Expert: Joyce A. Anthony - 7/8/2010

Question
I have raised my Lyra old granddaughter since she was 1 month old. My daughter(her mother)has schizophrenia/bipolar. Results of psychological testing just revealed ADHD and bipolar in my granddaughter. It was recommended by the therapist to put her on meads for ADHD and if no improvement after 6 weeks schedule her with a psychiatrist to treat the bipolar. After reading information on this site I do not think this would be the best way to go. I think I should call and schedule with the psychiatrist first. Please give me any information you feel will help me. Thank you

Answer
Hello Mary:

I can understand your concern.  The trouble with diagnosing bipolar disorder, however, warrants at least a trial of medication for ADHD.  However, you will see after only one or two doses if there will be a good change or not.  If your granddaughter is definitely bipolar, one dose of the ADHD medication will produce extreme reactions in her.  She won't be in physical danger if watched, but it could produce screaming, crying and completely out-of-control behavior.  This is the only true test of whether she is experiencing ADHD or bipolar disorder.

I would make an appointment with a psychiatrist and then agree to a two day trial of ADHD medication.  If all goes well for those two days, your grand daughter more than likely has only ADHD and you can continue.  If, however, her reactions are extreme, you know bipolar disorder is present and you need to cease ADHD medication until the bipolar disorder is under control.  Many times, treatment for bipolar disorder also corrects the ADHD symptoms.

Six weeks is definitely much too long to continue if she has bipolar disorder--a reputable psychiatrist will tell you the reaction will be seen with only one (and at most 2) doses of ADHD medication.

                                                   Joyce A. Anthony