Update on my son and daughter

Hmm, here are some of the side effects from Zoloft which relates to some of the things you've mentioned:

suicidal thoughts; trembling; appetite changes; headache; diziness; fatigue; nervousness; anxiety; agitation; insomnia; decreased concentration; hyperactivity; mania; abnormal thinking; .. and many more.

I'm a bit confused. How many meds is he on now? Is he still on Zoloft or did the doctor switch because of it's side effects. You didn't really say they were side effects, you just said the doctor said it was BP.

I thought since I'm at it, I'd give you the side effects for Depakote, being that you're nervous about this already. It might help you with your decision:

severe threat of fatal liver damage; changes in appetite; nausea; vomiting; stomach cramps; tiredness; behaviour changes; depression; jaundice; .. and more.

I haven’t posted an update in a while because we’ve had so many pdoc appointments. After my 12-year-old son's rage reaction to Zoloft in early November, we decided to have him evaluated by a pdoc because he was increasingly agitated, aggressive, depressed, angry, irritable – you name it! He was also school avoidant and completely oppositional about doing any homework. After taking a detailed medical history, reading DS's numerous neuropsych and other reports, meeting with us and then him a couple of times, the pdoc concluded today that DS is showing symptoms of BP. The pdoc prescribed Klonopin last week to settle DS down in the short run and will start him on Depakote next Wednesday when his winter break begins.

Meanwhile, last Friday we met with our 10-year-old daughter's pdoc, who concluded (from our observations and her therapy sessions with DD) that DD is having breakthrough episodes of both hypomania and anger/aggression. The pdoc is in the process of figuring out what med to add on and will let us know later this week. She mentioned Risperdal, but DS had such a bad reaction – involuntary muscle contractions and restlessness – that I’m nervous for DD. Of course, every kid is different, but I still worry.

DH and I are feeling quite overwhelmed about all this “news” – 2 kids with suspected BP dxs in 4 months. We know we have our work cut out for us.

If it were me, I think I would remind the dr that your son couldn't take it, so you know he is very aware of the fact. It may not influence his decision but if there is a greater risk of it not working for you dd, he will be reminded to consider it.

As bad as it seems to have them both dx'd bipolar, at least if you have the right dx, you can be sure they are getting the treatment they need. I have heard that the earlier the intervention begins, the better their chances of having a good life.

Thanks for all your support, Stepmom, Barb, Cynthia, Sheri and Lillian. It means a lot to me right now.

InaBox, while I don't feel any compulsion to justify my decisions, I do feel an obligation to set the record straight. My son is no longer on Zoloft. We stopped it the night of the rage reaction in early November. Anytime a child experiences a manic reaction to an SSRI (or a stimulant for that matter), the med is stopped and a dx of BP needs to be considered. That is standard psychiatric practice. So your list of Zoloft side effects is not necessary. Furthermore, I am not concerned about Depakote in the slightest (if you read my post, it is Risperdal I'm worried about. And don't send me the side effects of Risperdal -- I already know them). My daughter has been on Depakote since August, and it has cured 80 percent of her symptoms. Because my daughter has done so well on Depakote, the pdoc feels that Depakote may be a good med for my son as well.

In case you haven't read the bipoloar site I post, I'll post it again. Risperdal is not a mood stabilizer and tends to only work short term for bipolar mania.When my son had his bp dx. he trialed Risperdal, but had a bad reaction to it. Mood stabilizers are the best treatment--Lithium, Depakote, Lamictal (a new one that only has one serious side effect which you can watch out for--most people don't get it and my son has taken it for a few years), Trileptal (the verdict is still out on how well this works), and Tegretal. THe antipsychotics are Risperdal, Zyprexa, Geodon, Abilify and Seroquel. Antidepressants can make bipolar worse as can ADHD meds. I know you're too smart to try to treat bipolar in a natural way, but in case others are reading this, the suicide rate of unmedicated bipolar is the highest of any mental illness with 1 in 5 people succeeding. Even medication can't guarantee no suicide attempts, but they are less. Lithium has anti-suicidal properties and healing properties of the brain. A good site to join will also be listed below, but it costs $35. I would still join it if I had a child with bipolar. Lots of knowledge there with people who've been thru it all and know their stuff. Here are the links and lots of luck. I'm living proof that you can have a good, rich life with bipolar disorder. Smallmom, I know you have a lot of knowledge and am mostly posting for those who are unfamiliar with bipolar and the meds that help it. Again, trying alternatives for something as serious as bipolar can be seriously deadly. It's not ADHD and nothing to play around with.

