Guest guest Posted May 4, 2005 Report Share Posted May 4, 2005 Hi , Regarding the SSRI increasing OC's at first, might work, etc., that is something I read here when I first joined years ago. I assume it's knowledge picked up from reading, from doctor's comments/observations repeated, experience, etc. I have read this comment in posts in another group that doctors comment in. The only " written " thing on it that I have (that I can find today!) is at a website Q & A that I have saved. A part of which is: " sbg1124: Is it possible for some SSRI's to make OCD worse? Dr. Jenike: Yes. I think that, sometimes, worsening OCD symptoms (not side effects) actually predicts a good response. That is if the patient can stay on the drug long enough. It is a rare OCD patient who continues to have worsening OCD on these drugs, but I have seen it. Sometimes, the drugs help, but other times, they can make things worse. " http://www.healthyplace.com/Communities/Anxiety/site/transcripts/obse ssions_ocd.asp The same for where " sometimes people do better on a lower dose... " is where I've read doctor responses to Q & A's/groups, etc. I've read that several times, it seems like since I've been reading these/other things over the years. I guess key words on things like this are " some people. " Now - I have to read up on extinction bursts, as you've mentioned that here before and my mind is blank! Later, > I'm a little puzzled by the occasional mention that if a medication initially increases OCD behaviors, that means it might be the right med because what you're seeing is an " extinction burst. " My daughter experienced extreme worsening of symptoms when put on Zoloft, and neither psychiatrist who has seen her indicated that it Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2005 Report Share Posted May 4, 2005 Hi , I'm not sure the term " extinction burst " is quite right for the phenomenon of initial worsening symptoms while taking SSRI that may predict a good outcome. As you say, I *have* read that term to mean initial worsening of OCD when starting behavior therapy. However I can't recall any certain term that means initially worsening symptoms when starting an SSRI. Like some of the others, I know I have read of this possibility, and that some doctors believe it, including my child's pdoc. I wonder if it may be a clinical observation rather than something that has been proved by a controlled study. There is a Herxheimer reaction (sp?) which has to do with initial worsening symptoms when people take antiviral or maybe antibiotic therapy, but I don't think that applies to SSRI medications. And I searched +ssri +paradoxical which returned articles mostly having to do with the recent warnings re: suicide ideation and so on. Sorry not more help. Kathy R. in Indiana ----- Original Message ----- From: " Price " <firecooklmp@...> > I'm a little puzzled by the occasional mention that if a medication > initially increases OCD behaviors, that means it might be the right med > because what you're seeing is an " extinction burst. " My daughter > experienced extreme worsening of symptoms when put on Zoloft, and neither > psychiatrist who has seen her indicated that it might mean we were on the > right track. The first decreased the dose (which was already very low), > the second changed her to Prozac -- with which we saw improvement within a > few days. > > Since I am a librarian in a med school library and have access to medical > databases, I decided to check this out. I searched Medline, PsychInfo and > some Evidence Based Medicine databases. Found things related to extinction > of behavior, but they all seemed to relate to CBT/ERP and not meds or > reaction to meds. > > Can anyone provide any kind of citation or other documents to support the > " extinction burst " theory regarding meds? Just trying to get this clear in > my own mind. > > Thanks, > P. in NJ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 4, 2005 Report Share Posted May 4, 2005 Hi, When I tried to open the site it gave me this comment: ( Microsoft OLE DB Provider for ODBC Drivers error '80040e21' Multiple-step OLE DB operation generated errors. Check each OLE DB status value, if available. No work was done. /site/error404.asp, line 115 In this case can I have any advice to how can I manage to open this site. Or if somebody on this list is able to open it to copy & paste it & send it to me please. Thanks Huda >From: " " <@...