Julie, I so know where you are coming from having two kids with issues. I have two kids (13-year-old son and 11-year-old daughter) with working diagnoses of BP. Both had manic reactions to SSRIs in 2005. They are both doing better on mood stabilizers. Please don't apologize for the vent -- you are struggling and we understand. Please continue to come here with your questions and concerns.
You are absolutely right -- Seroquel is an atypical antipsychotic that treats mania in the short term and induces sleep. But I don't know how long you've been using it -- it can poop out over time.
I agree with OlderMom that it is a lot of med switching in a short time. I would go for a second opinion. I don't think your pdoc should have added Concerta just a few days into Zoloft. You then have no idea what's wreaking havoc with what. Having said that, Zoloft and other antidepressants can induce mania very quickly. My son became manic on five days of Effexor, even with the protection of a mood stabilizer. And I read an earlier post where you said your son had a manic reaction to Adderall. He may just not be able to take any stimulant.
A neuropsych evaluation is important, but with mood issues, a child psychiatrist with strong diagnostic skills and cutting-edge knowledge of psychopharmacology is a must. The neuropsych, in all honesty, can wait until September.
I hope things improve for you. Please keep us posted.
Oh gosh...I'm sorry in my first post I guess I didn't explain well. It was his pediatrician who told me to give him some benadryl, not his psychiatrist. The clinic that he is getting help from only has a Dr. there on Fridays Both of our boys are on Medicaid as my husband is self employed and with things the way they are right now with both of them we can't get insurance for them. I live in the state capital of Florida, and ironically there are NO pediatric psychiatrists that accept Medicaid except the one we are seeing, and the one I REFUSE to see who diagnosed him with bipolar and then refused to change his meds when they weren't working. So, for right now until I figure something out or win the lottery we are stuck. If something happens on any day besides Friday then I am supposed to take him to the ER to see the PERP nurse to be evaluated. I am trying to avoid this if at all possible as I have a pretty good relationship with Allen right now and I know having to do that would drive a huge wedge between us. My plan right now is to get the second opinion, and if it is different from our current psychiatrist's dx to take it to him and see what he says and how it goes from there.
I just reread my last reply and it didn't make any sense to me. I guess I'm too tired....
Smallmom....you know, my son's psychiatrist actually gave me the scripts for Zoloft and Concerta to be started on the same day, with no instructions as to weaning him off of the Abilify and focalin XR...he came off of those cold turkey a week ago. I made the decision myself to hold of on the Concerta for a couple of days until he had a few days to adjust to the Zoloft. I hope we can figure out soon what's going on with him. I hate to see him suffer...it just breaks my heart
Julie, how is your son today? I've been thinking about you.Thanks for thinking about me. He is okay today, he slept from a litle after ten until 9:30 this morning. When he woke up he was fine and right now he is at a friends house. So far, so good. We have an appt with his psychiatrist on Friday and I am definitely going to let him know what happened this weekend and see what he says. We have an appt the Friday after with the second psychiatrist that we are getting the second opinion from, so I'm gonna let him know also what happened and then let him decide what to do. I did give him his meds this morning, and what happens the next few days will be the deciding factor whether we will continue to take them until we see the doc or whether I pull him off of them myself. If we have even one more sleepless night then I'm gonna take him to the ER and let them figure it out.Sounds like a plan. Just out of curiosity, what dose Concerta and what dose Zoloft?
right now 36mg concerta. He started on 25mg zoloft last saturday, did that for four days and now 50mg. I think the plan is 50mg zoloft for the next month and then up to 100 if he needs it. He is a big boy......5'7" and weighs 175 lbs so he gets adult dosages of drugs....he is a swimmer so has a lot of muscle.
