Adhd? Bi-polar? I don’t know. NEED HELP! | ADHD Information

Kathy

my pdoc says you have to get the mood meds right before you can deal with the adhd side of things. My dd is adhd & bp and she is on depokote and serequel for moods and it is actually helping with the adhd too.  Two docs with opposite views I guess!

Mom of 2 in sc:

I'm not sure that doc knows what she is talking about.....from what you are describing, it does not sound at all like bipolar...but then again, I'm not a doctor...

There ARE OTHER medications out there to treat children with ad/hd BESIDES strattera.  maybe your child would do better on one of the other ad/hd medications?  I don't know much about treatment of children, I am an adult with ADD, and I don't have any children..(i'm 23 weeks pregnant, does that count??)  But I know I was tried out on that Strattera and it did not work for me, either.  A read about a lot of other parents that said their child(ren) "zoned out" and lost interest in things on the strattera (just look through the parents forum on this website, some of them wrote about it)....And I kind of remember feeling that way too, when I was on Strattera.  I think that the doctors get excited about Strattera because it is new and its a NON-stimulant, and they want to prescribe it for ALL ad/hders, and if it does not work, then HEY, THEY MUST HAVE SOMETHING ELSE...

But NOT ALL AD/HDers are created equal, even among our little fellow ad/hd children, and what may work for one AD/HD child may not work for another...I think maybe your doctor should have thought about some of the other medications used for ad/hd before introducing the possibility of a whole different disorder....

could you possibly get a second opinion from a different doctor?

sonya_h38423.6806828704

Well I was wondering how come the dosage that I have read on everyone is such a small dose on your child or children. My son is 11 years old and he is taking 80 milligram a day starting yesterday. 80 mg was alot to me but not sure what to think. He  has ADHD and TICS....  They increased it from 60 because it wasnt helping him.  I mean everyone I read that is on Strattera is always  a lil dosage and I think about 80 and scares me. The only reason she upped the dosage on that medication was becuz I wouldnt let the mental health doctor put him on EFFEXOR...That was a big nono...

You asked if he has periods of being hyper and then able to focus. Well, yes but...He is hyper when he is not on meds first thing in the morning. When the meds kick in then he calms down. The Strattera dose is too low and so he is hyper all the time lately. When he was on 25 mg. he was a zombie. When he was on 18 mg. he was zoned out and way laid back. On 10 mg., he seems to be the way he was before we began medication.  The other part of your question...yes, he is able to focus but not very well. He can focus on his movies (very well), at school (some), while playing gameboy (too well), on his video now (very well)...but the medicine seems to wear off by after lunch, even though it's a NON-stimulant. He isn't able to concentrate on doing things. He can't keep it focued long enough to clean his room or He goes to school from 7-10 and around 2 that's when he gets very antsy and looks for things to get in to. This week he has cut his pajama bottoms up. He dumped too much food in his fishtank and killed his fish (probably cause he's a curious 5 year old). He opened the front door and got out of the house twice, while I was standing within feet of him. He just seems to do things and not realize that he's going to get into trouble. He's very impulsive. The doc said that it's mostly ADHD and partially his age (young 5). The doc called me this morning (YES, on a Saturday) to tell me that he his dose of Strattera needs to be increased and that the reason why we're seeing "wear off" is because he "digests" it very quickly. (she used a more techinical term than digest. I believe the word starts with a "t" but I can't think of it.) So, we're increasing his Strattera to 20 mg. one day and 10 mg. the next day so that he should be at a constant 15 mg..  She said if it still seems to wear off by afternoon than we'll give him a 10 mg. dose in the morning and a 10 mg. dose in the pm. one day and 10 just once on the next day.

The reason why I don't think he is bipolar is because, from what i've read, he's suppose to have extreme mood swings. For the most part, he's always happy. He's hyper happy. He's always on the go and very silly, almost obnoxious. He makes noises ALL the time and very rarely finishes things he starts. He is very, very rarely angry. He gets emotional when he's got too much meds in him (25 mg.) and he argues sometimes, but what kid doesn't!? He gets annoyed easily with his little brother, but again...what kid doesn't?! Yes, I've read a lot of the same symptoms in BP as is in ADHD, but the only symptoms I see in him are ALL the ADHD ones. My main concerns for him are his inattentiveness and his impulsiveness. He doesn't have any moods that I worry about at all. I just don't know why she'd say bipolar maybe.

