Meds for BP/ADHD
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Meds for BP/ADHD
| Wed, 04-30-2003 - 11:17am |
Ok, just came back from my son's primary pdoc and he told me that the guy that is giving this evalution to him on Monday is more or less convinced that he is ADHD/Bipolar. So does anyone know how you medicate that?
The Bipolar Child says 2 things. A kid with BP should not take stimulants and that Clonodine should be avoided.
So how the heck do you medicate a kid with both. Respirdol and ritalin and clonodine def are not doing the job right now.
Elspeth
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Angel
Angel - Tired Momma to the Tagteam of Destruction and Disaster affectionately known as Deven (6/27/97), Dilen (10/20/99) and Ethen (4/14/05)Â http://tagteam_of_2_jerzydevils.blogspot.com/
DS' PED agreed that ds needs further evaluation, and seems to agree with me that bipolar disorder is something that needs to be looked at. So, I have some telephone numbers for p-docs that I need to start calling as soon as I finish typing this post. Unfortunately, local child psychiatrists are apparently much harder to come by than psychologists 'round here (you can't shake a stick without hitting a psychologist's office ... and law practices are so numerous it's *ridiculous*!) -- so, I have the phone numbers of three metro-area hospitals. I guess we are somewhat blessed to be living within a reasonable distance of all of these resources - two are very well-known and well-regarded teaching hospitals, and the third is a dedicated psych hospital. But I have a huge knot in the pit of my stomach at just the *thought* of making these phone calls. Nonetheless, I now (well, after I finish gobbling down my Chic-Fil-A lunch) have to start making phone calls to try to get an appt for ds. His PED told me that if they try to tell me they can't give him anything for six months, to let him know and he will try to see what he can do. Unfortunately, our PED practice doesn't have any alliances with any child psychiatry practices, so I am kind of doing this "blind" if you know what I mean.
PED assured me (as I swallowed back tears) that bipolar disorder can be very effectively treated, and that it is treatable in tandem with ADD. Why am I so much more ... freaked out by a possible bipolar dx than I was about the ADD thing? :o( ~ ruth
Good luck with your appointment on Mon.
I know you don't feel very lucky right now, but in a way you are. A lot of bipolar + ADHD kids are misdiagnosed and medicated incorrectly through their teens and beyond, with sometimes devastating consequences. There is even talk now that if bp is treated early enough, it may even prevent fullblown manifestation of the disorder, who knows. It will at the very least save you some pain.
Elspeth, you mentioned you already had The Bipolar Child (by Papolos), and Ruth, if you don't, that's probably the best starting place. I'd also strongly recommend the bpkids.org (Child and Adolescent Bipolar Foundation) site. They have a lot of additional information -- research, interviews, etc. in their Learning Center. They have some online support groups as well that are very helpful. There are several for very young kids, and Elspeth, I think there's even a very young bpkids Canada online support group. If your kids are bp + ADHD, those resources can save you years of aggravation and wasted time, energy, and money.
Generally, bp kids are treated first with mood stabilizers, and for many it takes 2. Often an antipsychotic is added to control aggression and/or hallucinations. Recently, some have begun using monotherapy with antipsychotics. Ruth, re what your ped said about treating bp + ADHD, well, the good news is that ADHD-type behavior is often misdiagnosed mania in these kids with dual diagnoses, and it can resolve with a mood stabilizer. The not so good news is that if it truly is residual ADHD -- as, I think, in my ds's case (he's 5) -- the ADHD component is tricky to treat.
But, there is a lot of hope. I can tell you we began this journey over a year ago, and life was pretty stressful back then. But our son is now mood stable, and that's a huge improvement! Now we're trying to find answers for the ADHD. But that is actually much easier for us to live with than the mood problems were.
So, (((hugs))) to you both, and good luck with the evaluations.
Melissa
Oh, with regard "mania being masked as ADHD": DS is ADD rather than ADHD - so, I'm not sure how this will affect either other diagnoses or the course of his therapy. The ADD dx was "confirmed" through an IQ test (the Wechsler III)administered by a private psychologist, and was pretty evident when looking at the skew between his verbal and performance scores (though ds still "lands" pretty firmly in the gifted bucket, even when the two scores are averaged).
Latest frustration: I called the three practices my PED recommended (at three large facilities in our metro area). One has recently discontinued all outpatient services and now only provides inpatient services; one has no doctors who both accept our insurance plan and who are accepting new patients who have our plan (which is, might I add, a PPO from a MAJOR provider, and this is at a very large teaching hospital, so I have no idea what is up with that); and, the third has not returned either of two v-mail messages I have left. I foresee some major headbanging (mine) ahead.
Sorry to have rambled (I seem to do that a lot on this board!) ... thanks so much again for your kindness. I'll keep you posted! ~ ruth
Go to bpkids.org they have a list of psych docs & may have one in your area. Just poston the main message board & someone may know of one in your area. Also, look at this sight, all you have to do it enter your info & see if there is a psych doc in your area. The list is made up from people who recomend the doc. It was easier for me to just enter my state. I found a few who I didn't know existed.
http://www.dbsalliance.org/referral/search.asp