Unexpected Responses to Mood Stabilizers?
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Q:  Unexpected Responses to Mood Stabilizers?

My 12 year old son has been diagnosed with bipolar II. He is extremely sensitive to medications and has very unexpected responses to medications. Depakote caused major rage, Lamictal caused irritability and now since starting on Lithium last week he is having rages constantly throughout the day. I am unable to find any case studies indicating this kind of response from mood stabilizers. Have you had any experience with this type of response? Does this mean he doesn't have bipolar disorder? The Dr. is also puzzled.

Dear Donna --

The most common explanation for this kind of experience is that the medications are bystanders and the irritability is coming from the illness itself. I've seen that many times.  By comparison, I'm pretty sure I've never seen Depakote cause rage.  Lamictal might do it once in awhile, at least a minor agitation, but not really irritability.  And lithium would be extremely unlikely to cause "rage". 

Unless your son was never really having "rage" like this, prior to these medications, I'd say the most likely explanation is that the medications just did not effectively treat the target. 

As you probably have considered, his age is just right for a new hormonal contribution to symptoms, and rage would be a common symptom in that context. 

Suffice to say that I would be astounded if all three of those medications were actually causing extreme anger.  On the other hand, there is always a first time, so I would not say it is impossible.  Nothing in this business is ever 100%.  Good luck figuring that out.

Dr. Phelps

Published July, 2008


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