Valarie

I have the oppisite problem. My son is bipolar with ADHD and the p-doc focuses on the ADHD. If a child is bipolar, stimulants can increase the cycling or increase aggression, but some stimulants don't work or cause bad reactions in children without bipolar too. I thought stratera isn't a stimulant but I have heard of it causing problems with some BP kids. My son was on it and it just didn't do anything. Does your son have times when he doesn't seem hyper or times of clearer focus? Bp and ADHD have alot of overlapping symptoms. The Bipolar Child by Demitri Papolos has a few pages on comparing BP and ADHD and you might find some info at his web site www.bpchildresearch.org

My son has been on Strattera since Jan. 31st. At first he did alright on it, but as the dose was increased from 18-25 mg. he began to have problems, stomache aches, zoned out, lack of interest in activities. So, we decreased the meds to 18 mg., but we still had the same side affects. Again, the psychatrist decreases his dose from 18 to 10 mg.  Well, 10 mg. is pretty much NOTHING in his system. It just doesn't seem to work. We began having problems with his impulsivity again after they decreased the meds to 10 mg. On this dose, he acts hyper, impulsive and is not able to focus. We've had a ROUGH, TERRIBLE week, and I just needed to get his psychiatrists advice on what to do with the meds, whether to increase of change medications. So, I'm telling her all of this and she tells me that he may be bi-polar.  What???? Bi-polar because he is agressive with his brother again?? Bi-polar because he does things before thinking them through?  Bi-polar because he's hyper?? Bi-polar because he's impulsvie. NO WAY! She wants me to try Risperadol, but I refused. She said that he very well could just be "highly ADHD" and in that case we'd increase to 14 mg. of strattera a day.

Now I'm heartbroken and angry as to why she'd throw this "bi-polar" diagnosis out there after only meeting him twice. Doesn't she realize that IF HE HAS ADHD AND THE MEDICINE ISN"T STRONG ENOUGH THAN THOSE ADHD SYMPTOMS ARE GOING TO BE THERE!???? As of right now, I'm going to be trying the Strattera 14 mg. and see how that goes. MY question is....why would a doctor diagnose a 5 year old as bi-polar this quickly?! He HAS become more hyper after the dose was weakened, but isn't that just a symptom of the meds being too weak?

Please someone...tell me why she'd jump to this judgement? Tell me why she wouldn't want to change his ADHD meds around to find the med. that works for him.

ANYONE with experience on ADHD, bi-polar and this medicine (risperdol) please let me know what your thougths are on this. I think she rushed to judgment on this one. After reading the symptoms of bi-polar disorder, he only had the characteristics that were characteristic of ADHD!!!

UGH! Advice...I need it.

Valarie

My psychiatrist and therapist believe I have both adult ADHD and bipolar disorder. They've said that many of the symptoms I have overlap and it's sometimes difficult to distinguish between the two. So, I'm not sure that your doctor really jumped to a conclusion, but I would consider a second opinion.

It's VERY difficult to find medications that work well without causing other problems. My doctors are also treating me for clinical depression and OCD. I take Effexor XR (150mg daily) for depression. I tried Trileptal, which is often used as a mood stabilizer, but it had little effect. I used Concerta for 3 weeks. That did NOT help me at all, and in fact, made me anxious inside.

Now, the psychiatrist started me on Lamictal, which was originally labeled as an anticonvulsant for epilepsy, etc. However, Lamictal has also been approved for bipolar disorder.

My neurologist and the psychiatric resident who is training with him also like Lamictal a lot. (FYI only - I see a neurologist for facial nerve pain and he typically uses anti-seizure medications to help control the pain. Many of the anti-seizure medications are also supposed to help with stabilizing mood.)

NOTE ADDED: Lamictal is only approved for people over 16 because of the increased risk of fatal side effects in children. See http://www.psycom.net/depression.central.lamotrigine.html

Good Luck!

Amelia

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Thanks and good luck

Melissa 

Did she say he was bi polar or did u assume she meant that from the risperdal script? Some kids that are extreme ADHD need the combination.

I didn't assume anything. She told me that with his worsening behavior on the ADHD medication, she thought that something else might be surfacing. I said, "What?". She said "Bi-polar disorder."

