Posted by SalArmy4me on July 8, 2001, at 23:27:18
In reply to My daughter just went into the Hospital, help us, posted by frenchy on July 8, 2001, at 8:36:17
Valproate (depakote) is the best thing they could possibly give her right now, according to the statistics:
KOWATCH, ROBERT A. M.D et al. Effect Size of Lithium, Divalproex Sodium, and Carbamazepine in Children and Adolescents With Bipolar Disorder. Journal of the American Academy of Child & Adolescent Psychiatry. 39(6):713-720, June 2000:
"Using this same response measure with the intent-to-treat sample, the response rates to mania and mixed states were as follows: sodium divalproex, 63%; lithium, 38%; and carbamazepine, 38% ([chi]22 = 0.85, p = .60). All 3 mood stabilizers were well tolerated, and no serious adverse effects were seen.Trazodone is a novel agent not so much for depression (it is eclipsed by better, newer agents for that endeavor), but for your child's REM sleep, an important part of a child's nightly well-being. Trazodone is unique because one does not develop tolerance to it. Thus, it always works.
Risperidone is a nice selection for your child, to eliminate any ruminating feelings; and it is becoming more known widely for its efficacy in the depression phase of bipolarity, oddly enough:
Journal of Clinical Psychopharmacology; Williams & Wilkins 1998. Volume 18(1) February 1998 pp 89-91. "Adding Risperidone to Selective Serotonin Reuptake Inhibitor Improves Chronic Depression"
O'Connor, Manjia:
"Risperidone was targeted for the suicidal ideation and agitation that were superimposed on depression and anxiety. These symptoms, and disturbance in sleep and eating behavior, had responded poorly to an AD alone and with augmentation. The improvement with risperidone was rapid, and a short-duration of treatment was sufficient to control symptoms in some patients. In one patient who relapsed some months after risperidone was discontinued, a rapid response was seen again on reinstatement...The mechanism by which risperidone augmentation acts is unclear. Adding typical antipsychotics to antidepressants can help in depression with _agitated_ features, possibly by modulating the dopaminergic system, [8] but these features were absent in our patients..."Wellbutrin is world-reknowned for efficacy in bipolar disorder without causing switches to mania. http://www.dr-bob.org/tips/split/Possible-indications-of-bi.html
Hope that helps...
poster:SalArmy4me
thread:260
URL: http://www.dr-bob.org/babble/child/20000813/msgs/262.html