> >Reply- > >Subject: Re: extinction bursts >Date: Wed, 04 May 2005 17:14:46 -0000 > >Hi , >Regarding the SSRI increasing OC's at first, might work, etc., that >is something I read here when I first joined years ago. I assume >it's knowledge picked up from reading, from doctor's >comments/observations repeated, experience, etc. I have read this >comment in posts in another group that doctors comment in. The >only " written " thing on it that I have (that I can find today!) is >at a website Q & A that I have saved. A part of which is: > > " sbg1124: Is it possible for some SSRI's to make OCD worse? > >Dr. Jenike: Yes. I think that, sometimes, worsening OCD symptoms >(not side effects) actually predicts a good response. That is if the >patient can stay on the drug long enough. It is a rare OCD patient >who continues to have worsening OCD on these drugs, but I have seen >it. Sometimes, the drugs help, but other times, they can make things >worse. " >http://www.healthyplace.com/Communities/Anxiety/site/transcripts/obse >ssions_ocd.asp > >The same for where " sometimes people do better on a lower dose... " >is where I've read doctor responses to Q & A's/groups, etc. I've read >that several times, it seems like since I've been reading >these/other things over the years. I guess key words on things like >this are " some people. " > >Now - I have to read up on extinction bursts, as you've mentioned >that here before and my mind is blank! > >Later, > > > > > > I'm a little puzzled by the occasional mention that if a >medication initially increases OCD behaviors, that means it might be >the right med because what you're seeing is an " extinction burst. " >My daughter experienced extreme worsening of symptoms when put on >Zoloft, and neither psychiatrist who has seen her indicated that it > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 5, 2005 Report Share Posted May 5, 2005 The psychiatrist who first diagnosed and prescribed medication for my youngest daughter used this term. When first went on Paxil, her behavior became more OCD than it had ever been at that time. It lasted about two weeks after she started taking medication. She did not act impulsively or dangerously as some children do when they are on the wrong medication. She cried more, had more " Seeing Things " and was much more fearful than she had been before. Immediately after that, she became quite well. She showed very few symptoms. That lasted about a week. Two years later, my second daughter experienced the same ups and downs when put on Zoloft. After the initial worsening and then sudden improvement of symptoms, both girls leveled out to where they are now: better but not symptom free. The doctor explained it to me by saying the when the chemicals in the brain are messed with, they react. The chemicals in the brain want to " right " themselves when they are disrupted and the OCD chemical levels are all it knows. It wants to get back to what it is used to. He said that it was perfectly normal and that many people experience it. My youngest daughter has a crossing eye and when she was very young, her glasses broke and her other eye started to cross. I called the doctor who was replacing the glasses and he told me that her brain was just trying to get the vision it had lost with the glasses broken back. I though of that when the doctor talked about the brain chemicals. Once the glasses were fixed, the other eye stopped crossing. I am still looking through the books I have to see if any of the authors have written about extinction bursts due to meds but haven't found any yet. I do trust this doctor and what he said to me made sense. I'll keep looking! Kelley in NV p.s. This is not to say that every bad reaction is a good indication that the meds are working. Sometimes a med is just wrong for a child and if they are showing dangerous behavior the doctor should be called! I'm talking about an increase in symptoms my children already had. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 5, 2005 Report Share Posted May 5, 2005 Hi, Huda I initially had the same problem. The URL breaks onto a second line, so you have to copy and paste it in two pieces. P. Huda Abi Rafeh <hudaarafeh@...> wrote: Hi, When I tried to open the site it gave me this comment: ( Microsoft OLE DB Provider for ODBC Drivers error '80040e21' Multiple-step OLE DB operation generated errors. Check each OLE DB status value, if available. No work was done. /site/error404.asp, line 115 In this case can I have any advice to how can I manage to open this site. Or if somebody on this list is able to open it to copy & paste it & send it to me please. Thanks Huda >From: " " <@...