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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by momof1bpkid on October 26, 2004, at 11:46:35
Hi,
I guess I am starting to feel some frustration. My child age 13 has been on a variety of medications since the age of 10. Not too much seems to help at all. He still experiences problems in school on a daily basis, And has suffered many unwanted side effects from his medications. He has tried just about everything and is on about everything.
Currently he is on many medications and I am starting to wonder, Is it even helping ? I have myself been starting to think, should I continue to medicate this child, when it seems that there is very limited benefits from these medications and who knows what it is doing to his physical body. Some times I even question if they are making him worse? But he has improved over the last 3 years in quite a few areas, but that might just be normal growing up, It also seems he has more problems in school than ever, and again he is at that age where a portion of this might be normal, although his behavior in school is not normal and worse than before, It may also be age and puberty in why we see it more?
I am not entirely sure it is the medication rather than the constant therapy and people working with him on a daily basis. But at times I also think, his issues caused him the need to be medicated in the first place and maybe it is necessary. Its so hard to tell at now. But my only concern is he is 13 going through puberty and My concern is why keep him on something that may not be benefitting him at all. His point of view.. he feels they "he doesnt feel different", and this is pretty much everytime he tries a new med. or maintains the meds he is on. I can and will say tho his first week of concerta was wonderful, but that wore off quick. Maybe these meds just poop out on him quick? I know there is alot of debate as well on medications and children, and the possibility it might not be helping or doing anything at all that it might do for an adult.
any thoughts on this? Please share your experiences.Thanks
Posted by jboud24 on October 26, 2004, at 13:24:26
In reply to To Medicate or Not? Pros and Cons, posted by momof1bpkid on October 26, 2004, at 11:46:35
Stop allowing your son to be a tool of the psychiatric industry. It isnt your fault, my mom has one of my brother on adderall and he is 8 yrs. old. It's awful, he's like a zombie during the day. And these meds do work on kids like they do on adults. That's not the problem. The problem is that you are altering some of the child's brain while their bain is still in its developmental mode. Thus, the brain tends to develop in a manner inconsistent with the way it would have developed without the medications.
For instance, an old friend of mine, she's female age 22, has been on adderall or dexedrine he since her very early teens. Fast forward 10 years. Now she struggles to feel any sort of motivation on an everyday basis, she takes 60-80mgs of dexedrine / day just to feel normal, and she used to constantly cry to me about how dissatisfied she was with her life, and how she wished she could just function again without an amphetamine 24/7. Constant amphetamine use has also caused her to become an alcoholic, because alcohol is the only thing that will calm her mind enough to get a few hours of sleep each night after the daytime dexedrine use. It was very hard having to watch her go through that.
If you are a consenting adult, have ADD/HD then great, take a stim, at least you know what you are taking and your brain isn't developing anymore. But a child? No,no,no. Not my child anyway.
Take care,
Justin
Posted by Dr. Bob on October 26, 2004, at 17:36:39
In reply to Re: To Medicate or Not? My experiences » momof1bpkid, posted by jboud24 on October 26, 2004, at 13:24:26
> Stop allowing your son to be a tool of the psychiatric industry.
Please don't post anything that could lead others to feel accused or put down.
If you or others have questions about this or about posting policies in general, or are interested in alternative ways of expressing yourself, please see the FAQ:
http://www.dr-bob.org/babble/faq.html#civil
Follow-ups regarding these issues should be redirected to Psycho-Babble Administration. They, as well as replies to the above post, should of course themselves be civil.
