My oldest son has Asperger’s Syndrome and as part of his Asperger’s there is a large component of Bipolar disorder. In fact his bipolar component is so high, that his psychiatrist has actually diagnosed it as a separate illness instead of a part of his Asperger’s (as is normally done.) I also suffer with Bipolar disorder, so it is probably hereditary from my side of the family. We are both treated for it using the medication Abilify. My son also takes a couple of other medications that help out with his Asperger’s and a seizure disorder.

Where we ran into a problem was when he had to go on antibiotics a few weeks ago.

My son rarely gets sick. I have often joked that God said,”OK, you shall have Autism – but you shall never catch a cold.” He has never had the flu, and up until this episode had only been on antibiotics 5 times in his 18 years of life. Once when his appendix was removed, once when his wisdom teeth were removed, and the other 3 times were for when he got sick. That’s it! So when the doctor asked me if he was allergic to any antibiotics I said, “No.”

The doctor put him on Sulfa. Within 2 days my son’s lips were swelling, he had hives over most of his back and torso, and his eyes were completely bloodshot; in other words, the beginnings of an anaphylactic reaction. Of course, this happened at 9 o’clock in the evening on a Sunday when the doctor’s office was closed. I called the answering service, they said to put him on Benadryl around the clock, wake him every 4 hours to give it to him, and to call an ambulance if he had any trouble breathing at all. As long as he was breathing OK they could see him in the office in the morning.

So Monday morning rolls around, my son is still swollen, but not as much so we head into the doctor’s office. This is when the nightmare really began. His doctor put him on a new antibiotic, told us to take Claritin (since it is only once a day, and not 6 times) and gave him Prednisone to bring down the swelling in his airway passages and other soft tissue linings.

Normally I question all new medications Michael goes on because they tend to have such odd reactions with his existing meds, but I was so relieved that I didn’t think this time. Prednisone is a steroid. It is not a bulk up, muscle man type steroid, it is a corticosteroid – but it is still a steroid, and it can affect behavior.

The following day Michael’s behavior became very erratic. He was extremely irritable one minute, then wanting to do several new projects the next. He would jump back and forth between being whiny with me about not letting him do something, and then getting extremely angry because I was not being fair. The behavior became more extreme as the day went on. By the time school let out for my other two children I asked my mother to keep them at her house because he was so erratic. My husband came home from work to help me out. My son was shaking in a rage with his fists balled up next to his sides. He was screaming at me. At one point in time he reached out his hands as if to grab me, then he wrapped his arms around himself instead.

At this point he seemed to “snap to” a little, but instead of going back to “normal” he spiraled into a severe depression. He was saying things like “everyone would be better off without me”, “I wish I weren’t here”, and other things that had my husband and I scared he was thinking of suicide. We refused to let him go into his room by himself and made him stay in the living room where we could see him.

I immediately called his psychiatrist and told him how Michael was bouncing back and forth between rage and suicidal thoughts. His psychiatrist instructed me to give him a dose of orally disintegrating Abilify. He said if that did not calm him down to bring him into the hospital. If it did, bring him into the office first thing in the morning. Luckily the medicine did work – although I would not sleep that night, and made Michael sleep with his door open.

His psychiatrist quickly diagnosed the problem as the prednisone. It had caused first a manic episode followed by a rapid and severe depression. He was taken off the prednisone and just kept on the Claritin. Luckily he did not have to be hospitalized. Within a couple of days the medication was fully out of his body and he was back to normal.

It is extremely important that you have all medications vetted by your psychiatrist – even the ones that seem harmless. Your primary care doctor probably knows the side effects and interactions, but your psychiatrist definitely will. It is also very important that you have all your medications filled at the same pharmacy, so that your pharmacist might see any red flags on prescription interactions. Your pharmacy can also keep up with any drug allergies you have.

The medications listed in this article are prescribed for my child and should not be self-prescribed just because you read about them here. Always follow prescription instructions provided by your healthcare provider.