15 year old with ADHD and BP
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15 year old with ADHD and BP

Q: My son, who is 15 years old, has been diagnosed with ADHD and bipolar disorder, and ODD. He is currently taking depakote, neurontin, zyprexa, and ritalin. The medications seen to have helped stabilized some of his high's and low's, but he has completely stopped doing anything related to school. He gets up every day and attends high school, but he is flunking every subject simply because he has refused to do any of the work. This child was a solid "B" student prior to attending high school. Is there any possible relationship to his refusal to school work and his illness, or his medications? Thanks, Dick

Dear Dick --
Yes.  In other words, your guesses could each be correct: medications, or illness.  Hard to tell without trying to back off something -- slowly -- and watching closely.  Then there's this Oppositional Defiant Disorder diagnosis, which is not necessarily part of either bipolar disorder or ADHD, so one wonders whether that is part of the school problem also (although my understanding of ODD -- this is not my area of psychiatry -- is that this would have been present in some obvious form before high school, and I would think it would be hard to have significant ODD and get straight B's. Some teacher I would have expected would get lined up for defiance also?  So I wonder about that part of the diagnosis -- knowing only 1 paragraph's worth, mind you.  The point there is that the school problem might not be bipolar or medications, which would make the trials of med' changes even trickier; and that this puzzle is happening in the context of some other factor that isn't entirely clear (at least to me at this distance, in this format).  Good luck.

Dr. Phelps

Published November, 2000

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