F.E.A.S.T's Around The Dinner Table forum

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My d is 1 yr 9 mo into recovery and although her eating is ok, her mood seems to be all over the place. She is happy one day and suicidal the next. Would like to hear from parents if this is entirely normal. She is not on any meds (other than occasional Vuvance for focus) but we are seeing her psyc tomorrow and see if he can prescribe something for her mood. She cannot sleep at night and has to fight her low mood constantly. She says her skills help sometimes but not all the time.

Would like to hear some experiences with meds, especially mood stabilizers.

Hi BraveMom--

My dd had mood issues before ED so, she takes meds for that.  She takes Lamictal.  It has been very helpful for her.  It takes a very long time to titrate up (months) and you won't know if it is really helping or not until it gets to the proper dosage.  Of all of the meds my dd takes, this one has been the easiest--few side effects, very helpful.  My dd also takes Melatonin at night to help her get to sleep.  If getting to sleep is the problem, then you can try melatonin.  If the problem is staying asleep, there is extended release melatonin.

Some things you might want to consider--there is now genetic testing for mood stabilizers.  The testing does not show whether a drug will work or not.  Rather, it shows how the body metabolizes the medication, so gives guidance for dosage.  The reason I share this is that through genetic testing, I found out that my dd does not process folic acid and has to take a supplement (L-Methylfolate).  This genetic mutation has been linked to depression and anxiety. I had to push my doctor for the genetic testing.  And, my insurance did not cover it.  But, I think it was helpful for this one reason (and I did the genetic testing before it covered mood stabilizers; I am considering redoing the test soon).

Also, if you are concerned about suicide, there is evidence that lithium reduces this risk substantially.  The good thing about lithium is that you can test her blood to see what level it is at and adjust the med appropriately.  I understand that about half of the population responds to lithium, so it does not work for everyone.  The downside, of course, is that it is lithium.  Your doctor will probably suggest something more mild (such as Lamictal) to start.  

Trialing meds is so hard.  I don't wish the process on anyone.  But, finding the right meds at the right dosage can make all the difference in the world.  

I have a lot of experience, so just ask questions.

Purple Cat
Thanks PurpleCatUSA - I was looking up Lamictal too this morning. While Lamictal is being titrated, is it possible for the psyc to give another mood stabilizer for short term that can be weaned off as Lamictal kicks in. I'm thinking that may mask the Lamictal results. Zyprexa seems to give relief quickly and can be taken as needed - wondering if the psyc can start off on both and wean Zyprexa when Lamictal kicks in.

Melatonin and any OTC sleep med does not help her [frown]  Once she sleeps, she can stay asleep, she can't get to sleep...
Most doctors will not make two changes in meds at one time because then you don't know what to attribute the changes to.  I think this is really important.  i know it is hard to go slow.  But, going slow will help you get at the right dosages / meds long-term.  

It is good you have an appointment with the psychiatrist tomorrow.  He will help you get thinking in the right direction.  Be sure you understand what to expect with any med you might try.  

He might want to start with an anti-depressant or anti-anxiety first (most do start here).  My dd did not tolerate these meds well, but for many children, they do work.  Often after that, it would be trying a mood stabilizer.  Then, it might include an atypical antipsychotic (AP).  The AP would be more important if there was a history of violence, psychosis, or hallucinations.  Zyprexa is an atypical antipsychotic.  People often take an AP and a mood stabilizer together (my DD does).  But, one will be started first and then the other added later if there are still symptoms.  APs generally have a lot more side effects, so often doctors will try something else first.  There are other PRNs (as needed) meds out there, I just don't know them as well. 

For sleep, what happens if she takes benadryl?  My dd was prescribed something similar to benadryl for sleep called Atarax but we live in a very dry climate and she ended up getting nose bleeds from it.  So, we had to stop.  But, that is something that either works or doesn't and it doesn't take days or weeks to find out.  Definitely ask your doctor about sleep as that is so important to mood.

Here is a great website for information about depression and bipolar in children: 


Purple Cat


I have been looking at genetic testing for my son before we give psychotropic medication.  I think such a simple (but $$$) test really takes quite a bit of the trial and error out of prescribing. The test used by the Kartini Clinic is Genecept Assay.  I didn't really look around for any others as I love the Kartini blog and kind of trust that they know better than me what to look out for. In any case, here is a link to the site. https://genomind.com/genes-analyzed/

Wishing you a positive meeting with the psychiatrist tomorrow,
2015 12yo son restricting but no body image issues, no fat phobia; lost weight IP! Oct 2015 home, no progress. Medical hosp to kick start recovery Feb 2016. Slowly gaining at home, seeing signs of our real kid.

May 2017 Hovering around WR. Mood great, mostly. Summer 2017 Happy, first trip away in years, food variety, begin socialising. Sept 2017, back to school FT first time in 2 years. 2018 growing so fast hard to keep pace with weight. 2020 Off to university, healthy and happy.
  • Swedish proverb: Love me when I least deserve it because that's when I need it most.
  • We are what we repeatedly do. Excellence Recovery, then, is not an act but a habit. Aristotle.
  • If the plan doesn't work, change the plan but never the goal.
  • We cannot control the wind but we can direct the sail.