> >Reply- > >Subject: Re: extinction bursts >Date: Wed, 04 May 2005 17:14:46 -0000 > >Hi , >Regarding the SSRI increasing OC's at first, might work, etc., that >is something I read here when I first joined years ago. I assume >it's knowledge picked up from reading, from doctor's >comments/observations repeated, experience, etc. I have read this >comment in posts in another group that doctors comment in. The >only " written " thing on it that I have (that I can find today!) is >at a website Q & A that I have saved. A part of which is: > > " sbg1124: Is it possible for some SSRI's to make OCD worse? > >Dr. Jenike: Yes. I think that, sometimes, worsening OCD symptoms >(not side effects) actually predicts a good response. That is if the >patient can stay on the drug long enough. It is a rare OCD patient >who continues to have worsening OCD on these drugs, but I have seen >it. Sometimes, the drugs help, but other times, they can make things >worse. " >http://www.healthyplace.com/Communities/Anxiety/site/transcripts/obse >ssions_ocd.asp > >The same for where " sometimes people do better on a lower dose... " >is where I've read doctor responses to Q & A's/groups, etc. I've read >that several times, it seems like since I've been reading >these/other things over the years. I guess key words on things like >this are " some people. " > >Now - I have to read up on extinction bursts, as you've mentioned >that here before and my mind is blank! > >Later, > > > > > > I'm a little puzzled by the occasional mention that if a >medication initially increases OCD behaviors, that means it might be >the right med because what you're seeing is an " extinction burst. " >My daughter experienced extreme worsening of symptoms when put on >Zoloft, and neither psychiatrist who has seen her indicated that it > > Our list archives, bookmarks, files, and chat feature may be accessed at: / . Our list advisors are Gail B. , Ed.D., Tamar Chansky, Ph.D.( http://www.worrywisekids.org ), Dan Geller, M.D.,Aureen Pinto Wagner, Ph.D., ( http://www.lighthouse-press.com ). Our list moderators are Birkhan, Castle, Fowler, Kathy Hammes, Joye, Kathy Mac, Gail Pesses, and Kathy . Subscription issues or suggestions may be addressed to Louis Harkins, list owner, at louisharkins@... , louisharkins@... , louisharkins@... . --------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 5, 2005 Report Share Posted May 5, 2005 Thanks, Kelley. I'll be looking forward to seeing what you find. In my daughter's case, too, it was an increase in existing symptoms. But since she was nearly non-functional to begin with, a severe increase was pretty hard to deal with. P. kelleydinkins@... wrote: The psychiatrist who first diagnosed and prescribed medication for my youngest daughter used this term. When first went on Paxil, her behavior became more OCD than it had ever been at that time. It lasted about two weeks after she started taking medication. She did not act impulsively or dangerously as some children do when they are on the wrong medication. She cried more, had more " Seeing Things " and was much more fearful than she had been before. Immediately after that, she became quite well. She showed very few symptoms. That lasted about a week. Two years later, my second daughter experienced the same ups and downs when put on Zoloft. After the initial worsening and then sudden improvement of symptoms, both girls leveled out to where they are now: better but not symptom free. The doctor explained it to me by saying the when the chemicals in the brain are messed with, they react. The chemicals in the brain want to " right " themselves when they are disrupted and the OCD chemical levels are all it knows. It wants to get back to what it is used to. He said that it was perfectly normal and that many people experience it. My youngest daughter has a crossing eye and when she was very young, her glasses broke and her other eye started to cross. I called the doctor who was replacing the glasses and he told me that her brain was just trying to get the vision it had lost with the glasses broken back. I though of that when the doctor talked about the brain chemicals. Once the glasses were fixed, the other eye stopped crossing. I am still looking through the books I have to see if any of the authors have written about extinction bursts due to meds but haven't found any yet. I do trust this doctor and what he said to me made sense. I'll keep looking! Kelley in NV p.s. This is not to say that every bad reaction is a good indication that the meds are working. Sometimes a med is just wrong for a child and if they are showing dangerous behavior the doctor should be called! I'm talking about an increase in symptoms my children already had. Quote Link to comment Share on other sites More sharing options...
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