Luckily, this new med. dosage is working like a charm!! I did research on the BP disorder and have formulated the conclusion that she does NOT know my child very well. He does not have mood swings--no more than any other person I have ever met. He's always a happy kid. He just also happens to be highly ADHD. With this new dose though, I think we have it under our control.

 

 

I was initially diagnosed with bi-polar, and given a couple of different bi-polar meds. They made me catonic, I was so tired I couldn't lift my head off the pillow, and this was even before I reached the full dosage.

It was than suggested that I had ADD instead of bi-polar, and I had a full work up of tests - IQ, MMPI, ADD evaluations - conclusion was ADD.

I now take Adderall, but I also take a LITTLE bit of Risperdal daily - just .25 mg. The reason? For anxiety issues. I took other anxiety meds for a couple of years, first xanax then something else (name escapes me), but the Risperdal has an overall "calming" effect and takes an "edge" off of me which Adderall just doesn't quite do, and the anxiety meds don't do either. It's not an anger issue, but just an "over the top" kind of thing. Hard to explain...

My point is, Risperdal gives me a calm which Adderall alone doesn't accomplish. I kind of freaked out at first when given the Risperdal script, because it's an anti-psychotic med, but I realize that it helps even out the rollercoaster of serotin/dopamine levels in my mind.

I also take an anti-depressant med, currently Zoloft. My depression isn't apparent to many, because I smile away the pain. But it's there.

Often feeling "different" due to ADD tendencies is enough to induce some feelings of depression in most persons with ADD. There is also some who suggest persons with ADD suffer from post-traumatic disorder symptoms brought on by the daily stress of struggling with ADD.

My point is, the answer is to find the right med combination and dosage level - not to worry so much about the diagnosis which comes along with a med.

If the symptoms point to a med which might address the symptoms, don't worry about the diagnosis as much as the symptoms.

If Risperdal is not right for your son it will be apparent immediately - he'll be really groggy and tired. At least that's my experience with bi-polar meds when I didn't need them. If I were to take the amount of Risperdal normally prescribed for bi-polar I would not be able to function. I take just a very small dose for other reasons.

Mom of 2, glad to hear things are working better. With your added desciptions of your son it does sound like ADHD to me as well (just another parents view).

 

Kathie,

What post are you replying to?

 

Valarie

I wasn't diagnosed with ADHD until I was 16 and then they put me on Ritalin. It did ok for a while but the I could feel myself slowly starting to not be able to concentrate again. When I said something to my Mom and then to my Dr. he upped my dosage and we did that for about 6 months. The Ritalin was working great but it seemed as my body built up a tolerance to it then it didn't work anymore.So they tried putting me on Aderall. That stuff about killed me! I felt like I was going to jump out of my skin! So for many year I didn't take anything and life was HELL! I was getting in trouble all the time, I was moving in and out of my parents house.... You know, just a rotten kid. Then when I was about 21 I started taking birth control and that seemed to help a little bit with the moodiness but I still couldn't stand myself and was having terrible depression. So now, as a 28 year old woman, I am taking Lexapro. I love being on it and half of my family is on it and does well also. But recently one of my friends was diagnosed with Bi Polar and his wife was telling me his symptoms and a little light bulb came on in my head! So I got online and checked out a few wedsites and I think I will be speaking with my Dr. about this soon! My friends wife did say that Lexapro is used in mild cases of Bi Polar or mood disorders, so my response to the drugs would make sense. I am pretty sure that Lexapro isn't a drug that kids can take but there must be something out there that is similar for children.

I am wondering if ADHD and Bi Polar alot of times go hand in hand b/c what you have descibed with your son sounds all to familar. I want you to keep in mind that when someone says Bi Polar and it is about your child it might sound scarey at the time and you get a stereo typical image in your head but it's not always as bad as you think. I know that after many years of putting up with the anger and termole within myself I am glad to be able to function as a normal adult. I know that I have been to alot of Dr's too and the one who found the right drug wasn't even my Dr it was the nurse practitioner at our local clinic. Maybe you should check into a couple of other Drs and have them do some blood work. Make sure that he doesn't have some kind of chemical imbalance that is causing ADHD symptoms. I know that what he is feeling inside is worse then any of the frustration that you could feel so please try to be patient with him. I was lucky that I had parents who tolerated me. Just image you mind, heart, and soul running on panic mode 24/7 and there is nowhere to put that energy and nothing you can do about it.

Jamie