Any advice on how to get my toddler down for a nap now? It seems like he's trying to ditch nap time lately and not even two yet
My fourteen year old has not slept in over 48 hours. He is coming off of Abilify and Focalin...has been off of them for a week, and on Zoloft for a week. Four days ago we started Concerta, the first two days were fine, the last two he has not slept a wink. He is currently in his room ,exhausted and stressing out. What can I give him to sleep? I dont' want to take him to the hospital. His ped suggested Benadryl and I gave him that 3 hours ago. He also had 2 Seroquel 4 hours ago. HELP!!!Julie, I'd be very concerned that the Zoloft and Concerta are sending him into mania. Staying up for hours on end is one of the foremost symptoms of the mania associated with bipolar disorder. You do not need to wean from Concerta so in your shoes, I would not under any circumstances give him more Concerta until you get a definitive answer about what's going on with your son. I would also ask your doctor about weaning him off of Zoloft. I am not a big fan of Zoloft because it sent my 13-year-old son into a manic rage that led us down the bipolar path. I don't know what to offer about getting your son to sleep tonight, but I also wouldn't give him more Benadryl. Benadryl can have a paradoxical effect that makes some kids more hyper. I'm really sorry you're struggling, but do take the lack of sleep seriously that something is not right. Your son clearly needs different treatment from what he's getting. Are you working with a board-certified child psychiatrist?
I'd take him to the hospital or find some kind of medical help. This isn't normal and you should look into it before something drastic happens. Don't wait! Get in the car and take him somewhere and get him some help! If you do and it's no big deal, then that's OK, you've wasted some time in an emergency room someplace, that's all. If it is a big problem and you don't get help, something bad could happen and you'd never forgive yourself!
Julie, it's the fact that he can't sleep that is a symtom of mania. My son was like that on Zoloft. He was staying up until 1 or 2 am and then getting up at 6 am raring to go (clearly not enough sleep for an adolescent). Your son probably looks drugged because he's had Seroquel and Benadryl, but the fact of the matter is he still can't sleep despite these meds. That is mania.
I agree with Susie -- if he's not asleep soon, take him to the ER. You and he can't go on like this.
Julie, don't be casual about this. Put him in the car now! Don't wait! Go to the ER and get some help. Have you asked him if he took something at the Lock-in? If he did, knowingly or unknowingly, that's just adding to the problem. Now go!
Smallmom...if it is mania (which it very well could be) shouldn't the seroquel be bringing him down enough to sleep? That is what it was originally prescribed to him for so when I gave it to him tonight I thought it would work. It is an antipsychotic that is given for mania (at least that's what our info sheet from the pharmacist says) and our psychiatrist told me I could continue to give it to him until the Zoloft started having an affect on his depression.
I agree that we definitely need a second opinion. I am working on that now. I took him to the pediatric psychiatrist who is the head of our hospital's psych ward and he is dx'ing him. His initial impression is that Allen is not bipolar but clinically and severely depressed...however they are going to do all the tests. In the meantime I am trying to get him in with a neuropsych. I have an appt with one in Ocala (4 hours from me) in September...I am looking for one that can get us in sooner. I'm hoping we will survive all of this until then. Not just him but me too. My youngest son (will be 2 on the 30th) also has issues...a communication delay...he has 5 hours of therapy a week. Evaluators initially told me when he was 14 months old that he had all the warning signs for autism, but he has been evaluated several times since then and the same evaluators took that back. His speech therapists do not think he is autistic either. But I am still scared to death......about both of them. I lay awake at night wondering who's going to take care of them if something happens to me. My husband refuses to believe that our youngest has any problems at all, and thinks our oldest is just lazy. Between running the boys around all day, dealing with my dh and his skepticism and trying to find correct dx's and treatment for the both of them I don't know whether I'm coming or going. I really need to be on antidepressants myself. Anyways, sorry for the vent there.
I just checked on him and he is asleep. Finally. Hopefully he will sleep long and hard. Thanks for the advice.
Okay, just read the other replies that came while I was farting around with my response and update and just wanted to say that if he gets less tham 6 hours sleep tonight I am taking him to ER tomorrow afternoon when my dh gets home from work. I'll post an update if I need to do that....or I'll just post an update period on how he sleeps tonight.Here's another thought. Even if he sleeps well tonight...what if I just take him to the ER tomorrow and have him Baker Acted?? Would they do that based on what happened today even if he appears lucid and rested tomorrow? Would it be worth it for me to do that even if he sleeps all night in the interest of getting a correct dx faster and getting the meds stabilized? I know that if I did that to him he would HATE me for it.
Julie, I'd also think about finding a new doc. Maybe I'm too critical, but I don't think much of his "give him some benadryl" advice. I may be sticking my nose in where it doesn't belong, and if so, my apologies. Watch over Allen tonight. I'm saying a prayer for you!