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Q: Trileptal & Daughter's Irritability
My 15 year old daughter was diagnosed with bi-polar and is being brought up to a thereuptic level of trilipital of 1,200 mg for now. Anyway
when I increase the medication by 150 mg. then to 300mg she becomes more
irritable and argumentative, oppositional. Is this normal? This is
the only medication for right now and I do not know how high of a dose we will
be going. We see our doctor in a week or so.
Dear Ms. K' --
Hard to tell what's going on there. If the dose is still just 300 mg and
you're on the way up, I'd generally guess that what you saw in the way of
increased irritability was part of her own cycling and it just happened to
coincide with the Trileptal getting added (especially if she has fairly frequent
episodes of such behavior; if they are rare, and one showed up right after
Trileptal was added, then I'd be scratching my head wondering "what's going
on here?" and if it happened again or there was a worsening again
after the next increase, I'd probably stop and switch to something
else.
If you're already at 1200 and seeing this, the same
logic would apply and I'd be planning to move the dose up to see if we could
stop such episodes; and again, looking to see if right after the next step up
there was an increase in such symptoms, with the same plan as above if
so.
The good news is that your daughter was started on
Trileptal. This means you're working with an up-to-date sophisticated
psychiatrist, most likely; so you can probably rely on the interpretations your
doc' has offered (by now).
Dr. Phelps
Published February, 2003
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