Question:
We are at our wits end. Does anyone out there know anything on how to
deal with a bipolar child. He's 9. The problems started when he was 3
1/2. We've been to so many doctors, psychs., counselors. He's been on
more meds. than I can honestly remember. Now he's on Depakote, and
Anafranil, been on for a while. But it just doesn't seem to be doing
the trick. The doctor is taking him off of Depakote and trying
Neurontin. He says if this doesn't work, he'll try adding Tenex (a high
blood pressure pill) which is supposed to calm him down long enough to
prevent the rages from happening. Put it this way the doctor's at a
loss himself. Now he's talking about putting my 9 year old child in a
hospital for a couple of weeks to be evaluated. Now imagine putting
your child in a psych ward. SCARY!! Does anyone out there have any
kind of similar experience? A child who is bipolar is pretty rare, and
finding support is even rarer.
Answer:
Due to Neurontin's extremely short half life, it should be taken in equal
amounts every 6 hours. I have included a suggested dosage titration protocol for
adult outpatients. I would suggest increasing the intervals between dosage
increases for a 9 year old by a factor of 2-3. If a 100 mg capsule seems to be
too strong, you could remove the contents and dissolve them in Cool Aid. Since
gabapentin is very bitter, you could compensate for the taste with added sugar.
Neurontin exhibits antidepressant effects in approximately 25% of adults with
bipolar disorder so care should be used when titrating the dosage of Neurontin. I am aware of Neurontin being used with children as young as 4. It is not as rare as you might think. Before hospitalization I have several
other medical alternatives that you and your psychiatrist might wish to
consider. If it makes you feel any better, I have plenty of friends who were
suicidal or depressed in their early youth. And they had no idea what
to do --- that's not something most people can just randomly tell
their parents. So he's lucky to at least be helped. Even if you're
only trying. You are trying as hard as you can! I doubt others get
that. I hope you have good communication with your kid, and wish you well.
