|
Q: Risperdal/Seroquel Combo as a Mood Stabilizer?
Dear Dr. Phelps,
My 10
1/2 yr. old daughter is dx'd with many disorders. Adhd, OCD, ODD, Tourettes,
PTSD and lastely Bipolar type 1 this past January. Her psych. doc had her on
50mgs of Starrera, 3 1/2mgs. of Risperdal and 150mgs. of Seroquel per day.
She has never been stable and was/is becoming worse. I had found a
support message board for parents of bp kids and many of them told me of the
possible effects of the Strattera causing manic in bp kids. I called her pdoc
and asked about the possability of the Strattera causing the manic after a
extreme manic episode. He said to take her off the Strattera and upped the
dosage of the Seroquel to 250mgs. He also mentioned wanting to talk to me about
putting her on Wellbutrin in place of the Strattera at her next visit. I asked
why she was not on a "mood stabilizer" he stated that he was using the
Risperdal/Seroquel combo as her mood stabelizer.
Many of the parents on
the message board have questioned this method and said they have never heard of
2 antipsychotics being used as a mood stabilizer. The boards administrator told
me I should write you and ask about this method and about adding the Wellbutrin
to an already unstable child.
What do you think?
Thanks for your
time.
Shelly
Dear Shelly --
Well, sounds like you're not really
trusting this doctor. Maybe time for a 2nd opinion? Or, if that's not possible
due to things like distance or $, you may have to figure out a way to work with
her to have more of a "team approach" than you've got going now. In that case,
I hope you might find something useful in my little essay on talking with
doctors.
To answer your question, I'm glad to hear the kind of
feedback you're getting from the other sources you named. It means that there
is a sort of an emerging "group think" out there that matches the expert
consensus opinion approaches (see my brief review of those consensus opinions on
my
mood
stabilizer list
page). I agree that Risperdal/Seroquel does not constitute
a "mood stabilizer" in the sense that the expert consensus guidelines imply.
Mind you, it's not exactly clear what a "mood stabilizer" is, or rather, how
that category ought to be defined. See a few more thoughts on that in my blurb
about
Risperidone/Seroquel/cousins.
Dr. Phelps
Published January, 2004
|