When a child has been diagnosed with bipolar disorder, you treat that first and foremost. That means mood stabilizers and sometimes an atypical antipsychotic as an add-on. I would definitely ask the psych (is that a child psychiatrist, I hope?) to consider discontinuing the Adderall because Adderall can increase moodiness and aggression. In general, stimulants (and antidepressants, for that matter) make kids with BP much, much worse.
About the Depakote: If she is not taking the long-acting Depakote (you don't say which), it is generally divided into two doses -- morning and evening -- for more even coverage. Furthermore, you need to have blood tests to determine the Depakote level in the blood to see if it's at a therapeutic level. That is generally in the 100 to 125 range. I have two children (including an 11-year-old daughter) on Depakote. It definitely controlled their raging and manic behavior, but they were depressed so we added the mood stabilizer Lamictal. The combo is very good for them.
Please don't give up. My 13-year-old son was totally out of control last fall, and with a good pdoc who has made systematic med changes over many months, he is doing a whole lot better (not perfect by any means, but improving). We have kept him out of the hospital thus far because we have worked very hard on getting the meds right. That really is the key to treating bipolar disorder successfully.
You should definitely get your hands on a copy of The Bipolar Child by Demitri and Janice Papolos. Good luck.
Adderall is a stimulant and can aggravate bipolar symptoms. You may want to discuss this with SmallMom. She's up on the bipolar meds. Do you have mood disorders or substance abuse in the family? Has this child ever been evaluated by a Child Psychiatrist (with the MD) or a NeuroPsycologist (who does extensive testing)? I'm not sure an MRI will do any good. Raging is usually not an ADHD symptom and stims can make it worse. I seriously doubt it's a learned behavior. Sounds like a psychiatric or serious neurological problem (not a brain tumor--my mom had one and you are VERY sick with one). pammar38964.3020717593
At the moment she is on 500mg of Depakote in pm and 15mg of Adderol XR in am.
Seeing 2 Psych. Dr's. one new one and one she has been with for a few years now.
Foxdud38964.3768402778She has 2 Dr.'s she sees now and her diagnosis range from ADHD, OCD, BiPolar,Intermatant Explosive Disorder, Her mother is BiPolar also.When she was dxed with bipolar, was she taken off stims and put on mood stabilizers?What type of doctors did she see? What were their credentials? That's important. Pediatricians and talk therapists are not really good at childhood disorders. If she has bipolar, stims aren't the ticket. It's mood stabilizers. Stims can make mood disorders worse, ADHD or not.It’s been a long time since I posted here or even viewed the forums for that matter. My last post was actually my first, which can be found here......