Re: How do I know when its time for inpatient therapy for son with OCD?

[Guest guest]

Hi Bill,

As I read your email I found myself wondering if Zoloft is the only SSRI that

has been prescribed for your son. If it is, it may be time to switch to a

different one. While my son, now 13, has not tried Zoloft, he has been on both

Paxil and Celexa, both of which did nothing for him at all. Prozac has been the

one med that has helped him with his OCD. Have you discussed this with his

p-doc?

I also am wondering at the reasons for increasing 2 medications so rapidly.

Seroquel will not help with OCD. It is usually prescribed for our kids to

augment the effects of SSRI's or to smooth out moods.

What is the treatment being prescribed for your son's PTSD?

I know nothing about the reputation of either of the hospitals you mention as

being apossibility for inpatient admissions. Have you asked this question on

the OCD support list?

While I agree with those who are suggesting that you apply for SSI for your

son, I can also see that you are being pulled in too many directions at once

right now. The SSI application can probalby wait a little while until you

hopefully have your son a little more stable. That process is lengthy and

energy zapping. It is possible that you may not even have all the information

you need to apply at this point either, since your son is still in the throes of

his diangoses.

I am glad that you are continuing to post.

Joye in Southeastern PA

justlivey <justlivey@...> wrote:

Hi,

Last Thursday was the start of my sons second week of taking 200mg

of generic Zoloft per day along with 150mg of Seroquel. His doctor

worked him up to that dose over four weeks. I have seen no signs of

improvement yet at this level. The only change I saw was when I

finally reluctantly agreed to let him drop out of 12 grage for the

first part of the year. Today was the fifth Sunday in a row he chose

not to attend church. He also has dropped out of the praise band in

the youth group on Wed. nite as well. Church somehow seems to make

him worse. I suppose it may be the scrupulosity issues that are

stirred up when he attends. His therapist says my choices are NC

Baptist Hospital in Winston Salem NC or Frye Hospital in Hickory NC.

She says she will not contradict what the med. doctor has prescribed

for him and with him suffering from PTSD, depression and severe OCD

this may be harder than we all thought. He turns 18 in April, his

senior year has been ruined by this OCD monster. I hate not being

able to fix it and worrying that my four year old has it as well.

One doctor friend of mine today smiled and said this will be a

lifelong thing for him with ups and downs. Some people emailed me to

say I should apply for disability/ssi/medicaid at once for him due

to his age being so close to 18. Do you think this is best or should

I wait a little longer so I will have more evidence of ongoing

treatment. Anyone have any experiences they wouldnt mind sharing

about applying for medicaid for a child with OCD?

Thanks, Bill

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[Guest guest]

Hi,

My son has not been well for 4 or 5 years. He has been in treatment

for 2 years and on meds. that long as well. Until 4 or 5 weeks ago he

was not diagnosed by a dr. with OCD. He was being counseled and given

meds for panic disorder and anxiety attacks and depression. He was

given 15mg or Remron at bedtime to help him sleep. As time progressed

he was switched to 20mg of Paxil, the 10mg of Lexapro. Never during

these times did any doctor say he had OCD much less severe OCD. His

last visit to his dr. was enlightening. After talking with him about

all the symptoms my son has now and him questioning my son he said he

has severe OCD, depression, and PTSD. He said the reason why none of

the meds have helped was the dose was prescribed for other disorders

besides severe OCD. He said a far greater dose of an SSRI was needed

to help severe OCD. He gradually increased the dose over several weeks

to the level he is at now. Currently he goes to therapy once per week.

The therapy is EFT and CBT combined. She always spends several hours

with him each session. We went with generic Zoloft because money is

tight with $40.00 copays each week and other expenses.

[Guest guest]

Bill,

One of the most difficult things, is the commorbid diagnosis.I have it, as

well as my daughter. I have been trying to get her on the right med combination

for almost 5 years now. (Still don't have it just right) When ocd is comorbid

with other diagnosis, it is a nightmare!

If your son has been on these meds for this length of time, and nothing has

worked, I would call the p-doc, and discontinue the meds and restart another,

only one med to start, and raise the dosage up slowly, than add another.

I have panic disorder as well as ocd myself, and I know first hand, you have

to have a benzo to function. In my opinion, your son should be on a benzo, for

the panic, as well as an SSRI for the ocd and depression. If he has tried this,

and has had the dose raised, and you have seen no improvement, than you need to

discontinue and try another med.

