The Long Journey to Correct Medicine Induced Weight Gain

When Aj was put on risperdone in May of 2012 he weight about 62lbs. Last week, Monday June 3, 2013, Aj weighed in at about 96lbs during his psychiatrist appointment.  Each time Aj went into the office for a follow up on medication, I nearly cried. Each day I wake up and see my six year old son gaining more and more weight. Each day I fought as he basically climbed the walls dying of hunger, yet he is very well fed. Each day my heart broke. My son Aj had been born chunky for sure, same as his little brother, they both weighed 9lbs 5oz (one within an ounce of the other). Yet, today my four year old is skinny with the ability at times to wear 3T or even 2T shorts, but my six year old is climbing into the sizes of a 10 or higher in boys but being that he is only 4’3″ tall, they are longer than need be on his body.

Aj July 2011

My heart kept breaking. Yet the risperidone was working. The weight gain had to have an eye kept on it and if it got to be a significant number then we were on board to try another medication for his mood disorder. Finally last week was the day that all involved decided a change in medication would be the ideal course. Abilify being the medication of choice as it’s in the same class as risperidone but with children they didn’t see the weight gain as often as they did with risperidone. Each person is different in that their bodies will handle the same medication in different ways, so there was no real guarantee that Aj would not gain weight on Abilify. We had hoped he would start to lose the over 30lbs he gained on risperidone but we knew that may not be the case and may require a change in medications yet again.

Aj 2012

Last week I wrote about my frustrations raising Aj and dealing with med changes, it not only affects the parents but it affects Aj as well as anyone involved in his world. Everyone can notice a change in Aj’s behavior and moods when doses change or medications change. Thankfully Aj has been blessed with not only a very loving home environment but also a very amazing, supportive group of teachers at school who work to keep him moving forward. Aj started school last year for the first time in Kindergarten and ended up, due to his anxiety, having to do Summer school. This year, Aj does not have to attend Summer school for anxiety nor school academic purposes, Aj has shown improvement to be where he is suppose to be with some small things he needs to work on. Overall, Aj is ready to head forward in a new grade this coming Fall and I couldn’t be more proud!

Aj May 2013

With the medication change to Abilify, it started at a low does, obviously they don’t want to hammer a kid or even an adult with a high level of the new medication. With any medication change it’s all about working from the bottom up and Aj has plenty of room to move with this dosage of Abilify. At this moment, the pysch had him increase his med dose by double last Friday into the weekend. Today I had a follow up call with his pysch to report how the medication at this level is working and honestly, so far so good. Aj still exhibits emotional meltdowns, he seems sad and easy to respond with hurt feelings, but he did switch off of one medication last Monday onto the new one Tuesday. He also had his dose change on Friday. This means that we are aware that his emotions could simply be on high alert due to the changes while his body adjusts.

I had great news yesterday when I did the weekly weigh in for Aj at home, he has lost 5lbs. I wanted to cry when he kept gaining weight and now I want to cry because my baby is finally losing weight. It is a shame that Aj had to gain over 30lbs in a year on a prior medication, but that medication worked. For someone raising a child or who has ever dealt with bipolar or a mood disorder similar to that, they may understand why at times the medication side effects out weigh living without a med that works. Right now, this new medication seems to be on the way to working but may require a dose change. Right now, I am happy to say Aj is sleeping through the night again, his moods are better, and he is losing weight. Those are all of the positives that I was looking for and hopefully in the next week we will know if this dose of Abilify is just right or not, but being able to have a full nights sleep really helps in the parenting department as well as the family unity department!

Another Journey with Aj Med Change

Today I share more news on Aj, my six year old son who I had always thought may have a mood disorder or something since he was born. I won’t get into all the long drawn out stories of Aj, but you can catch up on past blog posts about my son Aj by clicking here.

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Recently, meaning about one week ago there was a significant difference in how Aj was behaving, sleeping and reacting to various things in his world. Once he was on Risperidone about  a year ago, he became the “normal” four year old boy who would still test limits and do things that kids that age do within normal limitations. Without medication, Aj does not do anything within normal limitations for his age and tends to be irritable as well as easily placed into a fit of rage. Risperidone was helping. Risperidone had to be increased in dosage about six months ago, but it was working. Until about a week ago.

I noticed that Aj was starting to be psychotically hungry, climbing the walls as if he was starving and he is a boy who isn’t starved. Aj is 4’3″ and now weighs 96 lbs. Risperidone was putting weight on and it was only getting worse as time went on.  Then Aj started to have issues falling asleep, something that he barely does when on proper medication. Put it this way, if Aj was on zero medication he would seriously not sleep at all, well maybe a few hours a night, but never really getting into that deep sleep state.

Once we met with his psychiatrist this past Monday, it was agreed that Aj is not only having these symptoms at my house but also at his Dads. As much as his Dad and I hate to admit it, we had no choice but to change medications. Due to the significant weight gain, a side effect from Risperidone, his psychiatrist wasn’t comfortable increasing that dose and in all honesty it wasn’t working as great as it was a year ago anyways.  There really was only one other choice that isn’t known to have children put on weight with it, but it may increase activity levels. That choice was Abilify.

