolar and taking trileptal and risperdal.. they both seemed to work at first it was wonderful then the doctor wanted to try to get his adhd undercontrol and tried adderal and ritilan on him.. both of them threw him into a manic state so he was put back on trileptal and risperdal.. but they don't seem to be working anymore...i think it has something to do with the adhd meds..we have an appt. with a new doctor but not until nov.28th god i hope this doctor  puts him on something what will work

We have three kids that are bipolar (two are now over 18).  They see the "family" psychiatrist.  Heck, I never thought I would need a family psychiatrist! 

The oldest is 25.  She takes Abilify, Trileptal, Zoloft and Provigil.  It took about a year to get her meds right and she is doing well for probably the first time in her life.

The next is 18.   She has quit taking her meds and is BAD shape.  Just this week, she got fired, pulled a knife and threatened to kill herself and kicked in her biomom and her sister's front doors.  When the police showed up, they wouldn't do anything but talk to her.  HELLO!  She needs hospitalization and since she is 18, we need police help to get her there.

The youngest is 14.  She usually sees the family psychiatrist but is currently in residential treatment.  The best med combination she has been on was Depakote and Seraquel but they discontinued due to weight gain.  Nothing else has brought her in line and she ended up hospitalized four times in the last year.  She has been in residential treatment for a month now.  Prior to that, she was in a day program but that meant she had to stay with her mother, who doesn't care what she is doing as long as she isn't being bothered.  They had her on lithium and seraquel, but I don't know what they are using now because her biomom is attending to her since she lives 10 minutes from the hospital and we are an hour away.  This combo wasn't working but when she was moved to residential and they drug tested her, she had all kinds of drugs in her system (pot, speed, crack).  I am sure this is why it wasn't working.

It certainly doesn't hurt to try a mood stabilizer if they feel he is bipolar.  If it doesn't work, it can be discontinued.  If he is really bad, alot can happen between now and the time you get through with the process.  I really like depakote as a mood stabilizer, but since you are paying out of pocket, lithium is much cheaper and is considered the gold standard, with depakote right behind.

thanks smallmom - I have to say you said what I have been thinking - my other thing with the office that I talked to Fri is this - I went to them for the neuropsych eval which I have to pay out of pocket. Not therapy which I already have a someone in my insurance network that I can turn to if we decide talk therapy is gonna be one of our future options. So why pay out of pocket for both services when I dont have to - the eval costs enough w/o adding therapy that I am not sure what it is for. There is so much to look at and I am not convinced he is bipolar just that more was going on then simply ADHD - so a testin we will go (to the tune of hi - ho a cherrio...). I am going to wait until after the intake on thurs before I make any decisions on what to do next - we had a good day today (from what dh says - i was working AGAIN )!  SOrry I am very tired and very silly this evening but wanted ot check in.

I will keep in otuch  of course