Unsure Whether to Medicate for ADD When Comorbid with Bipolar

[goody2shuz]

I have a 16 year old daughter who was diagnosed with Bipolar NOS/ADD inattentive type a little over a year ago. She does exceptionally well in school (has a 90 weighted GPA) but is upset that she lacks concentration with reading, is disorganized, forgetful and impulsive at times doing things without thinking about the consequences.

The pdoc said that we should focus on treating the Bipolar first and in many cases once you do so the symptoms of ADD are taken care of as well. She is pretty much stabilized with the Bipolar and I would hate to upset the applecart but do see her struggling with reading and disorganization to the point that it may be interfering with her self esteem & overall confidence. She works two jobs during the summer and seems to be doing well so I am really unsure as to whether we should even bring this up with her pdoc since I would hate to add another med that may alter her overall stability with BP. I know that Strattera & Vyvanse are less apt to induce mania due to their non-stimulant properties so I would think that she would have little probems with either of them.

The question is....to medicate or to leave things be. Any suggestions???

{Also....as some of you may already know, I have an 18 year old daughter who recently scheduled a pdoc appointment to get herself some Adderall which she admits to using in college. My 16 year old is not asking to be medicated but if we are to do so it would be to everybody's relief if we chose something that is less apt to be abused since we do have those concerns.}

Thanks ~ Goody

[addprogrammer]

Goody,

Only a doctor can answer that one. We are really talking DANGEROUS. Not that it can't be done. Just be CAREFUL and follow ONLY the advise of a physician.

I have had some good results with a biofeedback technique that utilizes a metronome. If "metronome" therapy is conducted by a therapist I have every reason to believe that its focus enhancing benefits persist and build with each session.

I'm trying it. It is working. Do a little research on it.

Bob

[SuchGreatHeight]

If she is doing well without a stimulant, I would just leave the idea alone for now. Stimulants can upset symptoms in Bipolar, so you have to be real careful. I have Schizoaffective d/o and ADHD and was told that abrasive Stimulants (Ritalin, Adderall) would trigger symptoms and should stay away from them for a while. I was put on Provigil for ADHD and was doing fine, and when the stimulants Provigil and Concerta did well, my doctor is now contemplating on putting me on Adderall.

SGH

[index.html]

Certainly, it is possible to medicate the ADD along with the BPD, but as I'm sure you are already aware, it is very risky. There's a very real chance that any of the ADD meds will flip her into a manic state. I certainly wouldn't do it unless you have a psychiatrist with whom you have a great working relationship and in whom you have a great deal of trust.

If she is successful in school and the main area of concern for you is that the ADD is affecting her self-confidence and self-esteem, I would have her work with a good therapist first.

Good luck!

[goody2shuz]

Bob, SGH, & Index ~ Thanks for your responses. The general concensus seems to have prevailed!!!

We saw our pdoc yesterday and got some GREAT news!! Seems that our daughter has been given the pdoc's seal of approval as far as stability goes....he is pleased with her progress as far as her BP goes.....we haven't required any med adjustments for the past 3 months and she seems to be doing quite well. He has now decided that we can forgo the usual 4-6 week visits and now see him every 3 months. Soooo......he wrote out scripts to cover us for the next 3 months in terms of her meds (Lamictal and Seroquel) and our next appointment will be in November!!

We did discuss our concerns regarding the ADD symptoms and the pdoc didn't feel comfortable with upsetting the applecart by adding in another med especiall since we are doing so well. He brought up her grades and overall functionability pleased that she is able to work 2 jobs without any problem and said that there is always opportunity to re-evaluate in the future but that in his professional opinion we should not add another med at this time.

Sooo......we are celebrating this major milestone in our daughter's life and rejoicing in how much better her life is compared to last year where we had 4 hospitalizations, 2 suicide attempts, self-injury, and total chaos in our lives not knowing what was going on. Looking back we can only see how far we have come from a distant nightmare....it is GREAT to see our daughter smiling and laughing again. We thought that would NEVER happen but here we are to say that one should NEVER say NEVER!!

So no more meds for now.....just seeing our daughter happy again is more than we ever expected......to take a chance of losing that is not worth it. So we will find other ways to increase focus and concentration as well as organize ourselves. We will also look into using the "Metronome" as you suggested, Bob.

Thanks for all the wonderful advice!!

Love ~ Goody