Any medication that Aj is going to be on, due to his loose bipolar diagnosis, is dangerous. Each medication that he has for a choice is an anti-psychotic drug which carries huge health risks and require annual blood work to ensure his body and health is doing okay. Abilify is what we went with. Abilify started on June 6 and there will be a follow up in one month to ensure this medication at the dose given is working well.

Aj’s Dad and I are just frustrated because we just wish he wouldn’t need medication. It’s such a risk, however, the benefits outweigh the risks and watching him grow from baby to now, we have seen the really amazing benefits from having him on the proper medication. The good news is that his brain is still developing which means he could possibly outgrow this as his brain matures. With adults who have this condition, they cannot outgrow it because there brains are already fully matured.

 

Parental Decisions Never Seem to Get Easier

It seems life as a parent and decisions we must make for what we feel is best for our children do not get easier as time goes on. One would think as your children grow that the decisions you have to make would be less but that is not how life works. My middle child was diagnosed with a mood disorder, well first it was ADHD then it was the mood disorder, basically mood disorders do run in the family so it made more sense he was bipolar than ADHD. The symptoms didn’t really point 100% to an ADHD type scenario and I knew that in my heart from the day this little guy was born. Now that my son has been on a medication that really seems to work; keeps his moods steady but allows him to still be a lively six year old boy, he has put on too much weight.

IMG_20130515_160310I watch my sons who are currently four and six play around and ride bikes outside. No more can my six year old handle riding bikes or running as much as he used to. My six year old son is left feeling out of breath and gets concerned because his heart “beeps faster” {as he refers to it} and then my heart breaks a tiny bit. You see, my six year old son used to be that crazy hyper super active boy that my four year old is and has been all along. You see, my six year old son used to be skinnier but with a muscular/stocky build versus the tooth pick-ish figure of his four year old brother. Always stocky but usually skinny for the most part was how Aj, my six year old son, was built and has always been up until recently.

This past year Aj was put on risperidone which is the generic form of Risperidal and is a pretty heavy duty prescription drug that has shown amazing results with bipolar children. This medication has truly worked with Aj just as the psychiatrists had thought but the downfall is the weight gain. With Rispderidone comes appetite increase and with that comes weight gain. Aj has gained a bit over 20 lbs in the year he has been on Risperidone and now it just breaks my heart to watch him have lack of energy due to the weight gain. There are other options, for example we can make the decision to try Abilify I believe it is called, that carries the same medical treatment as Risperidone but has less side effects; meaning Abilify does not carry that appetite increase side effect.

I am at a point where I feel that switching medications may be a better option. Sure it’s a risk because who knows if he will properly respond and the family ends up dealing with turmoil of mood disorder coming back, but to me it seems like a risk worth taking right now. A risk that may in turn help Aj have his energy back and a chance to losing these extra pounds he has gained due to risperidone. It is one of those things that is difficult to figure out and on Monday I hope that my ex husband and I can come to some form of agreement upon a conversation with the psychiatrist of our concerns for Aj’s weight gain and make a parental decision with the advice of the psychiatrist that may help Aj to keep steady moods but also have a chance to stop gaining so much weight and get back to his active ways that I actually am beginning to miss.

IMG_20130519_145304Changing medications isn’t just a matter of seeking professional advice combined with a co-parenting decision, it also involves weaning him off of one medication so that it’s out of his system prior to introducing his body to another. That is the part that has kept me from really wanting to switch medications. If you never knew Aj off of medication then you would think “no big deal” but my ex husband and I know all too well how Aj is without any medication and so does my daughter; it’s close to a nightmare and extremely scary combined with major angry mood swings that end up being violent at times. That is not something I would want to go casually into so that means we need to really just have a solid discussion together as co-parents with Aj’s psychiatrist to weigh out the pros and cons of possibly trying a different medication for his mood disorder.

The decision seems easy when looking from the outside in, but having lived through what we have lived through with Aj, the decision is no more easy than it was five years ago when we started down this path to determine his proper diagnosis and proper medication type and dose.

Journey with Mood Disorder/Bipolar – Fighting For My Kids

Raising a Bipolar KidSince my last blog post on the weight gain with risperidal that has worked well for Aj’s bipolar/mood disorder diagnosis there has been some changes.  For one, it dawned on me that the medication Aj takes to help keep his moods steady also brings on weight gain, therefore one would safely assume there is a contradiction between this medication. For one, risperidal is somewhat based on height and weight of the child for dosing, but at the same time Aj gains significant weight on this medication due to the increased appetite side effect from risperidal. Make sense?! I think not.

With that being said, this medication has truly done amazing things for Aj; when he was first placed on risperidal it was the lowest possible dose. The lowest possible dose worked for nearly a year before his weight gain seemed to really be affecting the dose. The pediatric psychiatrist currently has Aj on .75mg given two times a day. That has been the dose for about two weeks before I noticed that Aj was starting to get his moods more and more. The medication dose change did not seem to help 100% just yet and they had noted to take one week before this new dose would affect him.

