I hate this. Did I say I hate this? I hate the medicine manipulation game. I need input here... My son (5yo) diagnosed with BP, ADHD and ODD... What are your thoughts on this...

Started first med Metadate stimulant... on the 6th day he was raging so bad, we took him off, 2 days later he started Abilify, was excellent for 2 weeks, and very slowly started to show more and more signs back of the ADHD, and after a couple more weeks more anger.. But not what it was before, it was infrequent, and instead of escalating and lasting an hour as before, he would turn it around within 5 minutes... So, Now its time for school and the pdoc feels he is "stabilized" (means unchanging correct?) with the moods on Abilify, and introduced Adderall..... 2.5 mgs 8am and noon... I dont see him until 3pm... BUt Sunday and Monday were raging days, I called the doc and said we must stop Adderall now.. They thought I was too quick and hasty... I expect too much, with BP there is no "cure" only relieves symptoms, and he will still have ups and downs just not as frequent or intense.. And the ADHD needs to be addressed so that he can focus to learn at school (which has been postponed)

There are my questions.... 1) how stable can a BP kid be on meds, what do I expect here?
Being that mental illnesses in children show many of the same symptoms, how do they know if its both BP and ADHD? 2) Maybe its only unstabilized BP? and not ADHD at all. Maybe Abilify isnt the drug for him... In true BP, stimulants make it worse, so maybe the research on this (treating ADHD in "alleged" BP kids) is inaccurate because they dont even know if its truly BP that they have in the first place.. right?? For example I know other parents who have said "my kid doesnt like not getting her way and throws fits too- Does that mean she is Bipolar?" So who knows how many are misdiagnosed. Just what are the odds that different parts of the brain have issues, then trying to treat the different parts while one med makes the other illness worse, trying to find a balance seems so crazy.. I am starting to believe its not both, its unstabilized BP...

Input anyone?

Hi, Mattsmom:wave: I totally understand what you are saying and I believe that your instincts are right.....I have read many sources saying that when there is comorbidity (meaning BP with another disorder) that the Bipolar should be addressed first and stabilized. It seems that you were on your way with that until they added the Adderall. When on the Abilify alone was your son able to focus??? Enough to learn and go to school in your opinion???

They say that many times if on has ADD along with BP that treating the BP will also help with the ADD. What are your observations with your son while on the Abilify compared to other meds??? I know that it is everyone's goal to have your son do well in school but if he is going to be thrown into rages and have worse behavior in relation to meds that must be taken into consideration as well.

I know that this is a difficult call but I say that you should follow your instincts.....document everything and show your documentations to the pdoc to show how your instincts correlate with your son's response/reaction to the meds and his mood and behavior when each med is utilized. Meds will stabilize one to be able to be as "normal" as possible but there will be some factors that cannot be medicated away and will require the person to change some of the behaviors that they can or their reactions to certain things when aware of them. And then again there are things in somebody who is Bipolar that just can't be changed that is all part of their personality which makes them unique and special.

((((HUGS)))) ~ Goody:angel:

Biological chemical imbalance as a cause of mental illness is only a theory and cannot be tested/proven or monitered by any chemical tests. But they do know about drug effects and how they work and just assume the drugs will balance things.

Funny thing is, from what I've read, stimulants cause more dopamine, correct? I also read that antipsychotics like the Ambilify block dopamine, so there is less... sooooo, when they are giving kids the antipsychotics with stimulants, how do they think they are getting anywhere???

That's just it. They really don't know. They are trying to suppress symptoms by drugging the brain here and there and hoping something will stick. And the brain's natural defense against the chemical intruders will also mix things up, eventually causing tolerance and downregulation(cell death).

Alternative methods besides drugs could be tried but are hard to find and may take some work and patience.

The thing they should be doing is finding the causes of mental disorders, not making up so many new ones and only drugging the brain into submission, but seems if they find the real reasons and cures, they'll stop making money on drugs so I'm guessing they are not in a hurry.

I guess if you have to go the drug route, maybe concentrate on the worse disorder, that might be bi-polar rather than the ADHD. Besides, obviously the stimulants seem to rub your son the wrong way.

And yeah, misdiagnoising is quite easy to do especially with no existance of any biological tests for any of it...how can they know which biological medication to give without biological conclusions?

Hi Mats Mom,

This disorder is so frustrating. My dillemma is always tring to figure out what's "normal" age approprite behavior and what's bipolar (or ADHD.)

I've read two great books recently that may be helpful.