Hope this helps.

Hugs

Judy

[Guest guest]

Hi Bill, so far as " time for inpatient " ...well, hard choice for any

parent.

My thoughts on what I might do/choose here in NC:

First, I would call Duke University since they do have a dept

experienced with OCD. (Have you tried them yet over these years??)

http://www2.mc.duke.edu/depts/psychiatry/pcaad/pcaad_contacts.htm

(search the site, you may find a better phone # to call)

They may have some good knowledge on which hospital is best, may know

where people who trained with them are working (Frye, Winston...),

may know of somewhere your doctor/therapist haven't mentioned. Of

course if you live near Raleigh/Durham, you could seek treatment

there. If you're within driving distance, there's an OCD study he

might get into:

http://www2.mc.duke.edu/depts/psychiatry/pcaad/pcaad_pots.htm

although with his cormorbid diagnoses, he might not fit into the

study.

I would also call Frye and Baptist directly and ask about their OCD

treatment. I think you've gathered enough info to know what they

should say about treatment. I think when searching for someone or

some program experienced, it's easy to hear someone/someplace does

CBT but CBT is used for lots of illnesses, and someone who is

qualified to do CBT really may have no experience with treating OCD

or even have a good understanding of it. So, I'd be calling to see

if I liked what they told me (Frye and Baptist).

I think I would wait until later about the SSI, but I'm no expert on

that topic (or OCD either, really, LOL). If you go inpatient, what

is done there will help with records/info needed when applying for

SSI, I would think. If he qualifies for SSI, he'll automatically get

Medicaid. Applying for Medicaid alone is based on family income,

which I guess you know.

Have you checked into any " patient assistance program " in your area

regarding help for paying for medication?

Regarding scrupulosity - I can't say if is better/worse for

all his participation in church, youth group, etc. Overall...I guess

he's better with it. I think he'd sink further down without going

because he enjoys going so much. He's away tonight with the youth

group where they are doing some type " community " work (building

something I think), staying overnight there. Next week they are

supposed to go camping at Hanging Rock. So there's some good things

going on, else he'd be staying home mostly too.

Oh, I catch him praying, down on his knees!, and tell him to get up.

He's so unhappy sometimes with these bad thoughts. And he's where

he's not sure if all his thoughts *are* OCD, maybe some are just

*him*. But I told him if he's worrying himself so much over it/them,

making him so unhappy, then let's call it " OCD. " The other night he

hit himself in the head a couple times, fed up and upset with his

recurring thought. Wouldn't share what it was with me, though I

tried to pry it out of him.

Have you talked with your son about inpatient help yet?

>

> Hi,

> Last Thursday was the start of my sons second week of taking

200mg

> of generic Zoloft per day along with 150mg of Seroquel. His doctor

> worked him up to that dose over four weeks. I have seen no signs of

> improvement yet at this level. The only change I saw was when I

> finally reluctantly agreed to let him drop out of 12 grage for the

[Guest guest]

Bill,

Call the Duke program before doing anything with the meds, and I can't help

but think they can help with the comorbid issues also. They also have a

department for GAD and ADD. So they are really working in all areas of these

problems. But don't touch those meds because they cannot take you with this

study unless you are at optimum like your son is, even if it isn't working,

that's really what this study is about.

Adele

_____

From:

[mailto: ] On Behalf Of jchabot

Sent: Sunday, October 15, 2006 8:49 PM

Subject: Re: Re: How do I know when its time for inpatient

therapy for son with OCD?

Bill,

One of the most difficult things, is the commorbid diagnosis.I have it, as

well as my daughter. I have been trying to get her on the right med

combination for almost 5 years now. (Still don't have it just right) When

ocd is comorbid with other diagnosis, it is a nightmare!

If your son has been on these meds for this length of time, and nothing has

worked, I would call the p-doc, and discontinue the meds and restart

another, only one med to start, and raise the dosage up slowly, than add

another.

I have panic disorder as well as ocd myself, and I know first hand, you have

to have a benzo to function. In my opinion, your son should be on a benzo,

for the panic, as well as an SSRI for the ocd and depression. If he has

tried this, and has had the dose raised, and you have seen no improvement,

than you need to discontinue and try another med.

Hope this helps.

Hugs

Judy