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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by gr8red on March 26, 2004, at 0:09:15
My son is on Effexor 37.5 and was on Seroquel. Off Seroquel due to side effects and put on Risperdal .25mg and Depakote 500mg. Is there an interraction with the three drugs that works? Seems to me that the last two are for the same thing (BP with mania).
I got info from the pharmacist...But being that I am not a Dr...Was hoping I could get some feedback that I could understand. His Dr has also increased seeing him from 1xmo to 1xwk. Oh~ and should I get his blood drawn regularly to check Depakote levels?HELP.Please.
Posted by linkadge on March 26, 2004, at 7:09:44
In reply to Effexor, Risperdal Depakote for 12 yr old, posted by gr8red on March 26, 2004, at 0:09:15
Depakote levels need to be checked regularly at first then the intervals can increase. The doctor will let you know what is necessary.
This does seem like an aweful lot for a young kid, but if it's necessary. Have you tried lithium, it is very good for both mania and depression.
Linkadge
Posted by gr8red on March 26, 2004, at 10:07:04
In reply to Re: Effexor, Risperdal Depakote for 12 yr old, posted by linkadge on March 26, 2004, at 7:09:44
This is really our first experience with any kind of, well, anything like this.Lithium has not even been brought up.I feel like there is something that he (son) is not telling us, like some kind of "trigger" that has made this all happen.Is that a regular feeling for parents? Like there is something that we don't know that made this all come about, and if we could just find out what "it" is, we could make everything better?
Posted by linkadge on March 26, 2004, at 19:15:35
In reply to Re: Effexor, Risperdal Depakote for 12 yr old, posted by gr8red on March 26, 2004, at 10:07:04
This is long but please, I think some will help.
There are so many factors to consider when the mind goes wrong, especially when kids are the ones involved.
The best tips I can think of for dealing with children are:
-Get a second, and third opinion.
-See the best posible person you can. If a
pediatric specialist is available is available
go to him.-Go very slowly. The problems didn't happen
over night, neither should the treatment.- Talk to anyone you know in connection with
your son, teachers, and friends.- You really need to be creative in finding a
way to really encourage honesty.- Make it clear that you want to do everything you can to help him feel better.
- Absolutely and totally *eliminate* any family
disputes. Put one person in charge of the
family for now, and any issues should be dealt
with in private. He really needs the safest
feeling environment to get better.I'm going to be honest, the effexor is the drug you want to watch. The risperdal, and depakote will tame him down but the effexor *may* be problematic.
Be sensitive to compaints like insomnia, and heart palpatitions. The risperdal should reduce the insomnia caused by the effexor.
**If you want my honest opinion**
You **need** to find a doctor that will prescribe lithium. Lithium is the gold standard for bipolar disorder, and anger disorders. The drugs combo he is on right now might really sap the life out of him. Lithium is *much* safer has fewer side effects, and has strong antisuicide effects, it will really reduce agitation, he may not even need a high dose.
Lithium should *not* combined with the effexor
in my opinion.I would really push for lithium monotherapy. It would be much better tolerated than the drugs he is on. I've been on all the drugs you have mentioned, and I hate to think that he might be going through what I have at a younger age. I am 21 and If I could turn back the clock I would have started lithium sooner.
That being said, effexor withdrawl is *not* nice at all, even for an adult. It sounds like much to ask but, if it is withdrawled, open up the capsules and remove about 10 granules a day.
That is my opinion, others may say differently,
but many times the doctors are only going by the book, they don't know what the drugs can make you feel like.Depakote will just calm you down, it should not make you depressed, it will cause cognitive dulling.
Risperdal, also will calm you down, it may depress, and it may cause cognative dulling.
The effexor is an antidepressant, but it can cause agitation, thankfully you are on a low dose, I would be VERY resistant to dose increases of this. If necessary I would be happier with the use of prozac or paxil, they may be less agitating than the effexor.
Anyhow, STAY on this board, and let us know what happens.
LinkadgeWhatever you do, work hard to get him better this summer. Let him know that feeling better is #1, and school comes later.
Posted by Sebastian on March 26, 2004, at 19:34:48
In reply to Effexor, Risperdal Depakote for 12 yr old, posted by gr8red on March 26, 2004, at 0:09:15
One is a mood stabilizer the other is an anti-psychotic. I was taking depakote and zyprexa together, also prozac for depression. Depakote can be hard on the liver, they suggest liver tests while taking it. Hopfully he won't need it for long.
Posted by interject79 on March 26, 2004, at 19:41:11
In reply to Re: Effexor, Risperdal Depakote for 12 yr old, posted by linkadge on March 26, 2004, at 19:15:35
Linkadge makes some extremely good points. If your son is currently in a manic state, the Risperdal was probably prescribed to curtail it quickly. Depakote is used for maintenance, and Effexor for anxiety/depression (though I think it's best that Effexor be kept as a LAST resort in bipolar cases). I think lithium is the gold standard for a reason. Side effects can appear substantial, but this drug has been around a very long time and is widely studied, where others are not (so they might be worse in the long run--who knows). Still many do just fine with Depakote.
I'd take the advice of going slowly seriously too. I believe I'd have been much more compliant in the past had the dosage increases been more modest and over a longer period of time.
Best wishes--and keep updating
interject
Posted by gr8red on March 27, 2004, at 8:42:57
In reply to Re: Effexor, Risperdal Depakote for 12 yr old, posted by linkadge on March 26, 2004, at 19:15:35
Linkadge~ thank you for your words of knowledge and encouragement. Even though we are new to the medication issues; my son has always been melencholy, my Eeyore.Even when he was a baby. So I have always known he was different~but had no idea it was this.I plan on getting a 2nd opinion regarding the BP~because there really aren't huge highs and then huge lows~ He is normally happy~ but if you were to go to him and ask him if he likes his life~ his answer will be NO.And his reasoning is not there.It was suggested by one of his Group Therapists that he was showing signs of Scizophrenia (sp), and after she explained why she thought that, I started recognizing that he really does respond to 'internal stimuli'.Sorry. Rambling.
Posted by linkadge on March 27, 2004, at 9:23:37
In reply to Re: Effexor, Risperdal Depakote for 12 yr old, posted by gr8red on March 27, 2004, at 8:42:57
These are very interesting observations, and you will know your son best. Diagnosing schizophrenia can sometimes be difficult. If you think that he really cannot tell why he feels this way, then he may be endogeniously depressed. If for some reason, you think he may be hiding something, perhaps voices he is hearing etc, then keep looking for clues.
Linkadge
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