Expert: Ivan Goldberg, M.D. - 9/27/2003

Question
I have a 14 1/2 year old daughter who my wife and I have had huge difficulties with for the past three years.  She has most recently came back from a quality mental health facility in San Antonio TX.  She has been diagnosed with BD--mixed states.  She currently is taking 600 mg Lithibid twice daily and 60 mg geodon---20mg morning 40 mg evening.  She still has problems with impulsiveness and figetiness.  She is excessively hypersexual.  Do you have an idea of what other medication she might need?  Also she has ran away numerous times. She has been through the courts system to no avail.  We can't be expected to keep paying her tickets when we have done all that can be expected of parents for her.  We live in OK. where quality mental health services are limited.  Any ideas on this issue?  Thanks in advance.

Answer
Hi . . .

It is hard to find truly qualified professionals to care for someone with a hard-to-treat mood disorder. What you might want to do is seek a consultation with a highly qualified professional who can take a complete history, review the details of the treatment so far, and map out a treatment plan.

A list of professionals who are capable of doing such an evaluation may be found at http://www.psycom.net/depression.central.psychiatrists.html

Best regards . . .

Ivan
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