Approx. 3 years later and I can see how far we've come. We are living with a much more stable M than ever. We went through many med changes, some growth in maturity, and see to have now found a good balance.
M currently takes 600mg of Seroquel XR, 100 mg of Lamictal, and a little kicker of 5 mg Celexa. Seroquel seems to be the only Atypical Anti-psychotic that works for him, though we must always be slow with our changes as not to cause urinary retention (those days were never fun). It keeps him away from the edge of explosion and the XR allows him to only take pills in the am. We added the Lamictal to further enhance his mood and it brought him up some. But, even then, M seemed like he was merely existing and that's no life for an 11 yr old. He should be living life and enjoying it as much as possible. So, I requested Lexapro, but since my insurance doesn't like to pay for it, we settled for its original version, Celexa. I realize that at 5 mg, it's like nothing. Celexa is like 1/2 the strength of Lexapro and even 5 mg of Lexapro is nothing, but we see a bit of improvement. Not sure if the pdoc will want to keep it at this "insignificant" level at our next appt, but if things are going so well, i don't see the point in messing with the equation. Also, his tics seem to be well controlled on this combo. We only see them when he is really stressed or perhaps over stimulated.
We switched pdocs about 2 yrs ago. Our original pdoc was always unwilling to listen and was very condescending. I don't suffer from anxiety, but I literally had a panic attack after one of our appointments and blacked out. The man is just awful. So, on the suggestion of a friend, we found an out-of-network pdoc about 30 minutes away from us that is wonderful.
One thing I do intend to keep an eye on is the developments with the new DSM. They are proposing a new dx called Temper Disregulation Disorder. Reading the description describes M to a "T"! I just sat there after reading it and said, "WOW!" The recommended first line of treatment for this is SSRI's, where for a bipolar dx, SSRI's can throw one into a manic state. So, it's a dangerous line and I hope if this new dx is added, that pdocs head caution and really look at the child before prescribing. But, perhaps our dx of bipolar could stand some revision over the years....as the teens hit, perhaps we'll get a clearer picture.
So, right now, we have a dx Bipolar, 11 yr old boy who's nearing puberty, but remains fairly stable. Thank the universe for that!
