Guest guest Posted September 27, 2003 Report Share Posted September 27, 2003 We tried a small dose zoloft for my 11 yr old daughter, Theresa, and after about 3 days of meltdowns that were more frequent, more intense (hair pulling, head hitting, abusive language), and just very minor triggers, I took her off. The meltdowns stopped until we had a " normal " trigger 3 days later (social situation- a birthday party), so, though it is hard to be certain, I felt the zoloft was not helping. It is confusing though, that (think I read here) sometimes symptoms increase initially with an ssri ? It seems like the panic and social anxiety limits us more than OCD lately, or maybe I am more used to the OCD and it takes place only at home, for the most part, and can be managed some when Theresa is willing to do ERP. I have been looking at an ASD girls list(autistic spectrum disorders) and find alot of similarities, such as panic attacks beginning with puberty. ASD is different in girls b/c their better social skills, though still a problem, seems to mask it (an autistic diagnosis) somewhat, and their good verbal skills can compensate for the NLD, and the difficulties only become more apparent and worse as they get older. They also say (on the list) that CBT needs to be somewhat modified for people with ASD. So maybe our next step will be a neurological asessement and then there may be some additional therapies that can help like OT for the sensory defensiveness, and social skills for the social panic. As for meds The p-doc thinks we should wait to try ssri's when Theresa is older (like her sister who is 15). I think she is afraid of triggering cycling as in BP. So now we are back to no meds approach and looking at therapy alone. I am not sure about that, maybe a neurologist would offer further opinions, b/c what are we to do about the severe social anxiety? I would like to find some girls like Theresa (ASD?)or a social skills group. She has friends now, but only with one on one situations- she cannot manage even a small group without panicky anxiety. nancy grace Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 29, 2003 Report Share Posted September 29, 2003 ----- Original Message ----- From: nmlinnen >We tried a small dose zoloft for my 11 yr old daughter, Theresa, and after about 3 days of meltdowns that were more frequent, more intense (hair pulling, head hitting, abusive language), and just very minor triggers, I took her off. The meltdowns stopped until we had a " normal " trigger 3 days later (social situation- a birthday party), so, though it is hard to be certain, I felt the zoloft was not helping. It is confusing though, that (think I read here) sometimes symptoms increase initially with an ssri ? *****Hi Grace, forgive me if this is old advice because by now I am getting confused about who has posted what to whom. But anyway your daughter may be one of those kids who needs to start very low, and increase her SSRI dose very slowly to avoid side effects. You are right that many doctors believe that initial side effects (which would include hair pulling--my child did this starting abruptly with Prozac--head hitting, abusing language, irritability, eating changes, sleeping difficulties, etc.) may be seen initially and may also predict a good response once the child is stabilized on the med. Using the liquid preparation, you can start with an extremely low dose and raise it very slowly. There is a limit to how small of fragments you can cut pills into without ending up with dust! Also, Kathy H. posted before about people starting out with one lick of a pill, next day two licks, etc. in order to bypass SSRI side effects. In reading your various posts, I get the impression that both your daughters are exquisitely sensitive, in which case they both may truly benefit from the right SSRI but introduced almost ridiculously slowly. In the case of Theresa, I am interested in why the doctor wants to wait until she's older to use SSRI? Is there less chance of triggering BP cycling if she's older? >It seems like the panic and social anxiety limits us more than OCD lately, or maybe I am more used to the OCD and it takes place only at home, for the most part, and can be managed some when Theresa is willing to do ERP. *****Panic and social anxiety are also treated with SSRIs. >So maybe our next step will be a neurological asessement and then there may be some additional therapies that can help like OT for the sensory defensiveness, and social skills for the social panic. *****We haven't tried the OT route for sensory defensiveness but did have good success with SSRI (I think this had a hand in it) but primarily ERP. Just FYI, Kel's social skills are very impaired when her anxiety/OCD symptoms are high, but when well controlled she is very gregarious and attracts friends. How often the phone rings/kids drop by for her has become a sort