One thing is certain. Childhood bipolar looks a lot different than adult bipolar...

"The Bipolar Child" By; Demetri Papolos, MD

AND in considering understanding what's going on in the brain

"The Mood Cure" By: Julia Ross.

Diet may not be the "way to go" but I feel certain that it has a whole lot to do with the issues. The "med only" approach sure does not seem to be working for most of the parents I've heard from. Myself, I'm tired of giving a second drug to overcome the side effects of the first and a third to correct the side effects of the second. Sounds like insanity to me! Best wishes...

Hi Mattsmom

Do you remember I have a son with ADHD/FAS/RAD? We recently had him re-evaluated by a occupational therapist, of course, whom has 'not' contacted us for over 3 weeks due to we assume insurance reasons (she said she would get back to us once the insurance contacted her)- and I called her; she hasn't returned my phone calls. ugh! :mad: Anyway.... IMHO.. Visit a OTfor some work with your son, as they can do wonders for him. Why?

a) work with aiding his sensory needs
b) helping him reach his boundaries and what his boundaries are with himself and other people
c) brushing therapy- this did wonders with my boys when they were in preschool; it really helps children who are hypersensitive- bipolar, adhd, add, autisitc, etc.
d) play therapy- playing with your son through toys. The therapist plays with toys, showing him 'how to play' with toys in different ways; i.e.- with playdough, pounding out frustration, anger, etc.
e) big toys- hurdiling through obsticles

and so forth. There are other reasons that I could go on why a OT could help him, but I won't waste your time. Do a search for Occupational Therapist and ADHD/Bipolar Child on the Internet through Google. It will help you see what a PT does in the work for a child who has special needs and all they have to offer in the programs.

What you are experiencing with the tantrums I can so relate. We had to increase our sons meds by double this summer due to his sever tantrums and rages. It was awful, and we did 'not' want to do it, but had no choice; he was destroying our home, cars, harming me and our other son, and our pets. That was how severe he became. It was just down right scary. Now he is the sweetest little boy only an hour after he takes his meds he is in la-la land, and that we absolutely hate. I can relate to that because after I take my meds, I have a similar effect as well with my Bipolar meds.

My son takes Ritalin, Ritalin LA (extended release), and Clonidine. He has taken Adderall and Risperderal. Neither of them worked for some odd reason. We are very concerned about his weight due to the Ritalin. He has no weight and only weighs 37 pounds for a 7 year old. :(

You are in my thoughts. I sure hope that things get turned around for you soon. Nothing is more frustrating and difficult than when the meds aren't working, and things at home are in turmoil due to things not clicking in unison.

Take care and many hugs

Coffeegirl :angel:

Nanalibby, yes, many times drug side effects are severe enough to warrant another drug to control them, medicating the medication is to me insanity itself and the fact that someday these kids might also need other medical drugs for any physical illness that develops makes me wonder if their future has about 10 or 15 meds a day in it just to survive.

Coffeegirl, if your son is so violent why on earth do they still have him on stimulants? Stimulants will cause aggressive behavior, they are uppers so to speak, it is a listed side effect. So I guess they try to mimimize that with a CNS depresant drug but sometimes that isn't always going to work and rebound aggression can happen after the med wears off.

Uppers and downers can cause a pattern that may result in bi-polar someday, it's not healthy. I would think any violent behavior would be first priority than even ADD (I'm guessing thats why they give him stimulant medication?), I mean, what would happen in the future when he's older if he decided or accidentaly forgot to take the downer during that aggressive high, or if the downer drug does not cover the overstimulation somehow, it could be dangerous. Stimulants, IMHO, should not be given to anyone prone to severe aggression. Just something to think about, or maybe get other opinions?

It really doesn't matter if he was aggressive before meds, the stimulants just add fuel to the fire.:blob_fire

In the brain of those who have ADHD Ritalin, a stimulant, reacts as a calming effect whereas in a different individual the drug would be more like caffiene or even worse of a reaction to the severity of hyperness. Do a search on Ritalin on the Internet over Google.

Coffeegirl

Calming effect is simply paradoxial or perceived as the ability to focus appears to be calming, but it's really lack of distractability so this is more noticable in children, since they metabolize drugs differently(most kids have paradoxial reaction to antihistamines for example). But the drug is still causing stimulant problems in the long run, aggression, insomnia, cardiovascular events, etc. I read where they have already proven non-ADD kids can experience same "calming" effect yet they do not pass on this info but rather the old school thinking that it only happens with ADD kids...