Thanks,
Bob
Posted by jboud24 on October 26, 2004, at 22:17:11
In reply to Re: please be civil » jboud24, posted by Dr. Bob on October 26, 2004, at 17:36:39
Posted by stresser on October 27, 2004, at 13:16:08
In reply to To Medicate or Not? Pros and Cons, posted by momof1bpkid on October 26, 2004, at 11:46:35
I don't mean to barge in, but I just read your post and wanted to tell you that I have a 16yr old daughter who has been on Lexapro, Effexor, Paxil, Wellbutrin, in the past. Now she is taking Topamax and Wellbutrin. It is very difficult with these medications because like you, I ask her if it is working and she says, "I think so,"or "it was, but now it's not anymore." I think it may be a catch 22, because you don't want them to be like they were, but if it's not helping you don't want them on it either. I do know that when my daughter went on SSRI's the first time, she had heavy anxiety. Lexarpo really helped her with that, but it caused weight gain and that was a downer, since she has an eating disorder to begin with. I hope I could help somehow, let me know how it's going. I'm going to see my daughter Pdoc. today and maybe some things will change for her? -L
Posted by SLS on October 27, 2004, at 15:45:17
In reply to To Medicate or Not? Pros and Cons, posted by momof1bpkid on October 26, 2004, at 11:46:35
Diagnostic Complexities and Treatment Issues in Childhood Bipolar Disorder
Melissa P. DelBello, MD
Medscape Psychiatry & Mental Health 9(2), 2004. © 2004 MedscapePosted 10/19/2004
Introduction
Bipolar disorder in children was previously thought to be an uncommon occurrence. It is becoming increasingly recognized that bipolar disorder commonly presents in childhood and early adolescence. However, the diagnostic process is complex in youth. The developmentally specific and variable presentation that characterizes pediatric bipolar disorder leads to diagnostic confusion, yet the impact of bipolar disorder on the psychosocial and psychological development of children and adolescents is significant. Early diagnosis and treatment of bipolar disorder may decrease the symptoms and possibly alter the course of illness. Treatment options for bipolar disorder are expanding rapidly, and the clinician is now better able to treat the disorder while minimizing side effects.
Prevalence
In a community sample of 1507 adolescents, the rate of bipolar disorders was found to be approximately 1%.[1] A subset of these individuals was resurveyed at age 24 years and the prevalence was found to be 2%. In a survey by the National Depressive and Manic Depressive Association, 59% of individuals with bipolar disorder reported the onset of symptoms during childhood or adolescence.[2] Individuals with early onset were more likely to report a positive family history of mood disorders, more depressive or mixed symptoms, and more frequent recurrences. Increased social difficulties were also associated with childhood- and adolescent-onset bipolar disorder, but these difficulties were lessened by treatment.
Diagnostic Challenges
Childhood manifestations of bipolar disorder often overlap with other syndromes.[3] Comorbidity is common in early onset bipolar disorder. In a study comparing children aged 12 years or younger with bipolar disorder (N = 43), attention-deficit/hyperactivity disorder (ADHD) patients without bipolar disorder (N = 164), and non-ADHD controls (N = 84), 98% of those with bipolar disorder also met criteria for ADHD.[4] The ADHD children with bipolar disorder had a higher incidence of major depression, psychosis, multiple anxiety disorders, conduct disorder, and oppositional defiant disorder than the ADHD children without bipolar disorder. In a study of 90 youths with bipolar I disorder, aged 5 to 17 years, 75% met criteria for disruptive behavior disorder.[5]Bipolar disorder is one of the most heritable of the psychiatric disorders, and studying symptoms in offspring aids our understanding of the evolution of the disorder.[6] In a review of 17 studies of children of bipolar parents, the rate of mood disorders in the offspring varied from 5% to 67% compared with the 0% to 38% rate in the offspring of healthy volunteers.[7] The rate of nonmood psychopathology was also higher in the bipolar parent offspring at 5% to 52% compared with the 0% to 25% rate in controls. The degree of relatedness to a bipolar proband has been shown to correlate with symptoms during childhood.
In addition to inheritance patterns, there may be a genetic contribution to treatment response. In a study comparing the offspring of lithium responders (N = 34) with lithium nonresponders (N = 21), the children of lithium responders tended to have good premorbid functioning with a classical episodic course.[8] However, the children of lithium nonresponders exhibited poorer premorbid functioning, a chronic course, and increased comorbidity.
