I do beleive it is odd that they will not try her on depakote or lithium (you can get lithium OTC, but I'd consult with an Integrative MD first). They did not work for my kids although Lamictal at least partially helped my older daughter and served as her base med for a long time. She was trialled on SSRI after SSRI for years because she tended towards depression, but she would get mixed states and in those states she'd cut herself and kept ending up back in the hospital, so that was eventually given up on... after years of trying.

One thing that might be immediately helpful is an "emergency medication" such as Lorazepam, hydroxyzine or Xanax which might at least stop whatever is going on and prevent a trip to the hospital.  I used to call the lorazepam a "re-boot" because they'd take it and go to sleep. It was like rebooting a computer. But it isn't something to take regularly. The pdoc tried Klonopin in my younger daughter as something to take regularly and that was a major fiasco.

Weirdly, in the end, the most effective antidepressant for my older daughter turned out to be getting off all grains, cow dairy and soy and healing her gut. She is also on Armour Thyroid medication putting her T3 & T4 level in the high-normal range.

--Jeanie aka "Naomi"
ItsNotMental-AuthorPage
Older dd: formerly(?) teen-onset bipolar (morphed into ultradian cycling): "Recovered" after over 13 years - stable off psych meds almost two years. Now fine on just diet changes and higher thyroid levels (after healing - addressing gut issues/Candidal overgrowth while using EMPowerPlus and other supplements). She added EMpowerPlus back on just because she feels better on it - gets sick less often.
Younger dd: formerly(?) Childhood-onset schizoaffective, TS, OCD, anxiety, PTSD, migraines. After over 15 years, is now "recovered" for almost 5 years after treating endocrine issues, food sensitivities, gut issues, sleep issues, nutritional/mitochondrial needs.

Well I don't think this pdoc is accurate in saying that most people with BP end up on an SSRI.  SSRI's are not a silver bullet for depression, even in folks without BP.  If it isn't working then it just isn't working.  Lamictal works great for my ds17.  He developed a rash several years ago, but it wasn't severe.  We stopped the Lamictal and struggled with unstable moods for 2 years before re-trying the Lamictal.   Now he has been on it for several years without any problems.  So you may have the option of trying it again in the future.

I agree with Jeanie about lithium.  It works wonders for many people with BP.  I would also strongly encourage you to have a complete thyroid panel checked.  And even if it is all WNL, ask the pdoc about supplementing with T-3 (Cytomel).  It has been used for years to augment psych. meds in people with persistent depression.  It was definitely the miracle cure for both me and my ds17. 

--

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

FROM TBMF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.

I feel like there's no hope...can't imagine how Taylor feels.

Went to see the Dr. today.  Honestly, the lady that checks her meds was very short with us.  I asked about the lamictal again because I KNOW it works for her.  Plus, the more we talked about it, the more we think the rash was a coincidence.  In the end...it ended up as a staph infection and she had "hives" for months.  I honestly think that's what it was to begin with, dd picked at it, and it became infected.  Even the Drs said it didn't present itself as typical SJS. 

Anyway, to make a long story short.  She increased the zoloft to max dosage.  Yes...let's up the med that is NOT WORKING!!!!!!!!!!  And said to come back in two weeks.  I asked about a MS and WHY won't they please do try that.  She just said that nothing works like lamictal and there's really nothing out there for adolescents.  WHAT????????????????   Depakote has already been suggested...what about lithium????  HELP HER!!!!!

ROUGH night here.  I have her calm...for now.  (oh, she also increased trazadone in hopes that Tay would sleep).  So basically, let's not help her, let's just drug her until she's a zombie.

I am going to cut out gluten, sugars, dairy.

I found a good phosp. (FIVE hours away)  we are in middle of nowhere so not many options.  Is it wrong to call back tomorrow and demand (in a nice way) that we try a MS or tell her I am going to have to hospitalize her??

We haven't switched because it took us to long to find this Dr. (she only does the meds) and we LOVE the psychiatrist/counselor she sees.  (Don't know why she doesn't do the meds too...but they do work together).  I could tell the psychiatrist was a little upset at the med. lady today too.

Suggestions?  Becuase all I want to do now is cry.

--

L Anxiety, Lexapro
Mom to:
T (16) Mood disorder (Depression, Anxiety, OCD, BP, SA, ADD?), Risperdal 1mg morning/night, Zoloft 150 mg., Abilify 5mg., Trazadone 100 mg.
Also has hypoplastic left heart syndrome (open heart surgery 3X), Lisinopril, Aspirin
10th grade-currently going to school online at home.
J (13)
J and C (10)

 Mama--I keep posting but its not showing up.  Using a different computer so maybe firewalled.  Thinking of you and sorry you are having a bad med check.  I so know what that's like...