Siblings Bipolar AwarenessIt had been about two weeks when reality hit and anxiety came back during transition from home to school. No longer did Aj just go into his classroom after a hug and kiss, no longer was he so agreeable to even get ready for school. The first five years of Aj’s life, prior to medication and proper diagnosis, flashed before my eyes and I could tell my daughter knew that this was just like before. Tears flowed. Hearts raced. And my daughter was just as concerned as I was, reason being? Prior to medication and proper diagnosis Kiara and Aj did not have a real bond, they were unable to form one because the bipolar made Aj unable to really be that sibling. Do not get me wrong, even on proper medication, they both have their normal sibling rivalry and Aj still has his normal six year old testing Mama boundaries going on as is age appropriate. However, when Aj is on the proper medication, things run a lot more smooth in the household and the up and down moods are not there with Aj.

Mama Bear Fights for her KidsBipolar is a chemical imbalance in the brain. Aj can not control his mood swings, the anxiety – none of it.  Some people just DO NOT understand. Heck when my sister was growing up and then later on in life diagnosed bipolar – half of the people in her world did not get it either! It is a confusing mental health condition that few know much about unless they have had it run in their family directly. This means, when Aj has his moods coming back due to lack in proper dosage of his medication due to weight gain, I have to spend time explaining why Aj is the way he is, and that it is a mental health condition. A true condition that is not to be taken lightly.

I get extremely frustrated when I have to not only deal with switching around medication dosing for Aj but also have to explain to new people involved in his schooling about bipolar. You see, there are a lot of people in this world who really do not get bipolar {honestly there is still lots more for me to learn}. Apparently they just seem to think it’s some over diagnosed thing like ADHD or ADD, I don’t know. I am not that type of person, so I honestly have no clue what they are thinking. All I know, is that I will fight tooth and nail for my son, all three of my kids know their Mama always fights strong, morally and for them. No matter what.

So as I journey into the land of Aj’s medication not working as well anymore, I have been told to try to give him .5mg in the morning and 1mg after dinner. This is a way to help see if moods stay steady, anxiety disappears and he can sleep through the night again. After all, the .75mg twice a day was working to some extent, but to up the dose to 1mg twice a day may knock him out cold. Another fun side effect of risperidal is the sleepiness.

I hope to educate more people on the topic of bipolar through my personal journey raising a child with bipolar. I hope to bring more awareness and I hope that if you have a story to share with my readers that you will contact me to share your story on site. This is an important mental health issue for many, both adults and children, it is time to bring the world more awareness to the topic of living with bipolar.

 

More on Aj’s Journey with Bipolar

Writing about my journey raising a mood disorder/bipolar child helps me to 1) connect with others who are going through similar situations and 2) move on from the stress and sadness that surrounds me while trying to raise a child with bipolar. I have blogged a lot about Aj, my now six year old son, who was finally diagnosed bioplar last year. Read more under Mood Disorder category here on site to catch up with the journey if you have not read all of the other posts yet.

AJ in pilot seatAj has been on risperidone which is the generic form of risperidal and it has worked wonders for mood stability in my son. This once always angry, mood swinging child, turned into a steady mood child who still has that normal child behavior. Aj still had his high spirits and joking nature as well as being a normal child who tests boundaries and gets upset when he doesn’t get his way. With risperidone he was no longer up and down in moods and the family unit grew stronger, more loving and happier.

Then it happened, Aj grew; one inch in height and about 20lbs of weight. According to Aj’s pediatric psychiatrist this weight gain is considered significant and increased appetite is a side effect of this medication, as we were previously warned. There are two concerns with this weight gain;

  1. How will this weight gain ultimately affect his health?
  2. Do we switch meds knowing this one works well?

I suppose there are ways to work around both concerns; first we could switch to abilify, a medication that has worked with some bipolar children as young as Aj, this medication does not have the side effect of increased appetite but doesn’t work for bipolar symptoms in all children. Or we can do the more “safe” route and increase the risperidone because due to weight gain he does need a higher dosage and he is already on the lowest possible dosage but work to meet with a nutritionist to help teach his Dad and me how to properly setup his meals and snacks to try to make him feel more full during the day, thus reducing his appetite increase.

Aj and Kiara togetherStep one for us was to not switch medications, we know this medication he is on works wonders for him. Of course due to weight gain his moods were coming back along with his other symptoms of bipolar so the need of a medication dose change was in order. The last resort step would be to switch medications if we can not get a handle on his weight gain. So now Aj has been stepped up from .5 mg two times a day to .75 mg two times a day for a week. If that works, then keep him on that dosage, but if not then up him to 1 mg twice per day. That should do the trick, if he is still showing signs of his mood disorder, well then I suppose we will be on the phone with his pediatric psychiatrist to figure out what to do next.

For now, I am on the look out to see if I can’t find a nutritionist to work with that could help with meal and snack planning, after all that would not only help Aj but help the family as a whole get more healthy. I wouldn’t put him on a separate diet than the rest of us, we are family and if we can eat the things he is recommended to eat, then we should,  just as a way to show our support for the little dude!

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