Need for Early Intervention
The consequences of untreated bipolar disorder in children are very significant. Children with bipolar disorder have more academic problems, difficulties in relationships with family and peers, legal difficulties, substance abuse, and increased suicide rates.[9-11] Early identification and treatment of the syndrome with psychosocial and psychopharmacologic interventions is advisable to normalize the developmental processes.Psychopharmacologic Treatment
There is a dearth of controlled clinical trials in children and adolescents with bipolar disorder. The clinician must therefore rely on data from adult clinical trials, although appropriate interventions in children may differ from those in adults with bipolar disorder. Mood stabilizers have generally formed the mainstay of treatment in children and adolescents; however, the atypical antipsychotics may be more effective as first-line treatment options. As in adults, mood stabilization is often difficult to achieve in bipolar youth, and polypharmacy is commonly used. One survey found that children and adolescents with bipolar disorder were treated with a mean of 3.40 ± 1.48 medications and had previous trials of 6.32 ± 3.67 trials of psychotropic medications.[12] Ninety-eight percent had been treated with a mood stabilizer, and the most commonly used agents were valproate in 79% and lithium in 51%.Lithium. Lithium, the oldest mood stabilizer, has the most extensive database in adults. However, there are few controlled studies in children. In a double-blind, placebo-controlled study of lithium in adolescents with concurrent substance abuse disorder, lithium was found to be efficacious in the treatment of bipolar symptomatology as well as in decreasing substance abuse.[13] In a recent placebo-controlled trial of lithium discontinuation in children and adolescents with acute mania, individuals who had responded to an open trial of lithium lasting for at least 4 weeks were assigned to a 2-week continuation phase of lithium or placebo.[14] There was a slightly lower exacerbation rate in the lithium-treated individuals compared with those on placebo (52.6% vs 61.9%); however, the difference was not statistically significant. Lithium has a narrow therapeutic window, and blood monitoring is essential. This may increase resistance to treatment in both children and adolescents. Side effects, including acne and tremor, may be particularly troublesome in an adolescent population since cosmetic issues are often of paramount concern in this age group.
Antiepileptic Agents. Although both divalproex and carbamazepine have demonstrated efficacy in adults with bipolar disorder, the data in children are much more limited and often based on case reports or retrospective reviews. In an open study comparing the treatment effect sizes of antimanic agents in the treatment of mania or hypomania, the effect sizes were 1.63 for divalproex (53% response rate), 1.06 for lithium (38% response rate), and 1.00 for carbamazepine (38% response rate).[15]
In an open label study of divalproex in youths, the response rate in subjects completing the trial was 61%.[16] Over 50% of the sample dropped out, primarily due to ineffectiveness, intolerance, or nonadherence. In a chart review of youths with bipolar disorder, the response rate was 53%.[17] The discontinuation rate was 40%, primarily due to side effects. The most common side effect was weight gain, which was noted in 27%. Liver enzyme increases necessitated discontinuation in one individual, although this normalized after discontinuation of the medication. Although the role of carbamazepine in adult bipolar disorder has been established, there are only case reports supporting its use in youths with bipolar disorder. The complex metabolic issues, need for blood monitoring, risk of agranulocytosis, and other serious side effects make carbamazepine a difficult agent to use.[18]
Both valproate and carbamazepine should be used with caution in adolescent females, since there is an increased risk of neural tube defects with both agents. The addition of folate may be helpful in preventing these defects; however, the data are inconsistent. Carbamazepine may accelerate the metabolism of oral contraceptives and thereby lower the blood concentrations, increasing the risk of an unplanned pregnancy.[19] Menstrual irregularities as well as polycystic ovarian syndrome have also been associated with valproate.[20]
Many of the newer antiepileptic medications are being evaluated for their effectiveness in children. Topiramate was found to effective in 26 children and adolescents with bipolar I and II disorder based on a retrospective chart review.[21] The rate of response was 73% over the 1- to 30- month follow-up period. Other antiepileptic agents that have some limited data indicating effectiveness include lamotrigine, gabapentin, and oxcarbazepine.[11]
Atypical Antipsychotics. There is emerging evidence from the adult literature that atypical neuroleptics are effective in the treatment of bipolar disorder, whether or not psychotic symptoms are present. In contrast to the typical antipsychotics, the atypicals have unique pharmacologic profiles that result in markedly different side effect profiles. The balance between therapeutic efficacy and side effects must be weighed to optimize treatment interventions.[22]
Olanzapine was the first of the atypical agents shown to be effective in adults with bipolar disorder. This agent also appears to have some efficacy in children. In an 8-week, open-label, prospective study of olanzapine in 23 youths aged 5 to 14 years, the overall response rate was found to be 61%.[23] Weight gain was significant, however, with an increase of 5.0 ± 2.3 kg over the 8-week course of the study.