--

Jennie (37) depression treated effectively with lexapro
Husband (58)
daughter Alison (14)
Bipolar I with episodes of psychosis; Oppositional Defiant Disorder
lithium, depakote, zyprexa, zoloft

Find a different doc!  Go through that CAM doc list I sent you.  You have no choice now.  This is INSANE.  You need to switch pdocs, so why not switch to one that specializes in the kind of treatment you want?  Depakote carries a slight possibility of SJS I believe.  I would be scared to retry Lamictal after what happened.  Get her into an integrative doc.  I think that is going to be your best bet.

--

Kim 33 Co-Mod Military with Katie and Heather
brandonsmom_1996@msn.com
Army wife and BSW student
PLMS, Insomnia, Severe D-IBS, Special diet
Iron and Mirapex for PLMS, Lunesta, Zyrtec
Brandon 15, BP 1, ADHD, Schizoaffective?, PDD?, IgG allergic gluten, casein, soy, eggs, peanuts
EMPower Plus 5 caps TID, AminoPowerPlus 4 BID, Lamictal (weaning), Synthroid, Melatonin 6-12 mg
8th grade (held back) homeschooled-Meridell Achievement Center 4/28- 9/25
Chris, 34 dh since 9/10, Army
Cheeto the cat: Hyperthyroidism (radioactive iodine 2/8), Separation Anxiety, and Chronic UTIs, rx diet Mystic: The princess of the house and HATES Brandon
Jackson: Lab, DOB 1/13/11, training to be psychiatric service dog eventually
Fort Bragg, NC
FROM TBMF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet.

I think it would be just fine to call the pdoc and state your concerns.  Maybe this pdoc can refer you to someone for a second opinion.  I am very concerned for your dd with the incr. Zoloft.  Have you thought about how you would transport her to the phosp if it comes to that?  That's a long drive with an unstable kid.  Please do not attempt to do it alone.

Does your dd still have hives?  I have one child who had chronic urticaria for several years.  We treated it with nightly doses of hydroxizine, and he eventually grew out of it.  My allergic kids get hives periodically.  If they clear up with antihistamines, then they are just hives.  If you are sure your dd did not have SJS, then it is worth cautiously re-trying the Lamictal.

While you are searching for a good pdoc it certainly won't hurt to make some dietary adjustments.

--

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

FROM TBMF: Do not start, stop, or change medications or other treatments for yourself or your child based on what you read on this Website or elsewhere on the Internet. Information presented here should not replace the considered judgement of a doctor who knows you or your child.

Brenda,

I can't be SURE it wasn't SJS.  They "assumed" it was and erred with caution.  However, when the dermatologist finally saw her and did a biopsy...said it was a staph infection.  (Okay, but we don't know if she had SJS and THEN got the staph infection, or if it always was one).

She does still get hives when really excited or stressed.  Once I pulled her out of school, it got a LOT better.  She was on one antihistamine in the morning and another at night.  Now it's not bad enough where she needs it. All of that info alone makes me think she had hives, picked at them, and got an infection.  And she felt so darn good on the lamictal.  UGH

Luckily, my parents live here and so one of them could go with me.  However, as odd as it sounds, she get ODDLY at ease when we go.  Almost like she doesn't realize it or it's a relief that she will be getting help.  I don't know.

However...today has been a much better day.  Don't know if it'll last, but I'll take each one I can get.

I guess it's possible that with the stress of the holidays, family coming in and out, being out of a normal routine, having my husband come and go, etc. was just too much and sent her into a mixed state???  Or maybe the zoloft is working?  She's "better", but she's not good.  And she's never felt as good as she did as on the lamictal.  Guess it's a waiting and guessing game.

--

L Anxiety, Lexapro
Mom to:
T (16) Mood disorder (Depression, Anxiety, OCD, BP, SA, ADD?), Risperdal 1mg morning/night, Zoloft 150 mg., Abilify 5mg., Trazadone 100 mg.
Also has hypoplastic left heart syndrome (open heart surgery 3X), Lisinopril, Aspirin
10th grade-currently going to school online at home.
J (13)
J and C (10)

Mama--

I was really thinking of you last week but my posts would not go through.  Wanted to check in and see how you are doing.  Wanted to let you know the following:

1.  I used to get the same line from my husband--"they're the docs, they know what they are doing."  He couldn't understand why I was so upset with the increases in SSRIs.  Now, if your husband is anything like mine, he would not ever actually buy a book, etc.  However, when I purchased "The Bipolar Child" and "What Works with Bipolar Children" he did go ahead and read it.  We started to be more on the same page in terms of her treatment.  Don't know if that's helpful or not; maybe your husband would take a look at these...

