med question

[historyteach]

The doctor at the hospital ordered Respiridal for Trevor's bipolar condition, along with an anti anxiety, (unsure which one.)
I was told yesterday, by the owner of a recovery house that Respiridal is for psychosis - hearing things; that it was not a mood stablizer; and he needed Depakote or another mood stabilizer for treatment. They won't allow Trevor in until he's on one.
The rehab he was in, before RI took him out, shredded his prescription for the anti anxiety. They wouldn't allow it.
Is Respiridal (sp unsure), used for bipolar condition? Does anyone know? Is it supposed to be taken with the anti anxiety?
Anyone know what's up?
Thanks...
Shalom!

[shutterbug]

Teach...

I just went peeking around the internet and found a board where some other parents were talking about their children being put on Resperdal for anxiety (I will place their discussion below). It appears that your son is not on an anti-depresent or mood stablaizer right now (depending on what that other med is). So it looks like you will need to take Trevor to a psychiatrist and get him on a mood stablizer, most likely.

I personally wouldn't advise Depakote, just because you will have to have his blood drawn every month to make sure the levels of the med do not get too high b/c they can quickly build up in the liver and cause all sorts of problems. Well...and when i was on Depakote: i ate chocolate and other sweets like there was no tomorrow (I gained 40 pounds in about 45-60 days) and my hair was falling out in small clumps.

Lamictal is another mood stabalizer that I was on for quite a while until this past week. It did pretty good for me i guess. The main thing to watch out for with it is that there is a small chance of developing a deadly rash from it so the dose has to start out small and be raised slowly and doctors should ALWAYS and CONTINUELY ask if any symptoms of a rash have appeared.

I've just started on Lithium (like 5 days ago) and so i'm not as familiar with it as I am with Depakote and Lamictal. But I do know that lithium is another mood stablizer where I will have to go get monthly blood tests ran.

Anyway....I think you will find the below dialogue helpfull:

The link is http://www.asdfriendly.org/board/lof....php?t999.html

Help - Search - Member List - Calendar Full Version: 3yr old on anti-anxiety drugs ASD Friendly > ASD Issues > Medical & Health
KittyMar 10 2005, 10:11 AM
Hi everyone,

I was wondering if anyone could give me a little info/advice?

I took H to see his Consultant on Tuesday for his routine appt. - and whilst we were talking he suggested to us to think about giving H anti-anxiety drugs
H is an incredibly anxious little boy but very able and the Doc says he doesn't want his anxiety to overcome the potential he has. I was a little taken aback as H is only nearly 4! Me and Hubby have discussed it and we think no way at the moment but something we will have to think about when H starts full-time as we can forsee his anxiety levels rocketing then

Has anyone had experience of these drugs especially on a child so young? Any advice gratefully received.

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kittyx
Greedy BirdMar 10 2005, 10:50 AM
I can understand how you feel about being reluctant to use medication, we were exactly the same but it got to the point that, physically, I could not manage our son when he had a really bad anxiety attack.

Originally we were looking for something we could use just on the days when we thought it would be needed.

However after speaking to a specialist, he suggested a trial period on prozac, this was about 3 years ago and my son is 10 now.

The main problems we had were visits to the hairdresser and generally social situations, which I was becoming less and less able to manage on my own. Once the prozac kicked in the improvements were really miraculous, going to the hairdresser for instance was no longer a problem. There were no side effects, which was really our main concern, and for about 6 months things went really well.

The effects did wear off though, we were warned this could happen, so we took him off it. We then tried a drug called risperidone (you may know this as risperdal). This had absolutely no effect on its own, our sons anxiety attacks seemed to come back and he was no longer coping very well in social situations.

The next step was to try a combination of prozac and risperidone. At first we were not certain about this as it seemed a bit extreme but our GP, and the specialist we were seeing reassured us that this was common practice and that the two drugs worked well together.

We have had pretty good results on this combination, our son is relaxed at home, his sleep pattern is really good, and as for the way he copes socially, that has improved, although it can be a ilttle hit and miss. We were not able to go out as a family, for a meal for instance, for a quite a long time, but his medication seems to have helped. Obviously sometimes we think the way he reacts to certain situations can be just down to his mood at the time and the fact that he is growing up, so we have to take a balanced view and not assume, just because he has a run of bad days, that the medication is not working.

For a while he was taking melatonin to help him sleep, but since he has been on the risperidone that problem has been solved.

