Need help
Just thought I would repost this relevant information about stimulants and anti-depressants from The Bipolar Child by Demitri and Janice Papolos. FYI, Strattera is an anti-depressant in the SNRI family. As you know, Adderall is a stimulant:
ABOUT STIMULANTS
"As yet, there is no consensus in the field and no established guidelines in the pediatric psychopharmacology literature regarding either the use or witholding of stimulant drugs. However, the following clinical scenaries should give families pause before pursuing treatment with stimulant drugs:
- There is a strong family history of bipolar disorder.
- Prolonged temper tantrums and mood swings are present along with symptoms of inattention, impulsiveness, and hyperactivity.
- The child is oppositional and defiant.
- The child appears to have better behavior at school and a marked deterioration of behavior in the home.
- The child is explosive and manifests aggressive behavior toward parents and siblings.
- The child has severe separation anxiety, night terrors, and a fascination with gore and mayhem."
ABOUT ANTI-DEPRESSANTS
"The SSRIs, Wellbutrin and the older tricyclic antidepressants can be miracle drugs for children suffering from nonbipolar depression, incapacitating obsessive-compulsive disorder, and anxiety disorders, but for those children who carry an inherited vulnerability for bipolar disorder, the rose can hide thorns . . . our survey of 120 children revealed that over 80 percent of those who were taking an antidepressant switched into mania or psychosis or became very activated, aggressive, and even violent."
As PSM said, Depakote is a mood stabilizer. It is used when kids exhibit manic, emotional or aggressive behavior consistent with bipolar disorder. My 10-year-old daughter is on it because she took an anti-depressant that caused her to have episodes of strange uninhibited and aggressive behavior. The pdoc took her off of the AD before putting her on Depakote, however. What kind of doctor dx your son? What kind of doctor is prescribing the meds? You may need to have your son see a neuropsychologist for a proper dx. And you may also want him evaluated by a good child psychiatrist for bipoloar disorder. Ogram is right -- PSM really knows her stuff. I'm sure she'll weigh in again with more info for you.
sounds like the early bipolar. I hope not, but psm will know. listen to her. she knows her stuff.
Hello. My 6 year old son is on strattera. He was very emotional and the doctor put him on depakote. My husband and I are not getting along and I am wondering if My son should go speak with a counselor before I continue with the depakote. Any advice would help. I'm sick about it. The doctor thought he could be bi-polar but Im wondering iif I should take him to a psychologist since tgere are other things going on at home.
Thanks
CArrie
My son was diagnosed with adhd last September. My brother is Bi-polar and I'm worried My son coul;d be. He is moody but he gets more upset than any other emotion. He was tried on adderall and became severely depressed. The psyciatrist told me that children who may be bi-polar become depressed on adderall. Im so confused.
I wish I knew...lol! If I did, I would have diagnosed my son correctly! I learned mostly from my own son's misdiagnoses and studying them carefully. Early onset bipolar IS highly hereditary and I do know that a child wouldn't be put on a mood stabilizer if the pdoc was thinking only ADHD. I wouldn't be too afraid of bipolar. If he has it, he is the same kid he always was and it can be stablized---I am bipolar and stable. My son actually was MISdiagnosed with bipolar and, because I have it, I just didn't see it in him. He didn't have the rages, like I had as a child and even into adulthood. Adderrall and all stimulants AND antidepressants usually make bipolar kids worse, so it's a red flag. If there are mood disorders or substance abuse in the family, those are BIG BIG BIG red flags as bipolar is highly genetic. Often childhood mania is mistaken for "severe ADHD." It manifests differently in kids. You don't see the huge moodswings you see with Bipolar I and II in adults (there are more mild forms of bipolar in adults too). Kids tend to cycle so quickly that they get stuck in a "mixed" state, which is a mixture of mania and depression. Therefore the child has depressive thinking with manic energy and becomes rageful and can even become violent. Bipolar in children is called Mood Disorder NOS because Early Onset Bipolar is not in the DSM yet so insurance will only cover Mood Disorder NOS. A good book is "The Bipolar CHild" by Dimitri and Janice Papalos. It's in the libraries or any bookstore. I think it's in paperback now. I do have to add that a NeuroPsych may not see bipolar because it's not his field. If in doubt, have the child see both a Child Psychiatrist and a NeuroPsych and confer with each other. Unfortunately, professionals are so spescialized these days that Psychiatrists often don't know about neurological disorders and NeuroPsychs often don't know about psychiatric disorders. It's nuts! I know. I swear my son saw every kind of professional there was and nothing seemed right or worked well until he was finally diagnosed with high functioning autism and given the proper interventions. The meds did nothing except make him mean (stims) or sedate him too much (bipolar meds). He was on twelve meds in all, at one time or another, before he got his PDD-NOS diagnosis. It's sad. As you can see, I learned from experience and wasn't always very smart!
I appreciate everyones input. My son was given depakote by a highly recommended child psychiatrist. I was not completely honest with the doctor when he asked if there were problems at home. My son gets very upset and can't let things go. Could he be just an emotional little boy with adhd? I do feel his strattera isn't working anymore. I was hoping to get everything straightened out by school, I am dreading him starting 1st grade. I question if he's bi-polar because he doesn't have physical outbursts although he seems like he's losing control more often. He hasn't been aggressive towards anyone yet, Can you be Bi-polar and not be aggressive ?
Carrie,
Absolutely, he could be an emotional little boy with adhd. And he could have bipolar disorder. We, unfortunately, do not have the training to diagnose your son over the internet.
I happen to have a 12-year-old son who has ADHD and anxiety. Sometimes his anxiety causes him to be emotional or angry. It has never crossed my mind that he has bipolar disorder. (His 10-year-old sister is another story, as related above.) Your son certainly could be reacting emotionally to what's going on between you and your husband. I don't know the answer to your question -- can you have bipolar and not be aggressive -- but since you are working with a highly recommended child psychiatrist, I encourage you to be completely honest with him so he can best help your son. If you think Strattera is no longer working for your son, by all means tell the psychiatrist so he can make some med changes. In the event you want to learn more about early-onset bipolar disorder, The Bipolar Child is a must-read. Please keep us posted on your son's progress.
Thank you for your help.
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