I don't knany if I can help but Igust wanted to mention that Tegretol is a precursor to trileptal so I don't see how it could be any more effective if the latter didn't work, and Tegretoljust has worse side effects.

Have combinations been tried? Were dosages adequate, with blood levels when appropriate? The only other mood stabilizer I can think of is neurontin and I don't know much about it. There's also the new investigative approach with ketamine if your son fits thecriteria, or there have been a few people here mentioning Namenda which works on the samepathways as the ketamine.

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Chris Stanley- DS 11 ADHD, ODD, mood disorder NOS
currently taking Lithium, Risperidone, Trileptal (weaning off)  Melatonin

thnx yes we did maximize levels each trial  but he has never been on two ms at same time.  if ms did not give improvement on its own, is it possible it could help in combo with another ms?  i am so confused.  if feel like the freakin pdoc sometimes!!

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jackie g

I know what you mean! I feel like I should have earned a degree by now and sometimes wonder why I'm paying people to write prescriptiothat asked on my advice.

Ibelieve that it's true that some meds can have an additive effect even if each didn't work on it's own. I'm not s ure if that's true if you didn't see ANY positive effect though, or if you'd need to find one drug that helped partially but not enough and then add something else to the mix. 

Was risperidone used in combo with a mood stabilizer in the past? I know that's a pretty common combo and makes sense since they work in different ways. I believe that a common problem is trying to get mania (ormixed state) controlled with just mood stabilizers, when it's often necessary to start both and then taper off of the AP MED later if possible. Mood stabilizers seem to work better at keeping moods stable long term while the APs cana work faster.

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Chris Stanley- DS 11 ADHD, ODD, mood disorder NOS
currently taking Lithium, Risperidone, Trileptal (tapering off) , Melatonin

risperdal was only med that brought his rages under control.  however, there were still other symptoms that we kept trying to tweak.  added lithium to risp and really didnt notice any difference.  planning to go back to risperdal but not because i want to.  he gained 50lbs (and now has since lost it) on it.  but its only med to control his brutal rages so we are stuck.  thought maybe two ms would be beneficial and would try to sell idea to pdoc

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jackie g

I agree with Chris about the additive/synergistic effect of MS's when used in combination.    A good trial is 6 to 8 weeks, especially with MS's.  AP's tend to work more quickly than that.  Has he had his thyroid checked?  Are there any allergies involved?  Food intolerances?  Med resistant sx sometimes have other unusual causes going on.

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Brenda,51, TBMF Parent to Parent Volunteer
Mom to A, 17, BP, Tourette's, OCD, ADHD: Eskalith CR, Lamictal, Cytomel, Allegra
E, 15 1/2, BP,AS: Seroquel, Eskalith CR, inositol, Buspar
B, 14 & H, 11
Married 18 years to DH, 50

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