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Is it Lithium Time??
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<blockquote data-quote="susiestar" data-source="post: 555142" data-attributes="member: 1233"><p>Abilify can be helpful for those with bipolar, but it is NOT a mood stabilizer. It is an atypical antipsychotic and is usually helpful with rages, etc.... </p><p></p><p>Are you aware that there is a recommended medication protocol for treating bipolar disorder? I know it is in the book, "The Bipolar Child" by Papalous, and it is recommended by the board that certifies psychiatrists. It is basically the same regardless if the patient is an adult, child or adolescent. </p><p></p><p>MANY psychiatrists seem unaware of this until you tell them you want to follow it. The psychiatrists we saw all wanted to say my son was bipolar (in spite of having almost none of the symptoms but most of the Aspie symptoms and an Aspie diagnosis) and they didn't want to do testing, just to write it down and put him on antidepressants. Antidepressants are the LAST LAST LAST thing an unstable person with bipolar should take. LAST thing. They CAUSE mood cycling. this has been shown in many studies, but for some reason most of the psychiatrists here want to ignore that. Drove me batty and I pestered them with WHY???? WHY not follow the protocol approved by the board who certifies you?? Usually I pestered until they said he wasn't bipolar (because he wasn't - many round of testing, etc proved it.)</p><p></p><p>If I had a child with bipolar, I would be pressuring the psychiatrist to put him on this protocol. It calls for starting with one mood stabilizer and then adding a second if needed. It can take 6-8 weeks to know if a medication is working, that is AFTER you get up to the therapeutic level. An atypical antipsychotic like abilify or risperdal or seroquel is also added in the early steps if the patient has the problems your son has. My son did take risperdal for several years and it was a huge help with his violence. I would suggest trialing another atypical antipsychotic if the abilify helped but isn't working as well now, and adding a mood stab also.</p><p></p><p>Lithium is a mood stab. it is often the 'gold standard' for bipolar patients because it seems to work for many of them that the newer medications don't help. It also seems to be one of the mroe effective ones. It does need blood tests, but many of the mood stabs do. Actually your son should have had bloodwork done before starting an atyp antipsych like abilify or risperdal, and some done periodically also. </p><p></p><p>For the majority of bipolar patients, once the right mix of mood stabs and atyp antipsych medications are at a therapeutic level (it can be a long hard road to that point though), most of their symptoms go away. For those that still have anxiety or depression or whatever, sometimes very small doses of antidepressants are tried, or stims if the person still has adhd symptoms. but I have seen a number of people with bipolar who had a total change once they were on mood stabilizers. they didn't lose who they were, they just became the best possible version of themselves. </p><p></p><p>I strongly recommend reading The Bipolar Child by Papalous and asking the doctor about the medication protocol = insist on it even. You also might want to look at the section of the book about medications that can cause mood cycling - medications like decongestants, stimulants, antidepressants, etc.... Knowing about that can help you make sure his psychiatrist is helping him effectively. Don't be afraid to ask the doctor why he wants this medication and not that one, and esp why he doesn't want to follow the protocol if he balks. And read about the medications before your son takes them, if possible. </p><p></p><p>I know a lot of people with bipolar and most of them have been shocked at how much better they felt once they got a doctor to follow that protocol. I even know moms here who finally got on mood stabs and were truly amazed at how they felt - they didn't know they could feel that good, that stable. Hearing that from moms here, and from people I know in real life makes me a firm believer in this medication protocol. Enough that I really pressured three different psychiatrists who wanted to change my son's diagnosis simply because he was a new patient (here they all want to give you a new diagnosis even if you only went to them because your psychiatrist moved or retired! even if the medications you are on are working wonderfully! Drove me NUTS!) and they wanted to 'reinvent the wheel' and ignore all the testing we had done. Usually they backed down because they didn't want to explain why they thought he was bipolar and why the antidepressants were better than the mood stabs. One told the that "the drug rep said that lexapro did a better job than mood stabilizers if you are bipolar." He had NO scientific or researched info on the subject, just what some marketing person told him (drug reps are paid to buy lunch for docs and staff, set up golf outings, hand out pens and hand sanitizer, and tell docs that their medications will fix everything. Drug reps are about SALES and not about medicine, and that doctor never again spoke t me about drug reps. He didn't realize that a number of my classmates from college are now drug reps and a drug rep will say almost anything to get a doctor to rx their drug. They are great salesman usually.</p><p></p><p>Sorry if I ranted, this drives me nuts. I want medications rx'd because they do what is needed, not because someone took the doctor golfing or to a seminar on a beach or gave him a handful of pens. I do think the medication protocol is your best bet for helping your child. Even though he is 18, the book may still be very helpful.</p></blockquote><p></p>