The atypical agents appear to be helpful as adjunctive agents to mood stabilizing agents such as lithium and valproate. Quetiapine was added to valproate in a double-blind, placebo-controlled trial in adolescents with mania.[24] Patients aged 12 to 18 years were randomized to receive valproate with quetiapine (dose titrated up to 450 mg/day) or placebo. The response rate, as measured on the Young Mania Rating Scale, was significantly greater in the quetiapine adjunctive group (83%) compared with the placebo adjunctive group (53%). These data are similar to the positive adjunctive role demonstrated for quetiapine in adults with mania.[25]
The effectiveness of risperidone in the treatment of 28 youths with bipolar disorder aged 10.4 ± 3.8 years was analyzed retrospectively via chart review.[26] The dose of risperidone was 1.7 ± 1.3 mg and the duration of treatment was 6.1 ± 8.5 months. A total of 82% of the sample manifested improvement in manic and aggressive symptoms, and 69% demonstrated improvement in psychosis scores.
Comparing Side Effect Profiles
Although the atypical agents all have a lower incidence of extrapyramidal symptoms and tardive dyskinesia compared with the typical neuroleptics, there are other side effects that occur frequently. The most significant side effect concern is the increase in obesity, hyperlipidemia, and hyperglycemia. Both olanzapine and clozapine have been shown to have the greatest risk potential in these areas.[27-29]Weight gain on olanzapine was found to be significantly greater than that on quetiapine in a retrospective study of patients younger than 18 years treated for 14 days or more.[30] The weight gain on olanzapine was 3.8 kg and on quetiapine 0.03 kg. In a study of Israeli hospitalized adolescents, both olanzapine and risperidone were associated with weight gain, although the gain with olanzapine was significantly greater compared with the risperidone-treated patients (7.2 ± 6.3 kg vs 3.9 ± 4.8 kg).[31]
Sexual dysfunction may occur with risperidone and may be particularly problematic in adolescence. Since patients may not spontaneously report this side effect or may be unaware of the association with the medication, it is important that the patient be informed about the potential for these sexual problems. In an open-label study in adults with schizophrenia, the incidence of sexual side effects was much greater in patients treated with risperidone (50%) compared with quetiapine (16%).[32] Only 11.7% spontaneously reported sexual difficulties prior to direct questioning. Risperidone resulted in retrograde ejaculation and urinary dysfunction in 2 adolescent patients.[33]
Summary and Conclusions
Bipolar disorder commonly presents in childhood and adolescence and is associated with significant psychosocial difficulties as well as psychological and behavioral impairments. Early intervention may decrease these difficulties. There are many new treatment options available for the clinician, making effective interventions possible. However, there is an obvious lack of controlled clinical trials in children and adolescents, so the child psychiatrist must extrapolate findings from the adult literature until rigorously designed studies are carried out in younger age groups. The clinician must weigh the benefit of intervention against the side effect burden of each agent in order to maximize treatment effects and maintain adherence to pharmacotherapy.
References
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Lish JD, Dime-Meenan S, Whybrow PC, Price RA, Hirschfeld RM. The National Depressive and Manic-depressive Association (DMDA) survey of bipolar members. J Affect Disord. 1994;31:281-294. Abstract
Biederman J, Mick E, Faraone SV, Spencer T, Wilens TE, Wozniak J. Pediatric mania: a developmental subtype of bipolar disorder? Biol Psychiatry. 2000;48:458-466.
