Posted by Solstice on February 19, 2012, at 0:45:12
In reply to Re: Desperate » Solstice, posted by SLS on February 19, 2012, at 0:14:37
Hi Scott! Thank you for stopping in to add your thoughts.
> Interestingly, I was thinking of Latuda, too. It was the logical next step. However, like your doctor, I have concerns that there is inadequate symptom reduction after 4 weeks.
Yeah.. the PDoc said that Latuda is similar to Geodon, and since my daughter did so well on Geodon, Latuda was her first second choice. But then again, maybe the Latuda isn't effective for the same reasons that Geodon lost its effectiveness?
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> I would think about adding Depakote. It can squash a bipolar II hypomania even more quickly than a neuropleptic antipsychotic.Really!? I'll ask her about it. I do know that she (PDoc) is somewhat careful about trying to stay with whatever is approved for 'children.' That said, my daughter is close enough to 18 that I think PDoc would consider medications that haven't been formally studied in children. And still again, I'll bet depakote has been studied in children, since it is an anti-epileptic.
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> Klonopin also occurred to me.I'll ask about that one too.
> I also have concerns that the stimulants are making the bipolar worse, but an expert would know better than me. Bipolar and ADHD occur so often in young people. They are very often hard to separate. I am wondering if the distractibility is really a bipolar thing and not a ADHD thing. Maybe there is no ADHD to treat. But then again, things were good for awhile on Geodon while also taking the stimulants.You know, once I got a fairly good feel for the differences between her ADHD and Bipolar symptoms, I really became convinced that her distractibility is just way more intense than what would be 'normal' for ADHD. Professionals who have dealt with it (even at school), have always commented that they have never seen anything like it. So I don't know if it's just really potent because it's bipolar, or if she has a double dose or something. I just don't know how it works.. and it really is difficult to distinguish between symptoms. I've also wondered if she's really just got bipolar, and that maybe it hasn't been treated effectively enough to address the distractibility part.. but then again - For nearly three years Geodon and Vyvanse were a total package - and believe me - missing the Vyvanse was asking for a disaster. Since Geodon builds up, she could miss one, or take it later, and it didn't cause a problem. But man.. miss the Vyvanse and within a couple of hours the school was calling! Still.. stimulants can trigger hypomania/mania, so that cannot be dismissed, especially when her state of adolescence is taken into account.
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> Regarding neuroleptic antipsychotics, Fanapt (iloperidone) has one of the better side effect profiles with respect to EPS and weight gain.yeah.. I looked it up and read some patient reviews (which were mixed, of course). however, one patient described themselves and it sounded exactly like my daughter - and they said the Fanapt really zapped the hypomania. And the weight gain thing is really important. So I can't wait to see the PDoc Tuesday to ask about it. But Scott - what is EPS?
Solstice
poster:Solstice
thread:1010739
URL: http://www.dr-bob.org/babble/20120212/msgs/1010779.html