Pdoc told me today he intends to start Depakote this weekend. He was waiting to get a pre-med blood test, but he talked today to our ped, who said he did blood work in April and all is OK. So onward we go . . . I'll let you know how it goes.

InaBox, Anytime a child experiences a manic reaction to an SSRI (or a stimulant for that matter), the med is stopped and a dx of BP needs to be considered. [/QUOTE] I don't understand. Are you saying that if a manic reaction from a stimulant/med is stopped, it's likely that the dx is BP? Or is there a gap of time in between. Maybe I'm just not understanding you. It sounds as if the med side-effect isn't really taken into consideration before giving the BP dx. Maybe I'm just not reading this part right.

[QUOTE] So your list of Zoloft side effects is not necessary. Furthermore, I am not concerned about Depakote in the slightest (if you read my post, it is Risperdal I'm worried about. And don't send me the side effects of Risperdal -- I already know them). [/QUOTE] You have to understand that you are all strangers to me. I can assume anyone of anything so I don't try to. I offered some information I thought might be helpful. I'm sorry if it wasn't. I'm on your side.

[QUOTE] My daughter has been on Depakote since August, and it has cured 80 percent of her symptoms. Because my daughter has done so well on Depakote, the pdoc feels that Depakote may be a good med for my son as well. [/QUOTE]

Great! I'm glad things are looking better for her. You seem like you've had a lot on your plate. I can relate with your frustrations. Best of luck with it all.

I'm not telling her what to do. I'm just passing on info I think may be of help. She may know and she may not. How can I gage that? Again, I'm new here so I don't know all of your individual stories. Please keep that in mind.

I didn't know BP had different levels: I II III. I know it's in my family as well. Something I've thought about as well.

Susie, the reason the pdoc is recommending Depakote for my son is because it's one of two mood stabilizers (Lithium is the other) that has received a lot of clinical scrutiny. Plus Depakote is the only one approved for kids (because it's been prescribed for many years for kids with epilepsy -- like you!). In addition, it has worked well for my daughter. My daughter needs to be on an anticonvulsant (which Lithium is not) because she has two small brain lesions, and her neurologist wants her to be protected in the event seizures develop. We are doing blood draws every 3 to 4 months to check for liver function and platelet count (at least at the beginning -- the time frame may lengthen). It's all very complicated, but I feel comfortable with the decisions our pdocs are making.

BTW, I didn't realize Depakote could cause acid reflux. My daughter has that, but she is taking Prevacid twice a day so she is protected (her GI doc OKed the Depakote). I also have GERD and developed Barrett's Esophagus, which is a precancerous change in the lining of the esophagus. It is so important not to ignore acid reflux (and now I can step off my soap box).

smallmom - wow! we hadnt talked in so long I had no idea all this was going on - if you need anything (even venting time) you know how to reach me! Even in all my craziness i am here if you need anything! I am sorry they suspect BP but glad you may finally have an answer - best wishes to you ad the kids! I am sending you the biggest hug i have got

I am not talking about simple side effects like loss of appetite or insomnia. I am talking about if a child develops manic behavior while taking a stimulant or AD and the med is stopped but the manic behavior continues even once the med has left the blood stream, then a dx of BP MUST BE CONSIDERED. [/QUOTE]

Well this explains the confusion which is why I asked. The way it was worder earlier wasn't so clear to me. I agree with this statement you've just made. Thanks!