Wozniak J, Biederman J, Kiely K, et al. Mania-like symptoms suggestive of childhood-onset bipolar disorder in clinically referred children. J Am Acad Child Adolesc Psychiatry. 1995;34:867-876. Abstract
Findling RL, Gracious BL, McNamara NK, et al. Rapid, continuous cycling and psychiatric co-morbidity in pediatric bipolar I disorder. Bipolar Disord. 2001;3:202-210. Abstract
Chang K, Steiner H, Dienes K, Adleman N, Ketter T. Bipolar offspring: a window into bipolar disorder evolution. Biol Psychiatry. 2003;53:945-951. Abstract
DelBello MP, Geller B. Review of studies of child and adolescent offspring of bipolar parents. Bipolar Disord. 2001;3:325-334. Abstract
Duffy A, Alda M, Kutcher S, et al. A prospective study of the offspring of bipolar parents responsive and nonresponsive to lithium treatment. J Clin Psychiatry. 2002;63:1171-1178. Abstract
McClellan J, Werry J. Practice parameters for the assessment and treatment of children and adolescents with bipolar disorder. Am Acad Child Adolesc Psychiatry. 1997;36(10 suppl):157S-176S.
Wilens TE, Biederman J, Millstein RB, Wozniak J, Hahesy AL, Spencer TJ. Risk for substance use disorders in youths with child- and adolescent-onset bipolar disorder. J Am Acad Child Adolesc Psychiatry. 1999;38:680-685. Abstract
Wolf DV, Wagner KD. Bipolar disorder in children and adolescents. CNS Spectr. 2003;8:954-959. Abstract
Bhangoo RK, Lowe CH, Myers FS, et al. Medication use in children and adolescents treated in the community for bipolar disorder. J Child Adolesc Psychopharmacol. 2003;13:515-522. Abstract
Geller B, Cooper TB, Sun K, et al. Double-blind and placebo-controlled study of lithium for adolescent bipolar disorders with secondary substance dependency. J Am Acad Child Adolesc Psychiatry. 1998;37:171-178. Abstract
Kafantaris V, Coletti DJ, Dicker R, Padula G, Pleak RR, Alvir JM. Lithium treatment of acute mania in adolescents: a placebo-controlled discontinuation study. J Am Acad Child Adolesc Psychiatry. 2004;43:984-993. Abstract
Kowatch RA, Suppes T, Carmody TJ, et al. Effect size of lithium, divalproex sodium, and carbamazepine in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2000;39:713-720. Abstract
Wagner KD, Weller EB, Carlson GA, et al. An open-label trial of divalproex in children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry. 2002;41:1224-1230. Abstract
Henry CA, Zamvil LS, Lam C, Rosenquist KJ, Ghaemi SN. Long-term outcome with divalproex in children and adolescents with bipolar disorder. J Child Adolesc Psychopharmacol. 2003;13:523-529. Abstract
Spina E, Pisani F, Perucca E. Clinically significant pharmacokinetic drug interactions with carbamazepine. An update. Clin Pharmacokinet. 1996;31:198-214. Abstract
Fattore C, Cipolla G, Gatti G, et al. Induction of ethinylestradiol and levonorgestrel metabolism by oxcarbazepine in healthy women. Epilepsia. 1999;40:783-787. Abstract
O'Donovan C, Kusumakar V, Graves GR, Bird DC. Menstrual abnormalities and polycystic ovary syndrome in women taking valproate for bipolar mood disorder. J Clin Psychiatry. 2002;63:322-330. Abstract
DelBello MP, Kowatch RA, Warner J, et al. Adjunctive topiramate treatment for pediatric bipolar disorder: a retrospective chart review. J Child Adolesc Psychopharmacol. 2002;12:323-330. Abstract
Nasrallah HA, Newcomer JW. Atypical antipsychotics and metabolic dysregulation: evaluating the risk/benefit equation and improving the standard of care. J Clin Psychopharmacol. 2004;24(5 suppl 1):S7-14.
