[kretzklan]

Today in psychiatrist appointment and I am not happy at all with the meds my children are currently on. I'd like any input about things that have worked for you.
Basically everytime I tell the doc what's going on, he puts the blame back on me saying that it's all behavioral and I have to work that out as a parent...but can't some meds help with the behavioral stuff. I know you can't treat RAD...but there are so many side issues. It's been a bad couple of months, especially with DD.
DD is incredibly oppositional in every second of every day. She has become quite angry and blaming everything on someone else, not willing to take responsibility for anything. Huge mood swings make me think we are dealing with bipolar, although it's not rapid cycling. She'll get in a 'depressed' state and that is when all heck breaks loose. She is mean to our animals and all of us. Her goal each day is to ruin anything happy that happens around her. She is still organized and not scattered...but she'll pretend that she can't remember directions. Her anxiety is off the charts, but the crazy stuff has died down (she doesn't think she'll be killed by a tsunami in the night). The day to day, hour to hour stuff is worse, way worse. She will tell me that she needs something to worry about because her brain says she does. She is still self-harming, although it is lessening (I think due to environmental changes I made). She is currenly on Zoloft and I'm just not sure if it's causing the mania or not.

DS2: Angry, angry and angrier...about everything. So incredibly negative. If he's playing and I ask him to play a game with the family (which he likes to do), he'll say "DANG IT" and stomp around before he simply closes his door and comes down. He is very hard on himself, constantly saying he's stupid and ugly and any other bad term you can think of. He's shutting off from us...just no affect whatsoever. There have not been any physical attacks, so some would say this is a better outcome...but I hate seeing him so 'yuck' and 'empty'. He is a scattered person, rarely knowing where his things are, constantly losing things, unable to complete homework in a timely or correct fashion as he can't remember what the teacher said. He's not hyperactive in any way - although he'll have bursts of energy that is usually used for 'bad'...like attacking a sibling (no real harm...but wrestling turned ugly). His processing is way off...he'll hear (or at least listen to) half a direction, but be totally unable to tell you what the middle part was...even when it's one sentence. While he's presenting as totally laid back and unresponsive...if you approach him, he reacts in high alert. He's starting backing away quickly as though he'll be hurt. He's on Vyvanse for the ADD and Depakote (500 mg) for the mood issues. I'm calling them the dumb pills (not to him) because his inability to have a conversation or even answer a question in an understandable fashion have totally eluded him since this mix. Also looking for an 'older' ADD drug that won't break the bank every month, if he still needs that.

Thanks for any ideas and sorry for short notice.

[akg1229]

I remember that when I was first diagnosed as bipolar at 14 they had me on zoloft, now just to stress the fact that EVERY PERSON REACTS DIFFERENTLY, it threw me into manias often and that's how they found the bipolar. Also When I was depressed it was more angry than what it is now. As Far as depakote goes I took that for a short time .. made my hair fall out
Alot of meds can make you "dumb" it's called psychomotor retardation. I get this a lot with my meds cause anytime they try to fix it with better the meds that increases norepinephrine it sends me into a mania.... so that's what I know about the meds you are currently using. I am currently taking risperdal which is a very effective behavior medication and topomax which is a seizure medication also used to stabalize moods( this does wonders for me) and elavil which keeps me from going to low on the mood swings. The only down side is they are sedatives so they slow me down a little but I still manage to do my job which is taking care of disabled children and adults. Sorry so long. Hope this helps a little. Oh they also had me on savella which helped me some but it was quite pricey.

[kretzklan]

It is so different for every person - I'm bipolar as well and have been on so many meds. Finally have one that works - but I worry about putting her/him on something that didn't work for me. I have to have an open mind...

[Perfect7]

I am not a med expert, but I do have one with bipolar. I know that giving her ADHD meds caused her to have major mania overnight. I've read that ADHD meds can be introduced AFTER they have been stabilized with a mood stabilizer but not before. I've read that SSRI meds can also have an adverse effect on bipolar, if that's what it is. They also cause major mania, but I've never had my daughter on those. It wouldn't hurt them to try a mood stabilizer for your daughter and see if it helps her. Psychiatry is obviously not an exact science with the overlapping symptoms of so many things. Lamictal works great for my dd, and we haven't tried any other mood stabilizers. It had the least side effects and doesn't require constant blood draws to check the levels. I'd also say if your pdoc doesn't listen, find one who will. They don't have to live with these kiddos!