Both these medications take a while to start working, and the doseage can take a while to get exactly right. For instance if you increase the dose of prozac to quickly it can make anxiety even worse, apparently because its an anti-depressant and its job is to give you a lift, it can give you too much of a lift if over-dosed on, which is exactly what our children don`t need!!!

You will find that risperidone is usually only recommended for adults over 16, but if taken carefully, under close medical supervision, and increased very slowly it is quite appropriate for children. I have heard that some children experience weight gain on this drug, although this is due to an increase in appetite rather than just a side effect, so we just hide the biscuits!

Some children take risperidone on its own and have good results, I suppose it is just down to the individual,

Our sons concentration levels have increased, he is relaxed and happy at school, and making slow but very steady progress.

We, hope, at some stage that he will come off the medication and that his improved behaviour will have become learned, but in the meantime we have been very happy with the results we have had and shall carry on with it.

I hope this helps (hope i haven`t gone on too much). If there is anything else you want to ask feel free. I know when we started on this road we had no-one to ask, and it does help to hear other peoples experiences.

Sal.

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debbie31Mar 10 2005, 07:26 PM
Hi Mel we tried all of the above drugs and whilst they seem to have worked miracles for others they had the opposite effect for us first we tried Melatonin it was great for a time but then it started to have the reverse effect and didnt help her sleep at all Prozac didnt help what so ever we tried for nearly a year with it altering doseage etc it didnt help with the sleeping pattern so we moved on to the respiridal it worked for a time Respiridal had an instant effect on my daughter i mean within 20 mins of taking it she was drowsy and she was on the smallest dose she began sleeping really well and things went great for a while no violent outbursts or stressed out A but then they returned with avengence we upped the dose things got no better and her weight began to sky rocket and she began having night terrors i dont want to do these drugs down and yes some worked for a time we never tried the combo as i didnt like the effect the respiridal was having on her full stop i dont want to persuade you against it hell if things got so bad again i would give them another try just wanted to give another perspective of them im not trying to frighten you and i hope i havent but respiridal is a strong drug and in the finish A was on the max dose of 1ml a day 0.5 of the morning and 0.5 in the evening it isnt a long term drug on its own so if you try it good luck dont be scared to disagree with the doctors or to question there every move ! Deb
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TwinkleMar 11 2005, 05:42 PM
My son has reacted very well to Fluroxetine (Prozac). He has calmed so much and is a lot happier. Today it was decided to keep him on it for an indefinite period as it is helping him.

It was also discussed today that as school have mentioned attention problems, then there may also be another drug that can be used. The psychiatrist is going to observe him in school and then decide.

C has an anxiety disorder in conjunction with everything else. I think, personally, that if we had known then what we know now, I would have taken the medication at a younger age because he then may not have grown up such a social outcast with his peers. It is very important to children to have friends and when you don't have any... Since he has been on medication, he has made good friends and he is accepted by the other children.

Anxiety can manifest itself in so many ways, with C it is with aggression and obviously I want to keep that under control.

The other thing that happened, due to his depression/anxiety, is that whilst he was mega upset, he was not learning and now his new school are having to plug the gaps.

I do not think that the medication route would have been suggested lightly. You could always give it a controlled trial and see how your son reacts. If you do not see any benefit or progress, then it could be discontinued. That is the attitude we took regarding the Prozac and, in our minds, it seemed less frightening than putting him on Ritalin at the time which the school were suggesting we put him on!

It's working well but it has to be what you and your husband feel comfortable with and you must not feel guilty or anxious yourself about doing it as that won't help you to see any benefits from it.

Lots of hugs M - it is a very stressful situation for you at the moment, but I am sure you will come to what is right for your child and family.
xxx
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MaxineMar 12 2005, 12:04 PM
Hi M,

It would appear we are in a similar situation. My son is also almost 4, (April) he has been dx autism with adhd.

Our Pead has mentioned to us a range of drugs which L may benefit from, but like you I am very hesitant about the situation. I too would like to wait to see how L copes in Sept when he starts m/s school.

My son gets very anxious and he just tends to run around, he has a very limited concentration span. As for going to the hairdressers, forget it, it takes 2 people to pin him down.