Frazier JA, Biederman J, Tohen M, et al. A prospective open-label treatment trial of olanzapine monotherapy in children and adolescents with bipolar disorder. J Child Adolesc Psychopharmacol. 2001;11:239-250. Abstract
Delbello MP, Schwiers ML, Rosenberg HL, Strakowski SM. A double-blind, randomized, placebo-controlled study of quetiapine as adjunctive treatment for adolescent mania. J Am Acad Child Adolesc Psychiatry. 2002;41:1216-1222. Abstract
Sachs G, Chengappa KN, Suppes T, et al. Quetiapine with lithium or divalproex for the treatment of bipolar mania: a randomized, double-blind, placebo-controlled study. Bipolar Disord. 2004;6:213-223. Abstract
Frazier JA, Meyer MC, Biederman J, et al. Risperidone treatment for juvenile bipolar disorder: a retrospective chart review. J Am Acad Child Adolesc Psychiatry. 1999;38:960-965. Abstract
Almeras N, Despres JP, Villeneuve J, et al. Development of an atherogenic metabolic risk factor profile associated with the use of atypical antipsychotics. J Clin Psychiatry. 2004;65:557-564. Abstract
Nasrallah H. A review of the effect of atypical antipsychotics on weight. Psychoneuroendocrinology. 2003;28(suppl 1):83-96. Abstract
Stigler KA, Potenza MN, Posey DJ, McDougle CJ. Weight gain associated with atypical antipsychotic use in children and adolescents: prevalence, clinical relevance, and management. Paediatr Drugs. 2004;6:33-44. Abstract
Patel NC, Kistler JS, James EB, Crismon ML. A retrospective analysis of the short-term effects of olanzapine and quetiapine on weight and body mass index in children and adolescents. Pharmacotherapy. 2004;24:824-830. Abstract
Ratzoni G, Gothelf D, Brand-Gothelf A, et al. Weight gain associated with olanzapine and risperidone in adolescent patients: a comparative prospective study. J Am Acad Child Adolesc Psychiatry. 2002;41:337-343. Abstract
Knegtering R, Castelein S, Bous H, et al. A randomized open-label study of the impact of quetiapine versus risperidone on sexual functioning. J Clin Psychopharmacol. 2004;24:56-61. Abstract
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Posted by Dr. Bob on October 27, 2004, at 17:34:17
In reply to Sorry (nm) » Dr. Bob, posted by jboud24 on October 26, 2004, at 22:17:11
Posted by crazychickuk on October 27, 2004, at 19:03:19
In reply to To Medicate or Not? Pros and Cons, posted by momof1bpkid on October 26, 2004, at 11:46:35
Im sorry to barch in but i must say this..
My daughter is a handfull she kicks me bites me all sorts BUT i wont take her to the doctors about it cus they will just prescribe medication for her.. and i think its wrong absoloute wrong.. their brains are still developing, please just try therapy first... it wont work over night but it will work!! must give it chance, theres a gr8 risk that meds can add more problems, all the bad side affects not to mention anxiety and dependance, yes dependance cus when u r on them most ppl need to be on the mall the time cus of withdrawl..
anyways this is my opnion sure others have more to say ..
good luck
Posted by yznhymer on October 27, 2004, at 22:23:05
In reply to To Medicate or Not? Pros and Cons, posted by momof1bpkid on October 26, 2004, at 11:46:35
> Hi,
>
> I guess I am starting to feel some frustration. My child age 13 has been on a variety of medications since the age of 10. Not too much seems to help at all. He still experiences problems in school on a daily basis, And has suffered many unwanted side effects from his medications. He has tried just about everything and is on about everything.
> Currently he is on many medications and I am starting to wonder, Is it even helping ? I have myself been starting to think, should I continue to medicate this child, when it seems that there is very limited benefits from these medications and who knows what it is doing to his physical body. Some times I even question if they are making him worse? But he has improved over the last 3 years in quite a few areas, but that might just be normal growing up, It also seems he has more problems in school than ever, and again he is at that age where a portion of this might be normal, although his behavior in school is not normal and worse than before, It may also be age and puberty in why we see it more?
> I am not entirely sure it is the medication rather than the constant therapy and people working with him on a daily basis. But at times I also think, his issues caused him the need to be medicated in the first place and maybe it is necessary. Its so hard to tell at now. But my only concern is he is 13 going through puberty and My concern is why keep him on something that may not be benefitting him at all. His point of view.. he feels they "he doesnt feel different", and this is pretty much everytime he tries a new med. or maintains the meds he is on. I can and will say tho his first week of concerta was wonderful, but that wore off quick. Maybe these meds just poop out on him quick? I know there is alot of debate as well on medications and children, and the possibility it might not be helping or doing anything at all that it might do for an adult.
