Meds for bipolar 2 and

[Anonymous]

I know this is often more of a children’s board. My child is now 21 diagnosed with bipolar about three years ago triggered by an SSRI. She has been on Abilify for about a year and a half taken by injections since she is away at school just to get more compliance. But pretty sure it is not working and she’s been having some hypo manic cycles. Just really at a loss for a better medicine. She was on lamactil early on which we are trying to add back in now.

Also, if you have a psychiatrist that has more of a specialization in bipolar along with ADHD along with now substance use disorder (so complicated profile), I would love any recommendations.

[Anonymous]

My son is bipolar 2 and ADHD. Also got triggered by every SSRI he tried with serious self harm and a suicide attempt. It’s a tough combination.

Medications that have been tried include abilify, lithium, xyprexa, risperidol, lanectal , and olazapam that I can remember. There were more and sometimes there were more than one at a time.

It was incredibly hard to find a doctor who would agree to treat ADHD with stimulants, which were the only thing that worked. He went a few years without but recently restarted.

Current medication protocol is an olazapam, trazadone and Vyvanse. The sleep medication is a key component to success but took a lot to get him to agree to it.

We use a psychiatric nurse practitioner because we could not find a doctor who would treat the entirety of his issues.

[Anonymous]

Anonymous wrote:My son is bipolar 2 and ADHD. Also got triggered by every SSRI he tried with serious self harm and a suicide attempt. It’s a tough combination.

Medications that have been tried include abilify, lithium, xyprexa, risperidol, lanectal , and olazapam that I can remember. There were more and sometimes there were more than one at a time.

It was incredibly hard to find a doctor who would agree to treat ADHD with stimulants, which were the only thing that worked. He went a few years without but recently restarted.

Current medication protocol is an olazapam, trazadone and Vyvanse. The sleep medication is a key component to success but took a lot to get him to agree to it.

We use a psychiatric nurse practitioner because we could not find a doctor who would treat the entirety of his issues.

Thank you for this. Yes my daughter also has ADHD. Unfortunately, because of the new substance use, she can no longer take stimulants. So it feels like an impossible situation because I’m sure the ADHD is also impacting impulsivity that can sometimes look like hypomania. It is super hard to figure this out and treat it well. I’m curious if you have ever taken your son off all medication‘s as, a chance to see where things are and restart? And if you’re willing to share your nurse practitioners name, I would love that.

[Anonymous]

nuts. Happened to me as an adult. Took lithium for a couple of years. Off it now for over a decade, no mania.

[Anonymous]

Taking stimulants with bipolar is not a good idea.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My son is bipolar 2 and ADHD. Also got triggered by every SSRI he tried with serious self harm and a suicide attempt. It’s a tough combination.

Medications that have been tried include abilify, lithium, xyprexa, risperidol, lanectal , and olazapam that I can remember. There were more and sometimes there were more than one at a time.

It was incredibly hard to find a doctor who would agree to treat ADHD with stimulants, which were the only thing that worked. He went a few years without but recently restarted.

Current medication protocol is an olazapam, trazadone and Vyvanse. The sleep medication is a key component to success but took a lot to get him to agree to it.

We use a psychiatric nurse practitioner because we could not find a doctor who would treat the entirety of his issues.

Thank you for this. Yes my daughter also has ADHD. Unfortunately, because of the new substance use, she can no longer take stimulants. So it feels like an impossible situation because I’m sure the ADHD is also impacting impulsivity that can sometimes look like hypomania. It is super hard to figure this out and treat it well. I’m curious if you have ever taken your son off all medication‘s as, a chance to see where things are and restart? And if you’re willing to share your nurse practitioners name, I would love that.

Please read the thread on the deficiencies in nurse practitioner training before you seek out an NP to prescribe a stimulant. With a bipolar diagnosis the impulsivity is mania, not ADHD. It’s very risky to administer stimulants to a person with mania.

[Anonymous]

OP here. Yes looking more for bipolar med ideas primarily just to keep the thread focused there.

[Anonymous]

Would Strattera or Guanfacine be options to treat the ADHD ? They are non stimulants although I'm not sure if they are OK with her other medication and substances and bipolar disorder.

[Anonymous]

Anonymous wrote:Would Strattera or Guanfacine be options to treat the ADHD ? They are non stimulants although I'm not sure if they are OK with her other medication and substances and bipolar disorder.

First PP. guanfacine made mine incredibly violent, requiring the police, a hospitalization and a several month stint in residential treatment. It’s a rare side effect but it was so awful that I wasn’t sure our family would recover. Straterra did nothing.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My son is bipolar 2 and ADHD. Also got triggered by every SSRI he tried with serious self harm and a suicide attempt. It’s a tough combination.

Medications that have been tried include abilify, lithium, xyprexa, risperidol, lanectal , and olazapam that I can remember. There were more and sometimes there were more than one at a time.

It was incredibly hard to find a doctor who would agree to treat ADHD with stimulants, which were the only thing that worked. He went a few years without but recently restarted.

Current medication protocol is an olazapam, trazadone and Vyvanse. The sleep medication is a key component to success but took a lot to get him to agree to it.

We use a psychiatric nurse practitioner because we could not find a doctor who would treat the entirety of his issues.

Thank you for this. Yes my daughter also has ADHD. Unfortunately, because of the new substance use, she can no longer take stimulants. So it feels like an impossible situation because I’m sure the ADHD is also impacting impulsivity that can sometimes look like hypomania. It is super hard to figure this out and treat it well. I’m curious if you have ever taken your son off all medication‘s as, a chance to see where things are and restart? And if you’re willing to share your nurse practitioners name, I would love that.

PP here. This has happened a number of times. The residential he went to did not allow antipsychotics and he went twice. He overdosed a few times which led to eliminating all meds for awhile. Each hospitalization (and there were 8 that I recall), resulted in eliminating meds and restarting a new protocol. Every doctor had their preferences. Some cocktails worked for awhile and then they didn’t. There was one year where there were 13 different medication cocktails that were tried. It’s all trial and error. But getting the ADHD piece under control after a few years of not treating it was a game changer.