There is a family of psychotropic medications that are sometimes prescribed as a first-line treatment for children with a variety of emotional issues…they are known as “mood stabilizers” or “anticonvulsants”. This family of medications includes:

Depakote
Lamictal
Tegretol
Topomax
Trileptal
Neurontin

Lithium, probably the most prescribed mood stabilizers, is not an anticonvulsant medication.

Most people associate these medications with a diagnosis of Bipolar Disorder, but many are also prescribed for seizure disorders, such as epilepsy. Some sources cite mood stabilizers as effective for Borderline Personality Disorder (which some professionals believe may be a disorder that manifests itself as children with unresolved Reactive Attachment Disorder reach adulthood.)

Many of these mood stabilizers require close monitoring (i.e. regular blood tests) because of their impact on white blood cell count, liver function and hormone levels. In our case, LuLu is on Depakote, which requires a quarterly blood draw.

You have probably noticed that there are many mood stabilizers. And, although Lithium, Depakote, and Lamictal are the ones FDA-approved for bipolar, the others are often the ones found to be most effective for some of our more complex children. Sadly, though, the only way to know if a specific medication is going to work is to try it.

This is one of the major downsides to the use of these medications…the trial and error factor. If a medication works, it is a Godsend. If it doesn’t, it can make the child’s symptoms so much worse. We knew in less than 48 hours that Neurontin was NOT the medication for LuLu, for example.

Two neurological/psychiatric groups have evaluation tools they claim can help narrow down the medication choices that might be beneficial for our children. At the Amen Clinics, they use a tool called SPECT scans. These scans show the amount of blood flow to various parts of the brain and are able to build 3-D models of the brain structure and function. The data is then compared with their database of brain scans for the same age group and areas of dysfunction are pinpointed. From that database information inferences can be drawn as to which families of medications would be most effective.

The folks at Crossroads use QEEGs as their evaluation tool (measuring electrical brain waves, not actual blood flow…and no 3-D images). They, too, through the use of a normative database, can make suggestions of families of medications that may be helpful based on the abnormalities in brain function seen on the QEEGs.

These tools are beneficial, but for medications are also limited. While they may narrow down the types of medications needed (mood stabilizers vs. anti-depressants for example), they do not tell you which specific medication will work best…so it’s still trial and error.

However, both tools do give valuable information about which areas of the brain are impacted and how severely. Neurofeedback protocols that are more tailored to the individual can be derived from both tools. And parents who use these tools often report that being able to “see” the level of dysfunction and show other professionals working with the child make it clearer that the child truly has a disorder, and is not just misbehaving.

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