[QUOTE="susiestar, post: 555142, member: 1233"] Abilify can be helpful for those with bipolar, but it is NOT a mood stabilizer. It is an atypical antipsychotic and is usually helpful with rages, etc.... Are you aware that there is a recommended medication protocol for treating bipolar disorder? I know it is in the book, "The Bipolar Child" by Papalous, and it is recommended by the board that certifies psychiatrists. It is basically the same regardless if the patient is an adult, child or adolescent. MANY psychiatrists seem unaware of this until you tell them you want to follow it. The psychiatrists we saw all wanted to say my son was bipolar (in spite of having almost none of the symptoms but most of the Aspie symptoms and an Aspie diagnosis) and they didn't want to do testing, just to write it down and put him on antidepressants. Antidepressants are the LAST LAST LAST thing an unstable person with bipolar should take. LAST thing. They CAUSE mood cycling. this has been shown in many studies, but for some reason most of the psychiatrists here want to ignore that. Drove me batty and I pestered them with WHY???? WHY not follow the protocol approved by the board who certifies you?? Usually I pestered until they said he wasn't bipolar (because he wasn't - many round of testing, etc proved it.) If I had a child with bipolar, I would be pressuring the psychiatrist to put him on this protocol. It calls for starting with one mood stabilizer and then adding a second if needed. It can take 6-8 weeks to know if a medication is working, that is AFTER you get up to the therapeutic level. An atypical antipsychotic like abilify or risperdal or seroquel is also added in the early steps if the patient has the problems your son has. My son did take risperdal for several years and it was a huge help with his violence. I would suggest trialing another atypical antipsychotic if the abilify helped but isn't working as well now, and adding a mood stab also. Lithium is a mood stab. it is often the 'gold standard' for bipolar patients because it seems to work for many of them that the newer medications don't help. It also seems to be one of the mroe effective ones. It does need blood tests, but many of the mood stabs do. Actually your son should have had bloodwork done before starting an atyp antipsych like abilify or risperdal, and some done periodically also. For the majority of bipolar patients, once the right mix of mood stabs and atyp antipsych medications are at a therapeutic level (it can be a long hard road to that point though), most of their symptoms go away. For those that still have anxiety or depression or whatever, sometimes very small doses of antidepressants are tried, or stims if the person still has adhd symptoms. but I have seen a number of people with bipolar who had a total change once they were on mood stabilizers. they didn't lose who they were, they just became the best possible version of themselves. I strongly recommend reading The Bipolar Child by Papalous and asking the doctor about the medication protocol = insist on it even. You also might want to look at the section of the book about medications that can cause mood cycling - medications like decongestants, stimulants, antidepressants, etc.... Knowing about that can help you make sure his psychiatrist is helping him effectively. Don't be afraid to ask the doctor why he wants this medication and not that one, and esp why he doesn't want to follow the protocol if he balks. And read about the medications before your son takes them, if possible. I know a lot of people with bipolar and most of them have been shocked at how much better they felt once they got a doctor to follow that protocol. I even know moms here who finally got on mood stabs and were truly amazed at how they felt - they didn't know they could feel that good, that stable. Hearing that from moms here, and from people I know in real life makes me a firm believer in this medication protocol. Enough that I really pressured three different psychiatrists who wanted to change my son's diagnosis simply because he was a new patient (here they all want to give you a new diagnosis even if you only went to them because your psychiatrist moved or retired! even if the medications you are on are working wonderfully! Drove me NUTS!) and they wanted to 'reinvent the wheel' and ignore all the testing we had done. Usually they backed down because they didn't want to explain why they thought he was bipolar and why the antidepressants were better than the mood stabs. One told the that "the drug rep said that lexapro did a better job than mood stabilizers if you are bipolar." He had NO scientific or researched info on the subject, just what some marketing person told him (drug reps are paid to buy lunch for docs and staff, set up golf outings, hand out pens and hand sanitizer, and tell docs that their medications will fix everything. Drug reps are about SALES and not about medicine, and that doctor never again spoke t me about drug reps. He didn't realize that a number of my classmates from college are now drug reps and a drug rep will say almost anything to get a doctor to rx their drug. They are great salesman usually. Sorry if I ranted, this drives me nuts. I want medications rx'd because they do what is needed, not because someone took the doctor golfing or to a seminar on a beach or gave him a handful of pens. I do think the medication protocol is your best bet for helping your child. Even though he is 18, the book may still be very helpful. 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