Bipolar Disorder/Risperdal/4 year old

shinyblue.rn · Aug 29, 2004

Is this young for one to be diagnosed with bipolar? I, too, have a son with it,but he was diagnosed at age 15--pretty normal until about a year before, started getting agitated and mouthing a lot.

memphispanda, RN · Aug 29, 2004

I think that's on the young end for bipolar diagnosis, and I would be very leery of having a child that young on Risperdal--or any other anti-psychotic. I am speaking as a parent who has done research, not as a nurse. We took my 13 year old off Risperdal, tried Geodon and took him off of that because the side effects are not worth it at this time. I would try everything--and I mean everything up to and including inpatient treatment--before using that drug on a 4 year old.

I also wanted to add a thought here...

My now 5 year old was absolutely off the wall from the time he was about one until he was 3. Could pitch horrible screaming fits for up to 6 hours without stopping, would hurt himself, was totally out of control. I took him to therapy, I took him to doctors, and we finally got an answer. One thing that was a problem was anxiety--he was diagnosed with Separation Anxiety Disorder. The other thing was allergies. We had him tested and we also kept a food log. We were able to determine that certain foods seemed to trigger some of these episodes for him, and it wasn't things like red dye or gluten that you hear so much about. For him it was V8--that would set him into a 2-3 day long line of bad problems, strawberries, eggs, soy, and milk. When we removed those from his diet, his behavior improved. Honestly it was almost magical. We did treat the anxiety disorder with zoloft for about a year and gradually weaned him off that. He is now in Kindergarten and comes home with "crowny faces" for behavior each day--something we wouldn't have believed possible when he was 2.

My point is to make sure you have checked out all possibilities.

lucianne · Aug 29, 2004

I think you might find some helpful information as well as support at http://www.bpkids.org

There is a great deal of information there about childhood onset bipolar disorder, treatment, medications, school issues, etc. There are also some message boards where you can find support and see what other people have experienced. I would take what some people there post with a grain of salt, but others have good insight and helpful suggestions.

Yellow Rose RN · Aug 30, 2004

My son has been DX with Bipolar Disorder as well. (was diagnosed a year ago after many other dx's and medication treatments. He has been on Risperdal since Dec. The one thing that I have noticed as a potential side effect that my son does exhibit, is tremors. He has tremors on the right side of the body. Mainly his hand, but it can become the whole body if he is under stress. It is a hard decision, but for my son,(whom is 11) it has saved him. He still has some breakthrough symptoms and may need a mood stabilizer soon, but is basically a different child now that the meds are a better "fit". You might want to pick up the book, The Bipolar Child. Also, the website that was given earlier is a great resource and there are several books reccomended that are good too! Good Luck.

michelle95 · Aug 31, 2004

Doc does not want to diagnose him yet. They just mentioned bipolar because they are not sure what is going on with him. He certainly has mood swings. He will be fine and then set off at the smallest incident.

I would love to test him for allergies. I have thought about that. I'm not sure how to go about it right now, unfortunately. He is on medicaid and I don't know if that will pay for it. But, I am going to mention it to the doctor.

What other medications are given to children with aggression?

Thanks you guys.

Yellow Rose RN · Aug 31, 2004

Doc does not want to diagnose him yet. They just mentioned bipolar because they are not sure what is going on with him. He certainly has mood swings. He will be fine and then set off at the smallest incident.
I would love to test him for allergies. I have thought about that. I'm not sure how to go about it right now, unfortunately. He is on medicaid and I don't know if that will pay for it. But, I am going to mention it to the doctor.
What other medications are given to children with aggression?
Thanks you guys.

If you are on medicaid, ask you pediatrician for a referral to an allergist. Medicaid will pay 100% of testing as long as the specialist accepts medicaid.

There are also mood stabilizers that are used for Bipolar disorder as well. My son is very moody and has many classic symptoms of bipolar. You can also have him evaluated by a psychiatrist (medicaid will pay as well as long as the Dr. accepts medicaid) for a more definitive dx. Good luck and let us know!

michelle95 · Aug 31, 2004

Thank you. I didn't realize that medicaid would pay for allergy testing. I am going that route if I can. And, if the pediatrician won't let me...I'll change primary care physicians. Anything to try to get him off this med. I hate him on medicine, I really do. I just don't know what else to do. He's been starting to hurt himself and others and I can't have him doing that.

Pediatric Critical Care Columnist · Sep 1, 2004

http://www.currentpsychiatry.com/2003_03/0303_pediatric.asp

This is the most up-to-date information available on pediatric bipolar disorder, considering it's dated with todays' date... How's that for timely? I found it to be quite interesting. According to one of the studies quoted in the article, ~5% of bipolar patients begin expressing symptoms before the age of 5. Risperidone is one of the atypical antipsychotics used to treat it. Now I'm looking at my second child from a different angle! Hmmm.

memphispanda, RN · Sep 1, 2004

That article seems to suggest that lithium or other modd stabilizers be tried first, then add an antipsychotic if needed.

Heck, my 3rd child seems to fit their definition of childhood bi-polar, but honestly, he's just a grouch when he doesn't get enough sleep or when his allergies are acting up. I think we are far to quick to try to give kids serious labels like this when it may be nothing more but their personality, some underlying medical condition, some other disorder altogether, lack of discipline, etc.

Yellow Rose RN · Sep 1, 2004

That article seems to suggest that lithium or other modd stabilizers be tried first, then add an antipsychotic if needed.
Heck, my 3rd child seems to fit their definition of childhood bi-polar, but honestly, he's just a grouch when he doesn't get enough sleep or when his allergies are acting up. I think we are far to quick to try to give kids serious labels like this when it may be nothing more but their personality, some underlying medical condition, some other disorder altogether, lack of discipline, etc.

This may be true, that some docs are quick to "label" some kids. But also realize that there are many children who truly have true mental/psychiatric

disorders and are just "labeled" severe ADD. If the children who are truly Bipolar are not diagnosed properly, then they suffer. It is not an easy diagnosis with blood tests and such. I have spent the last 5 years getting my son evaluated and trying different meds. He has been closley evaluated by some of the best psychiatric Dr's in Texas. It has taken so much out of him and us as a family to get the right diagnosis (not a label). Now, he is getting the help that he needs and maybe since he has been diagnosed early, he might get the treatment needed to lead a more productive life. Not that I disagree with you about some kids that are quickly "labeled" with a mood disorder, but just so you know that is not always the case.

Mom to a Bipolar Child...

memphispanda, RN · Sep 1, 2004

If you will read my first post on this thread, you will see that I have dealt with children with psychiatric issues. I am not one of those people who refuses to think that children can have these types of problems. I do think that it's important to think long and hard before putting a FOUR year old on lithium, risperdal, etc. And that's speaking as someone who put a THREE year old on Zoloft. You have to be sure what's going on before jumping into medications.

Also, what bloodwork is there for testing for bipolar? Never heard of such. I have heard of testing afterward for lithium levels and such, or is that what you were talking about?