>
> any thoughts on this? Please share your experiences.
>
> Thanks
>
>Hi there...
First of all, I just wanted to send you some positive energy and tell you I feel for you facing this difficult dilemma. And I want to commend you for seeking medical as well as educational help and other resources for your child.
My oldest son has had many health and mental issues since his premature birth 22 years ago. His OCD and depression during his Middle school and HS years were particularly trying... and he did have one awful Junior year in college. Nevertheless, he's done well enough (he just graduated from a good college, made friends, etc.)and I have hopes that his future will be a good one.
I can share a few observations about my experiences:
1. Things got somewhat better as he got older. Ages 11 through 14 were the worst. From that point on he got more and more stable.
2. I utilized every resource. Some things work better than others, and some work better in concert with others.
3. Giving meds to children is always scary. Don't be afraid of meds but be scrupulous about researching them and monitoring your child. Zoloft and Buspar were key in helping my son... his obsessive thoughts were very upsetting and debilitating before the meds. I worried that he might become suicidal.
4. Having someone to talk to about my son's problems and the decisions we had to make made a big difference to me. Not only did I feel better, but the process helped me analyze and resolve problems more effectively.
That said, I have to admit being very uncomfortable for a long time about my son's continued reliance on these drugs. He gained a lot of weight in a short period of time that he hasn't been able to lose. He has social anxiety though he's made a lot of strides over the years through therapy, in particular. Neverthless, he's never dated. I can't help but wonder if he has no libido from the SSRI... might not even know what he's missing since he started the meds so early in life.
He recently tried a go at dropping the meds, and I was hopeful that he'd do OK without them. But due to the stress of looking for a job after college, but particularly due to his mother's vicious attacks (yeah, I'm a bit angry about that) on his lack of progress in finding something, his anxiety ratcheted up in direct proportion to the plummet in his self esteem. So he went back to his pdoc and restarted the meds. I'm holding out hope that once he moves away from Mom he'll be able to try again, perhaps with a little more support from a therapist.
I don't know if this is helpful or not. Seems to me you have good instincts and are asking the right questions. I'd say, trust your gut. Perhaps you can have your child go on a trial without some of the meds and see what happens... maybe have a little extra support available to ensure success. The meds will still be there if you need them.
I'd express all my concerns to his prescribing doctor and discuss the issue thoroughly. The bottom line is we can only do our best... this is not a situation where you can predict results with great precision.. And you can always modify course as you see what happens.
Good luck to you,
Mark
Posted by linkadge on October 28, 2004, at 14:30:18
In reply to To Medicate or Not? Pros and Cons, posted by momof1bpkid on October 26, 2004, at 11:46:35
Did you try lithium ??
Linkadge
Posted by momof1bpkid on October 30, 2004, at 2:55:28
In reply to To Medicate or Not? Pros and Cons, posted by momof1bpkid on October 26, 2004, at 11:46:35
I just wanted to thank everyone for their input here. I don't agree with "no meds ever tried theory" i was anti med for a long time.. and it finally came a time to try to help him with meds because nothing else worked... He has and is on lithium currently. I thank you all for sharing your stories with me also. they help my stress knowin im not alone dealing with this for this child.
Thanks much to everyone.
Posted by linkadge on October 30, 2004, at 7:57:29
In reply to Re: To Medicate or Not? Pros and Cons, posted by momof1bpkid on October 30, 2004, at 2:55:28
Lithium is probably the safes and perhaps most effective treatmentthat he can recieve. Most of the other treatments have not shown the positive effects of lithium conclusivly.
Please read this article on lithium.http://www.dbsalliance.org/Research/ResearchUpdate5.html
Linkadge
Posted by Sebastian on October 30, 2004, at 16:36:27
In reply to To Medicate or Not? Pros and Cons, posted by momof1bpkid on October 26, 2004, at 11:46:35
You can always try taking away some meds for a while, see what he does. Usualy it seem the meds are doing nothing untill you remove them. I would try half doses for a little while and monitor him closely. Could go well. And even if he needs to go back up in dose after a few months what ever, sometimes it helps to just take a break.
Sebastian
This is the end of the thread.
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