Does anyone know whether allergy shots interfere with the performance of Risperdal or other drugs used to treat bipolar children?

Our son was on Risperdal for ~18 months and was making great progress. He was able to go to kindergarten and 1st grade; he was making A's & B's; and his classroom behavior was similar to that of other young boys.

After an asthma attack in 10/05 put him in the hospital, he went back to school and his behavior continued to improve. In 12/05 we decided to give him allergy shots in an attempt to eliminate nasal congestion.

Almost immediately his classroom behavior began to get worse and his ability to concentrate on his school work went away. He also became more agitated and his manic episodes returned. In early 3/06 we took him out of the classroom environment and a school employee came to our home twice a week to help him with his school work.

In late 3/06 we replaced Risperdal with Geodon and his ability to concentrate returned and he finished the school year with all A's. His pleasant personality also returned without the manic episodes. The side effects of Geodon were that 1) his taste buds changed and he could not find any food that tasted good any more and 2) he had some involuntary physical movements (hopping and shoulder movements).

However, by June the positive effects of the Geodon had gone away and he became even more violent. In working with our psychiatrist we have tried various combinations of lithium, Geodon, Risperdal and Depokote. Nothing seems to bring his behavior back to where it was before the allergy shots. My wife is now home schooling him, but he has a lot of trouble concentrating even with all the one-on-one attention.

I have read that allergy medications such as Sudafed and St. John's wort should not be used with bipolar medications. Do you think allergy shots could cause problems that are similar to those caused by other allergy medications?

Looking for answers & ideas,

Fly2max

Few allergies are so dangerous - to wasp & bee stings - as to warrant allergy shots. Even years of injections cannot guarantee any "cure". Actually, I know many who took years of injections for bees & wasp stings and still need to keep emergency injectables to treat themselves.

If I were you, I'd would have taken him off the the shots right away. Nasal saline spray works fantastically. If it gets really bad, a bit of decongestant liquid or spray can solve it. There are many good drugs and aerosols for asthma. Ten years of injections and my sister still has asthma. They just aren't that effective.

Even now, I'd take him off the shots. It would be great if he wasn't on such a cocktail f drugs. Is this for proven bipolar or is he just severely ADD/ADHD? What kind of behavioral treatments have been tried? Have you talked to MrsD about non-drug treatments that might help tremendously.

Atypical antipsychotics to not cure anything. They depress a lot of frontal lobe activity. The drug someone into placidity. Antipsychotics are popular in prisons and nursing homes for violent and agitated people. They are highly implicated in diabetes in even young slender children. We have NO IDEA AT ALL at what kind of changes those kind of drugs will cause to a child's developing brain.

It costs a great deal more and involves a lot more effort and time, but there are a lot of behavioral approaches to behaviors like this. I know a lot more about these things now for I have an autistic grandson and he is virtually uncontrollable at the age of 4.
Parents can learn alot about these therapies and even learn to do them themselves (takes training sessions). With one out of every 166 children now being diagnosed as on the autistic spectrum, the need for society and the public schools to help meet these children's needs.

We have to make such hard decisions. My children struggled to not treat my granddaughter's bipolarity when she was little, and with a lot of behavioral reinforcement, she is now in Junior High and doing well in school. Not to say it couldn't manifest again, but for now, things are stable. With my grandson, they are also avoiding meds. They took a 6-day road trip (3 days both way) rather than face the impossible scenarios of having this 4-year-old on a plane. But he is in a good public school program for the past year and he goes to public school every day for a full-immersion program. But that is just for now -- who knows?

When it comes to St John's wort, I would strictly stay away from it as it is capable of triggering mania. As far as the decongestant sudaphed, as his pdoc and your phamacist, too. Pharmacists are great resources - for docs as well as patients.

Teri

My son has been successfully treated with zyprexa since the age of 6. (he just turned 10) Before that, school, home, and life was a nightmare. We tried everything before deciding to medicate, but nothing worked until he was successfully on medication, and then he was a different child. It was exactly what he needed to be given the chance at a normal childhood with friends, activities, school, and home. There are, of course, the possibility of side affects, but I know exactly where you are coming from on weighing those against the benefits. The benefits of medication far outweighed the decision to not, and I will never regret our decision to medicate.

I will say that he is very sensitive to medications; both over the counter and prescription, and we are very careful about what is prescribed to him. I would suggest keeping a journal of every OTC/prescription med you try, the effect, what other meds he was on at the time, and the reason he was using it. It makes it much easier to decide what would be ok to use in the future, as well as what to avoid.

I would avoid St. John's Wart as well as Sam-E for your child unless given under the strict supervision of his doctor. Any herb, supplement that is used for depression related issues has the potential of mania. There is a warning on the bottles stating that people with bipolar should not use. (should not be given to patients with bipolar disorder as it may result in mania or hypomania.) Bipolar children seem to be extremely affected by meds and supplements (different ones for different kids) so it would be wise to discuss any decision to try any new OTC or Prescriptions/supplements with his doctor first.

As for your son's education; was he given proper IEP accomodations? Were they followed? Is there a more appropriate setting, or a certified home study teacher that the school district could provide until such time as he is ready for a mainstream classroom? They are required by law to provide a free and appropriate education, regardless of whether he is currently able to be in a classroom setting; despite the fact they would never offer this information or assist you in getting it for him. If you need help with any information regarding this, or resources / advocates in your area, please feel free to contact me. I do this for a living and would be happy to help.

Good luck. Things will eventually get better - even though its hard to see the light when things are so hard. Lordy I dont miss those days; I feel for you.
Bobi

I would not think the actual injections would be what changed his response to the Risperdal. Really, an allergy injection is just like being exposed to the allergen in the environment just in a higher amount. I went through allergy shots for nearly 4 years and it was a huge help. I was allergic to most everything and now I only have my grass, weeds, molds, and cockroaches. When I was 12, I spent my whole summer indoors in the airconditioning with tile floors and all my bedding wrapped in those plastic bags just to avoid having breathing problems. I haven;t used an inhaler since 1998.

Bipolar is phasic, changes with time and it is hard to manage meds because the brain chemistry in a child is still growing and developing. I know a simple thing like a filling will set one of our boys back for weeks while the other one is unphased. They are really different inside and out and react to meds completely different.