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Re: Son - autism and bipolar » e503

Posted by Ritch on February 10, 2002, at 16:02:49

In reply to Re: Son - autism and bipolar, posted by e503 on February 10, 2002, at 11:23:28

> I'll try to answer some questions. Autism vs. bipolar? Ben has been like this as long as I can remember. Over the years we never knew what the deal was (he is adopted). He was obsessive and got agitated, so of course, we tried the SSRI's. One thing I do remember was when we put him on anafranil. It was new and the pdoc kept on raising the dosage. Ben was jumping all over the house and was bruised and I remember thinking maybe he had leukemia (my daughter had it when she was a baby). OF course, it was the anafranil. Over the years we have tried everything. Mellaril, prozac, ritalin, dexarine, luvox, etc. A few years ago, he was on risperdol and zoloft. FOr some reason, we tried to add seroquel to the mix. Well,,,,Ben got totally wild and out of control. My pdoc was out of town and the doc on call told me to put him on tegretol. That was it. It was a miracle. So....is it bipolar or autism? I dont know, but whatever it is, he does get help from the mood stabilizers. So, anyways, he was on tegretol, 1 mg. risperdol and 75 mg. zoloft for probably abut 2 or more years. Quite stable. Life was great! In the last few months we have had to increase his tegretol. Now it is at 1400 mg. day/level was 8.4. 1 mg. risperdol and night only. (seems when i gave it to him during the day, he got more agitated, and cut back to 50 mg. zoloft. He is still cycling somewhat and i feel horrible for him. I don't know when my pdoc will be back in town. i will call tomorrow. on the bipolar kids sites it says to get him off ssri's, but i really don't know what to do.
> Sorry for the ramble, but just wanted to give the details. Anyone help? PLEASE??????


Hi, if he is generally responding to the Tegretol quite well, and you have the dose pretty much maxed out already-you could add on another anticonvulsant. Neurontin might be a good choice. It works well for partial complex seizures and helps with anxiety. It is elminated only by the kidneys, so the addition wouldn't mess up his Tegretol levels. The suggestions about reducing the Zoloft might help, too. I am bipolar and Zoloft definitely aggravated hypomania. However, if he is real obsessive and the SSRI's definitely seem to help, a flip to Celexa or Paxil might be less agitating for him (I didn't see those two in your list above).

One interesting thing in your post-you mentioned the addition of *Seroquel* made him worse? There have been reports of hypomania with the new atypical antipsychotics. Possibly the Risperdal is indirectly fueling the mania? Combined with a high dose of Zoloft, that could be possible. Also, a lot of restlessness could be Risperdal induced akathisia.

good luck, keep us posted on what happens,

Mitch


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poster:Ritch thread:93523
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