Zoloft Questions

[Guest guest]

My daughter, age 12, just recently started medication for severe OCD -

..25 mg of risperidal twice a day and 25 mg of Zoloft in the morning

(after 5 days of 12.5 mg of zoloft). She's been on this combination

for a week, and she has horrible insomnia, with increased anxiety and

nightmares. She has great trouble falling asleep, and is up during the

night after nightmares. She also has a lot of general anxiety at night

now. We're going crazy with this.

On the other hand, she is significantly more rational and willing to

discuss her OCD and copes better with life, with many fewer rages. Her

OCD symptoms are still there, but she has a little perspective on them.

Over the phone, the psychiatrist told us today to try giving her the

zoloft at night, starting tomorrow, and see if that helps. We see the

psychiatrist on Friday. The doctor may try taking her off risperidal

and adding something for sleep. She says the zoloft could be having an

activating effect, but the child is both more anxious and calmer at the

same time, and is certainly not manic.

It's early days still for us with medication, and she probably needs a

higher dose as well. We plan on cognitive-behavioral therapy and ERP

therapy once she's calm enough with the meds. She's certainly a lot

closer to that with just a week of the 25 mg of zoloft, in spite of the

higher anxiety.

Has anyone had experience with this type of thing?

I've got to run. Another OCD incident is starting.

Miriam in NY

[Guest guest]

Hi Miriam, Zoloft is somewhat activating for my dd so we give that in the a.m.

When she was starting on the med and for the first two months or so, she had

insomnia/night waking/difficulty falling asleep which we gave Benedryl for at

the suggestion of her pdoc--if this didn't work he was prepared to prescribe a

sleep med for her temporarily. We were told we could safely give more than the

stated dosage on the package but I no longer remember the details of this. Some

kids unfortunately have a paradoxical reaction to Benedryl and become wired

rather than sleepy on it--fair warning :-)

Risperdal otoh makes my child sleepy, so we give that about an hour before bed.

The Risp plus a Benedryl back when we used it virtually guaranteed she'd fall

right to sleep, though she often was up then later in the night during this

first two months on Zoloft. If it had been long enough, I'd give another

Benedryl.

All the SSRIs my child has taken gave her vivid and sometimes frightening

nightmares, at least to begin with.

All these problems reduced over time and my child has taken Zoloft +Risperdal

for over two years now with very little problem. It's a rare occurance that she

has problems falling asleep or is up in the night. She is a little jazzed on

Zoloft still, but this is manageable.

Sleep problems are awful on top of OCD and med adjustments--you have my

sympathy, I remember thinking *I have to solve the sleep problem, must have

sleep* :-) OCD was always 10 times worse the next day whenever my child did not

have adequate sleep. IMO the main drawback to SSRIs is that they take so long

to get going, and often enough in the meanwhile give you many reasons to think

giving them to your child is a big mistake!

HTH,

Kathy R. in Indiana

----- Original Message -----

My daughter, age 12, just recently started medication for severe OCD -

.25 mg of risperidal twice a day and 25 mg of Zoloft in the morning

(after 5 days of 12.5 mg of zoloft). She's been on this combination

for a week, and she has horrible insomnia, with increased anxiety and

nightmares. She has great trouble falling asleep, and is up during the

night after nightmares. She also has a lot of general anxiety at night

now. We're going crazy with this.

<snip>

[Guest guest]

My daughter is 12 and she developed very severe OCD at age 10. Her

obsessions revolved around extreme contamination fears. She had some

counting and prayer rituals as well as endless washing. It goes on

and on... Anyway, she started on Zoloft (which was titrated up to

150mgs eventually) and we saw very little impact. We waited for

about six weeks with hardly any relief. Then her doctor added

risperdal (now at .75mgs). Within a few days of adding the risperdal

we started to see a huge change in her OCD behavior. Her rituals

were no longer a problem! However, she began to have other

behavioral problems with rage and aggression. I would often have to

physically restrain her to get her under control. This period was

very traumatic for the entire family. Well, now her rage attacks

have stopped and she just seems to have an endless amount of energy.

She dances and sings constantly, is often irritable, and requires a

high level of noise (TV, radio) in order to concentrate. To answer

your question, I don't know. This may be the effects of the Zoloft.

However, there are so many variables at play . . . puberty, OCD, two

meds, personality. I'm not sure. Let me know if you find out

anything on this.