Expert: Ivan Goldberg, M.D. - 7/20/2008

Question
My son will be 17 in a few days. He was diagnosed and treated for juvenile
onset BP at age 11. The first line of defense prescribed was Trileptal and we
added on abilify to help him sleep. Over a 5 year period the dosage for
Trileptal increased until he reached the max then it seemed to totally lose its
efficacy. His MD decreased his Trilpetal for 6 weeks and then prescribed
Lamictal. My son stopped taking the Lamictal stating he did not like the way it
made him feel. Since then he has been more than usual non compliant  with
just about everything. In the last few weeks he has totally switched his sleep
pattern, is eating less and I have not seen any of his friends nor has he asked
to go to his friends house. He has not left the house in weeks! He will not do
his school work(he is homeschooled via internet). He just stays in his room,
will not even watch TV with me. I am very worried. I went to see his
psychiatrist (my son would not get out of bed to go with me) and the
psychiatrist stated it's not BP but a personality problem and that there is
nothing else he can take if he won't take the Lamictal. My son may have co-
morbid diagnosis but it still seems relevant to me that he is not properly
medicated.

Answer
Hi Lynne,

There are many mood stabilizers that are useful when it comes to treating people with bipolar disorder. Probably the most underutilized and best mood stabilizer is lithium. In addition, Tegretol, Depakote, Keppra, and Zonegran have been used successfully by some people.

It sounds as if you need a second opinion regarding your son's treatment. A list of experts who might provide such a second opinion can be found at: http://www.psycom.net/depression.central.psychiatrists.html

Best regards . . .

Ivan
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