Let me know what you decide
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Hi,

After thinking about it I've asked the Doc to refer us to a Clinical Psych. to see whether we can help with behaviour management (I hate that phrase!), but the waiting list so I've heard is very long so I'm not holding my breath!
Also I've been looking into herbal remedies and may try certain ones to see whether they make any difference?! H's anxiety is rather inward rather than aggression etc so I'm at a loss as to how he really feels (he doesn't really understand feelings or how to verbalise them). I'm trying to look at other routes at the moment rather than medication (my Husband is VERY against the idea of meds - but he doesn't spend all day every day with H! )

kittyx
MaxineMar 13 2005, 08:35 PM
M

It sounds like our children are very similar, L's anxiety is also very inward and he struggles to tell me how he feels. My son is verbal but very much delayes, e.g he can say the black cat is jumping, ice-cream please, I want a wee-wee, come on mummy get out of bed. However he can't say, Mummy I am scared, or I dont like this or I cant go over there because their are too many people (have I got my theirs mixed up!!).
He really does not understand feelings at all.


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[shutterbug]

okay.....more internet peeking:

Apparently Resperdal is also BOTH and anti-psychotic and is used for treating bipolar I disorder

Here's what This Web site says:
www.risperdal.com

Now approved for bipolar mania

RISPERDAL® (risperidone) is a prescription medication that has been approved by the Food and Drug Administration (FDA) for treatment of bipolar I disorder or to treat acute to manic or mixed episodes associated with bipolar I disorder. It is approved for use as therapy alone or in combination with drugs called mood stabilizers, such as lithium or valproate.

Although RISPERDAL has recently been approved for treating bipolar mania, it's reassuring to know that RISPERDAL has been around for more than 10 years and is used worldwide.


How does RISPERDAL work?

Symptoms of bipolar mania are thought to be caused by chemical imbalances in the brain. These chemicals are called dopamine and serotonin. Exactly how RISPERDAL works is unknown. However, it seems to readjust the balance of dopamine and serotonin. While it's not a cure, RISPERDAL may help control your symptoms so it may help you reconnect with your life.



When does RISPERDAL start working?

For some people, RISPERDAL can start working as soon as the third day. However, it will take several weeks to get the full benefit of your medication. So please be patient and give RISPERDAL a chance to take effect.



How long do I need to take RISPERDAL?

Keep on taking RISPERDAL every day as prescribed by your healthcare professional.



What about improvement of symptoms?

In a clinical trial, almost twice as many people who took RISPERDAL and a mood stabilizer (depakote or lithium) had symptom improvement compared to people who took a placebo (sugar pill) and a mood stabilizer. Two different scales confirmed this improvement in the clinical trial.






Important Safety Information

Elderly patients with dementia-related psychosis treated with atypical antipsychotic drugs are at an increased risk of death compared to placebo. RISPERDAL® (risperidone) is not approved for the treatment of patients with Dementia-Related Psychosis.


The most common side effects that may occur with RISPERDAL, in the treatment of BIPOLAR MANIA either alone or in combination with a mood stabilizer (Valproate or Lithium) are: sleepiness, muscle stiffness, restlessness, tremor, indigestion, nausea, abnormal vision, muscle aches, dizziness, runny nose, diarrhea, increased saliva, stomach pain, and urinary incontinence. In the treatment of SCHIZOPHRENIA: anxiety, sleepiness, restlessness, tremors, and muscle stiffness; dizziness, constipation, nausea, indigestion, runny nose, rash and rapid heartbeat.

Studies suggest an increased risk of elevated blood sugar-related side effects, and sometimes potentially fatal, in patients treated with this class of medications, including RISPERDAL. Some people may need regular blood sugar testing.

You may have heard the term "tardive dyskinesia." These are potentially irreversible, uncontrollable, slow or jerky facial or body movements that can be caused by all medications of this type. If you have these symptoms, talk to your health care professional.

A rare but serious side effect that has been reported with this kind of medicine, including RISPERDAL, is known as NMS or neuroleptic malignant syndrome. NMS is characterized by muscle rigidity, fever and can be serious.

[shutterbug]

And even more Resperdal info if you wish:
http://www.drugdigest.org/DD/DVH/Use...perdal,00.html

[historyteach]

WOW!
Thanks, shutterbug!!!
So, it is used for bipolar, then. That's what I was wondering mostly. Lots of good information there. Thanks again!
Shalom!

[shutterbug]

Teach....it's not a mood stabalizer though. Just because it's used to treat bipolar doesnt' mean it's a mood stabalizer...like lithium, Valproic acid and lamictal, which is what the guy was saying that Trevor has to be on.

[historyteach]

Thanks, SA. No, I hadn't seen it nor have I heard of it.
Hope you're doing better...

I understand, shutterbug, thank you.
Shalom!