Expert: Joyce A. Anthony - 8/8/2008

Question
My son is currently taking 150mg of Lamictal and 30mg Vyvanse.  He has been stable and happy all summer. No rages for a long time. Today was the first day of school and he fell apart tonite. (He really hates school. He is very bright and in the Gifted program, but due to ADD he has difficulty focusing.) He became despondent and irritable.  I know that change is difficult for him.
We have tried many alternative treatments for him, but have had the most success with Lamictal.  His doc has been pushing to add Abilify.  I have been reluctant due to side effects.  
Any experience with Abilify?  I wondered about upping his Lamictal dose to 200mg.

I would very much appreciate your thoughts.

Answer
Hello Kari:

Children with bipolar disorder often become anxious in a school setting.  I do not believe additional medication is the answer since your son seems to be stabilized in situations other than school.

It may be helpful if you could find an alternative schooling method for your son.  Often these children do so well when homeschooled or have a private tutor.  Once the anxiety of dealing with a classroom is removed, they have more energy to concentrate on learning.  Is this an option you have explored?

If one of these one-on-one methods is not possible, maybe you could consider some form of counselor attending school with your son for at least a short time.  This may help relieve the anxiety.

As a last resort, adding Seroquel may be a better choice for anxiety  It works well with the Seroquel and is less likely to cause a lowering of your son's mood.

                Joyce A. Anthony