[crick]

Sorry you are having difficulties with finding the right meds! Sounds so frustrating!

I don't have any advice but wondered if there are drugs that really "enhance" the hormonal and puberty effects and if the ones they are on are doing just that?

[its_a_small_world]

My son isn't RAD, but he does have classic ADHD and ODD. He has been on Adderall XR for a few years and it works well. He did try Vyvanse for about a month and it did NOTHING for him. Now he takes Adderall XR 40mg in the morning and sometimes takes regular Adderall 5 mg in the afternoon if there is a ton of homework. It definitely helps him focus better.

For his mood he takes 2 mg abilify, 125 mg depakote in morning and 500 Depakote ER in the evening. In the morning he was also started on .5 mg of Tenex for his anxiety, it seems to have helped. He doesn't have classic bi-polar symptoms, but man his mood can be very aggressive when he isn't on medication. Therapy and talking has definitely helped also.

He is very good about taking pills, he doesn't like it but knows he needs them. We do have to adjust his Adderall each year, which is a pain because you never know how much will work for him. Thankfully we have a great Medication Specialist who works with us. The funny thing is, Adderall is supposed to supress your appetite and his is amazing! He has only been on abilify for 6 months so we can't count that for his appetite.

[rm2000hg]

I really like gabapentin. It is a kind of weird drug that was originally used for epilepsy or neuropathic pain but has a gazillion of off label uses. It can be used to help with anxiety, depression, moods, sensory stuff... I like that it just sort of seems like it lessens the intensity of anything going on with the nervous system rather than affecting a certain symptom which can backfire creating more problems. It makes everything a little easier... a little less intense...

[hrisme]

Have your children had a thorough evaluation for neurological conditions and learning disabilities? It sounds as if there is so much more than RAD going on here! And treating physiological/developmental issues as behavior problems can completely undo any attachment therapy approaches you are utilizing--if a child truly can not change a behavior consequences do not work and will only serve to frustrate the child & thus the behavior will escalate and it is entirely likely the child will give up on trying altogether.

As previous posters have said, ADHD medication & SSRIs can both increase the severity of bipolar disorder. Unipolar depression can also lead to bipolar disorder, so just because an SSRI was working doesn't rule out bipolar in the future. Your daughters comment on her mind having to have something to worry about makes me wonder about OCD--this is exactly what I experienced as the severity of my OCD increased. It could, of course, also be generalized anxiety. With either a mild anti-anxiety medication may be useful (though stay away from benzos if at all possible).

Many of the mood stabilizers have the "zombie effect" (this is a highly technical term that many psychiatrists refuse to acknowledge), especially at higher doses. While I'm in no way, shape, or form an MD the fact that your child's dose of Depakote is more than twice what mine was as an adult seems off to me--especially when I was getting the "zombie" effect on the lowest dose
(125 mg?). Granted, I'm underweight and meds sensitive, but still....If it's not just a side effect of the meds it could be various learning disabilities, including an auditory processing disorder.

The standard 'older" ADD drugs are Ritalin & Adderall, both can have nasty side effects, but sounds like he's got those already! Generics are available for both of these.

Do you have to work with this psychiatrist? If not, find someone else ASAP. Psychiatrists are notorius for ignoring patient concerns, but not all of them! I literally went through over a dozen psychiatrists before I found one that actually listens, I'll do anything to stay with him (including paying out of pocket!). If it comes down to it, even an MD or a nurse practitioner who is willing to listen to your concerns and help you make a knowledgable decision may be better than a psychiatrist who presumes the fault lies in the parent.

[AmyAnne]

Rispridal worked well for Austin. So did Wellbutrin. Depakote actually made his behaviors WORSE.

Austin was on Rispridal to stop anger issues that led to poor impulse control,fake tantrums, willfully peeing the bed, and screaming fits at bedtime. We went from 5 nights a week of hell to no problems at bedtime ever again. I would recommend trying that for your DD

Wellbutrin worked better for Austin than Zoloft, so that might be worth a try.

The "Zombie" drugs for Austin were Depakote and Remron plus Straterra. I HATED when he was on Straterra in the morning and Remron in the evening. It left us with a 90 minute window during the day in which he was pleasant to be around.

I agree, Addressing the behavior with parenting is important, but the medication helps on that road, it really does. IN the beginning we were adamant we did not want kiddo on meds, and it became clear after a year that either they were going to have to medicate him or me.