2.  I just wanted to call your attention to Trazodone.  My daughter was on that for a long time.  Be aware--it is used as a sleep med, but it was originally developed as an antidepressant.  Although it was shelved for that purpose, it does still have an antidepressant effect.  We were always concerned, from our observations while our daughter was on it, that it made her worse and accentuated her psychosis.  Just a heads up; I know everyone knows it as a sleep med but I think it is helpful to have the history.

HOpe things continue to be better--been thinking of you.  Taylor and Alison, through the posts, sound a lot alike in terms of interests and age and history. 

--

Jennie (37) depression treated effectively with lexapro
Husband (58)
daughter Alison (14)
Bipolar I with episodes of psychosis; Oppositional Defiant Disorder
lithium, depakote, zyprexa, zoloft

My heart goes out to you.  I am in the same situation here.  I stood against the SSRI until they stopped it.  I had to ask a couple doctors a couple times.  I have also been switching doctors until I found a good clinic.  It is only 1-1/2 hours away.  I am HOPING and praying that they will do right by us.  We go again tomorrow as a crisis work-in, as our daughter has not been sleeping.  They still don't have her meds right, but are trying.  If your doctor says there is nothing out there for adolescents, then they are unschooled and you need to run away fast, before they do more damage.  The wrong meds are damaging, and should not be trialed after obviously making things worse.  We have never had to drive over 3 hours.  We have usually had to drive 1 to 1-1/2 hours.  Guess we could have it a whole lot worse.  Just keep praying, keep looking, and never give up hope.  Sometimes we live in such constant crisis that it becomes hard for us to recognize when inpatient is necessary.  We use it as a last resort, as they can mess things up worse.  Again - we have nothing to go on but prayer.  Then pick up the pieces and carry on when we get them back.  With our new clinic, they are associated with a hospital, and while they try to keep them out, I am thinking they can follow them more closely if they are in.  Our daughter cannot take any mood stabilizers without becoming more unstable and more manic.  I don't know why???  Lamictal worked, but then the rash started.  We have never retried.  Lithium I HOPE works, as it did in the past, but now they don't have it high enough to be therapeutic.  All we can do is try to be supportive of the kids while nagging the doctors and hoping and praying.

Hang in there.

--

Pilgrim, dd 20 , BP, PDD, PTSD; risperdal, and other meds being trialed.

I was going to say the same thing about Trazodone.  It might have triggered mania for my daughter. 

My daughter was on Trileptal (a mild mood stabilizer) and Depakote (a good mood stabilizer, but can cause weight gain) and that worked pretty well, but we took her off Depakote to try Lamictal again (which she had been put on 2 years before, but got a rash which turned out to be just hives (but at the time she got hives all the time and we got tired of them yanking her off every time she got hives so had stopped putting her back on).  I much prefer the lack of side effects of Lamictal (you know, as long as they don't get the rash).  We didn't see much effect from Lithium and the side effects were annoying (of course nowhere near as bad as my son gaining 5-9lb a WEEK on Depakote).

I've got to say advocate as hard as you can for a mood stabilizer (or two since most work better in combination), and stay as far away from the ADs as you possibly can.  We've actually found that sometimes we can suggest to the psych hospital that they start her on a new med and the pdoc will allow her to stay on it, even though they weren't willing to start her on it in the first place.  Phosps aren't great, but they can have an advantage in this respect.

Mary

--

Mary themom, 41, BPII, no meds, Member Teen 5
http://marythemom-mayhem.blogspot.com
Founder: http://groups.yahoo.com/group/PCT_ParentsofChildrenofTrauma/
Mom to biokids Ponito(12) and his sister Bob(15)
Sibling pair adoptive placement from NE foster care 11/06
Finally finalized on Kitty(16) on 3/08 - 2 weeks before her 13th birthday!
RAD, C-PTSD, Bipolar Disorder, ADHD, learning disorders, cerebral dysrhythmia, traits of borderline PD...currently in residential treatment
1800mg Trileptal, 40mg Abilify, 1000mg Depakote, 20mg Focalin XR, Omega 3, Super B Complex
Finalized on her brother Bear(18) 7/08. He turned 15 the next day.
RAD, C-PTSD, Bipolar Disorder, ADD, ODD?, cerebral dysrhythmia, traits of personality disorders...
2400mg Trileptal, 200mg Lamictal, 500mgWellbutrin, 300mg SeroquelXR, .2mg Clonidine, 5mg Saphris, 20mg Concerta, Omega 3, Super B complex

" Saying "no" is not being negative. Negative is saying "yes" to things that are destroying you."