of barometer for me on how her OCD is doing, so tight has been this connection between high OCD/anxiety and social impairment over time. Take care and good luck Grace, Kathy R. in Indiana Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 30, 2003 Report Share Posted September 30, 2003 Hi Kathy, I had the same question about waiting till older. The p-doc thinks the acute sensitivity can wear off with age and size, and that Theresa will be able to use ssri's when older, as does (my 15 yr old) with less sensitivity (if she does not have an underlying mood disorder i.e bipolar). The other list for ASD seems to support the idea of acute med sensitivity in ASD (autistic spectrum disorder). But the other consideration is that with Bp in my family (my brother- depending upon which of his p-docs you talk to) the p-doc feels cautious about possibilty of triggering anything that could be manic, since it is harder to tell in a child whether one is seeing med sensitivity, or rather the induction of mania/cycling, which can be very rapid or mixed in a child, and not euphoric, but irritable, rage, panic etc. If that is her concern, waiting til older to discover whether ssri's trigger cycling, is not so great- but better than triggering manic-depressive cycling in a child, which apparently would have a worse cumulative effect on the brain, i.e if every episode causes some degree of further brain damage or disturbance. But I will ask to try a liguid dose of ssri. I don't think we can go on like this, Theresa had a screaming meltdown today over the correction of a math probelm, and that triggered compulsive erasing, so we discontinued her work, but then she became depressed and lethargic, b/c she just slumps if she does not have her schedule and her work to enliven her. nancy grace > > ----- Original Message ----- > From: nmlinnen > > >We tried a small dose zoloft for my 11 yr old daughter, Theresa, and > after about 3 days of meltdowns that were more frequent, more intense > (hair pulling, head hitting, abusive language), and just very minor > triggers, I took her off. The meltdowns stopped until we had > a " normal " trigger 3 days later (social situation- a birthday party), > so, though it is hard to be certain, I felt the zoloft was not > helping. It is confusing though, that (think I read here) sometimes > symptoms increase initially with an ssri ? > *****Hi Grace, forgive me if this is old advice because by now I am getting confused about who has posted what to whom. But anyway your daughter may be one of those kids who needs to start very low, and increase her SSRI dose very slowly to avoid side effects. You are right that many doctors believe that initial side effects (which would include hair pulling--my child did this starting abruptly with Prozac--head hitting, abusing language, irritability, eating changes, sleeping difficulties, etc.) may be seen initially and may also predict a good response once the child is stabilized on the med. > > Using the liquid preparation, you can start with an extremely low dose and raise it very slowly. There is a limit to how small of fragments you can cut pills into without ending up with dust! > > Also, Kathy H. posted before about people starting out with one lick of a pill, next day two licks, etc. in order to bypass SSRI side effects. > > In reading your various posts, I get the impression that both your daughters are exquisitely sensitive, in which case they both may truly benefit from the right SSRI but introduced almost ridiculously slowly. > > In the case of Theresa, I am interested in why the doctor wants to wait until she's older to use SSRI? Is there less chance of triggering BP cycling if she's older? > > >It seems like the panic and social anxiety limits us more than OCD > lately, or maybe I am more used to the OCD and it takes place only at > home, for the most part, and can be managed some when Theresa is > willing to do ERP. > > *****Panic and social anxiety are also treated with SSRIs. > > >So maybe our next step will be a neurological asessement and then > there may be some additional therapies that can help like OT for the > sensory defensiveness, and social skills for the social panic. > > *****We haven't tried the OT route for sensory defensiveness but did have good success with SSRI (I think this had a hand in it) but primarily ERP. Just FYI, Kel's social skills are very impaired when her anxiety/OCD symptoms are high, but when well controlled she is very gregarious and attracts friends. How often the phone rings/kids drop by for her has become a sort of barometer for me on how her OCD is doing, so tight has been this connection between high OCD/anxiety and social impairment over time. > > Take care and good luck Grace, > Kathy R. in Indiana > > Quote Link to comment Share on other sites More sharing options...
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