Post Edited (jk) : 8/4/2005 4:50:37 AM (GMT-6)
Abilify is being pushed, tho not approved, for monotherapy in bipolar disorder. Monotherapy means no mood stabilizer, nothing for depression. It is still in the experimental phase; it is not proven to be effective as an all around stabilizer. It can worsen anxiety, relieve it for others, cause depression, and help calm mania, but not eradicate it for everyone. It seems to be very person-specific. I do recommend you take the samples for a good month (if he can tolerate it that long) before you cough up the high co pay.
I am concerned that no one has put your son on a mood stabilizer. Abilify and Risperdal and Seroquel are a class of drugs called atypical antipsychotics. They typically do not work on stabilization, only the psychotic episodes (throwing things, freaking out, hallucinations, etc). He is big enough physically to be taking meds that are approved for adults. He could have been tried on any of the mood stabilizers there are, anyway. His doc should have known that Geodon does not work on bipolar disorder, nor does Neurontin. The recommended meds are lithium, depakote, tegretol, trileptal, lamictal and topomax. The last 5 are anticonvulsants, used in epilepsy, so are Geodon and Neurontin, but these 2 are ineffective.
I would watch him very carefully; although getting good sleep is important, it doesn't take care of mania or psychosis.
Most patients are on a stabilizer, antipsychotic, antianxiety, and lamictal or welbutrin for depression (no SSRIs, as these cause mania). The brands are varied from patient to patient; all work differently in each person, it's a trial and error basis.
I highly recommend to every patient and every family member that they study, study, study about bipolar illness. It is perhaps the most complicated along with schitzophrenia. There are new studies that show a link between the two, that's why they mimic each other and are often misdiagnosed. Read about what each class of meds does and what you can expect. It is also important that your doc know which ones NOT to prescribe (SSRI antidepressants namely).
You have to work with your doctor; there is no one med or combo that will treat every person; the more you know, the more effective the treatment plan. There are tons of websites done in layman's terms just for the sufferers and their families to learn from.
Since he is that bad to where you can't even physically control him, and he has drawn blood on your daughter, you really have no choice but to get him into the hospital. Your insurance will cover that. It really is an emergency. Just taking him to the ER won't change anything.
Otherwise, you have no choice but to call the police, and they will take him to juvie. You just can't put yourself and your daughter at risk, there is no telling what he will do next. Even if he calms down, it will more than likely happen again, probably later today. He desperately needs to be stabilized ASAP. They will do that in the hospital, that is the whole reason he needs to go. You don't have 2.5 weeks, and your pdoc should have known that if he listened to your complaint.
Please follow my advice, I wouldn't recommend it if it wasn't an emergency.
jk, I understand your concern, nobody wants to think they or their kid needs to be hospitalized. But they are there for a reason!
Your son is downright dangerous due to his mania. Don't you think that's a good enough reason to get him stabilized? Think about it.
The usual stay is 4 days. They will stabilize him before he gets out. That's the sole reason for going.
They will stabilize him with medication, and he will be under strict observation 24/7. It's nothing like what you see on TV, that's ridiculous. There aren't crazy people walking about, drugged out of thier minds. You really wouldn't even know it, unless somebody is just admitted. He will share a room with someone, or alone, depending on the load. It's usually a fairly small place, not like a big hospital. The doors are locked at all times, but the patients are free to walk about, there is a TV room, snacks, but lots of intense group therapy and frequent checks with the doctor. Every possible thing you could think of is taken from them, so as to not hurt themselves. It's basically impossible. Not even shoelaces are allowed.
You need to trust the medical professionals to do their job, you cannot. When he gets out, he will probably be a little angry, but he will be stable. They will prescribe meds to continue it, of course! There is usually outpatient therapy for a couple of weeks when he gets out as well.
You do not have to tell the school what kind of hospital he's in, just get a doctor's note that he was ill (do not specify) to cover the few days he's in, no biggie.
This is totally to be expected with manic BPs. No one gets out of it, really. You need to do whatever you have to do to keep your family (and him!!) safe.
Please get him in there TODAY!
I am not really sure of the paperwork end of this; call your insurance company (the mental health line on the back of the card), because they can all be different in what they require. Ask about which doc to call, or if you even need to.
You won't have a choice of who he sees in the hospital, it depends on who's doing call during that period of time. It will be the same doc, tho, not different ones on different days, so the treatment will be consistent. Besides, jk, it really doesn't matter, they are all qualified to stabilize him, and he is going to hate whoever treats him, anyway. He doesn't have to follow up with whatever doc treats him, the important thing is that he get better - quick. It's time to stop babying him, he is very sick and needs more help than he has been getting. It simply doesn't matter what he wants or likes. He won't like anything. And I know you are probaly very worried that he will "hate" you. No, he won't. He will be very angry, especially when you take him, and he may need to be restrained by the ambulance, since he is stronger than you. When he is feeling better, he will probably thank you. It's the best thing you can do for him, your doc is right, it's either the hospital or juvie. I think you would prefer the hospital, and so would he.
Please, if you don't trust anyone, trust me on this, OK?