[QUOTE=IMac]Inabox, why don't you sit back and listen and learn. You offer advice about things you're not really informed about and then claim to be "new" when someone calls you on it. Chill out and just talk to people. Ask questions and actively listen. Knowledge is power. [/QUOTE]

I ask lots of questions. I also offer advice from the knowledge and experience that I have. When I say I'm 'new' I mean it in the sense when people attack me saying that "so-and-so KNOWS that, you don't need to tell her" .. nonsense, how am I to know that? Do you think I spend hours reading threads dated from years past? No. I read the current threads. Some I've had to review further back a bit but I'm not about to read every sentence this forum has ever had to offer. No one has 'called me' on anything. I speak from experience and if I'm not sure about something, I'll say so and ask. There's no shame in that.

[QUOTE] Reciting the rare side effects from medications is annoying to people who know they are rare. [/QUOTE]

I'm reciting ALL side-effects. What's rare to one person is not to the next. Again, I'm generalizing. Please don't assume I believe that all people taking these meds are going to get ALL of these side-effects. I'm not at all. It's still good to know and watch out for if you're trying a new med. KNOWLEDGE IS POWERFUL - which is why I'm passing it on.

Not everyone is informed as many are here, which is why they come here in the first place. Don't assume the worst of me. I do have the greatest intentions at heart.

I am not talking about simple side effects like loss of appetite or insomnia. I am talking about if a child develops manic behavior while taking a stimulant or AD and the med is stopped but the manic behavior continues even once the med has left the blood stream, then a dx of BP MUST BE CONSIDERED.

A Cautionary Note

Effective treatment depends on appropriate diagnosis of bipolar disorder in children and adolescents. There is some evidence that using antidepressant medication to treat depression in a person who has bipolar disorder may induce manic symptoms if it is taken without a mood stabilizer. In addition, using stimulant medications to treat attention deficit hyperactivity disorder (ADHD) or ADHD-like symptoms in a child with bipolar disorder may worsen manic symptoms. While it can be hard to determine which young patients will become manic, there is a greater likelihood among children and adolescents who have a family history of bipolar disorder. If manic symptoms develop or markedly worsen during antidepressant or stimulant use, a physician should be consulted immediately, and diagnosis and treatment for bipolar disorder should be considered.

[QUOTE=IMac]This is not about intentions, Hon. It's about the facts and the truth. The side effects listing on the drug info sheets are listed in categories. Again, you seem unsure of how the system works. This isn't some arbitrary method. Drug companies must report any and all side effects. If one person in the study had a headache, it is recorded. You don't know what I'm talking about, do you?

[/QUOTE]

These side-effects I've mentioned didn't come from the top of my hat. They've already been made public. I'm just bringing it to this forum. It's ALL ABOUT THE TRUTH. I didn't go into specifics of categories. I've listed them as they were. Anyone can have any number of these side-effects, regardless of what categories. If there was a reason to be concerned than they should bring this info to their doctors. At least its written for people to be informed on.

I apologize. I'm getting a little sensitive about all the people who have arrived on the message board in the last month or so and are attacking forum members. SmallMom has been struggling long and hard to get the right dx and treatment for her son, and I didn't think she needed to be told all the scary side effects of different meds.

Thank you. I really appreciate your apologies. Really, I'm not here to attack anyone and I'm sorry that you've all had to deal with this in the past. I don't know SmallMom's situation rather than the few posts I read and replied to. I was trying to be helpful - not make her feel inadequate. People have been too quick to assume I'm up to no good. I'm only one perspective of a lot.

I posted the side effects for the purpose of information. She mentioned she had some tough side-effects and I thought maybe it could of been from the meds. If it wasn't she could have just said so. I think she did eventually clarify that. Also, there are many newbies who may relate to her story (along with everyone else's). They may want/need those tid-bits of information I'm putting out there. I'm not here to disrespect by any means. Believe me, I have challenges of my own and have had very little support in return. That last thing I want to do is bash someone else.