Re: when a child's behavior changes for the worst on their meds/akathisia, mania

[Guest guest]

Hi Angie, of course you must go by your doctor's advice...but my thought is,

how intrusive/disabling is the ADHD vs. the OCD? My dd's pdoc told us we

should basically choose which disorder was worse in terms of affecting her

daily life, self confidence, abilities, etc. and focus on treating that.

For us that was OCD hands down, so we focused on finding the right SSRI and

the right dose which as you know can take months--over a year for us as it

turned out. Then and only then, once her OCD was stabilized and low-level,

would her pdoc want to consider treating any ADHD. Once she was stabilized

on an SSRI the ADHD stuff seemed to diminish, apparently a lot of the

attention problems, activation etc. were due to obsessions, anxiety and so

on. As it turns out Kel's ADHD-type symptoms are manageable so far so we

haven't even explored medication for this, since it can certainly worsen OCD

and tics which is something else my child deals with. She's 10, fourth

grade, I don't know if her disorganization and attention problems will

become bigger issues in higher grades, we'll just have to see and adjust

accordingly at that time.

So maybe you would have better results if you very slowly increased your

daughter's SSRI to a therapeutic level, and tried to manage the ADHD

behaviorally and without meds until then? Have you tried an extremely slow

titering up of the SSRI? Using a liquid preparation makes this easier.

Kel's pdoc sort of laughs at my very cautious and gradual increases (and

decreases) in her SSRI but endorses it so that's what I do to minimize

behavior side effects, insomnia and etc. Your daughter probably needs a

higher dose of Zoloft to make a dent in her worries and other OCD symptoms,

my child takes 150 mg. daily.

Zoloft was " the one " SSRI for my child, it was the fourth one she tried. I

also despaired that we would find a med that helped with the OCD without

causing all sorts of unacceptable side effects. It was a little activating

for her, but nothing near the activation and etc. she got from Prozac. Some

SSRIs are considered to be activating in most people (Zoloft and Prozac)

while others are thought to be more sedating in their effects (I thought

Luvox was one of these.)

HTH, I know the frustration and despair of trying to get the meds balanced

to good effect. FWIW once my child was stabilized on Zoloft, that " not

herself " effect faded away though this caused me much distress while it was

going on--I second-guessed myself nearly daily during this phase, whether

she should be taking that SSRI or any SSRI.

One good thing is, side effects from SSRIs are reversible and they cease

when the medication is stopped.

Take care,

Kathy R. in Indiana

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

> My name is Angie, and I have posted a few times. We are still trying to

figure out what it going on with my 9 year old daughter. Her OCD got so

severe this year we had to try medication. She had a bad reaction to luvox

(made her angry, hear voices, etc.), but has seemed ok on a low dose of

zoloft, 25mg. At 50mg of zoloft was very angry, (busted out her bedroom

window with her fist), which is so UNLIKE her usual sweet nature. She is

also unable to sit still. Her doctor is now trying to prescribe medication

for possible ADHD symptoms, however he did no testing for ADHD. We tried

Adderall, but it just made her OCD worse. I have been reading about how

some children just cannot tolerate the SSRI's like others, and the SSRI can

cause the inability to sit still (akathisia) or bad behaviorial changes,

even mania. I feel so helpless. I am curious if anyone else here has had

any similar experiences, or has any knowledge of children who could not take

the SSRI's. It seems like now, even on the low dose of zoloft, some of

those same behaviors that I saw on 50 mg are returning. I read that in some

children the medication isn't metabolized fast enough so that even on low

doses, after several months these behaviors return. I am so afraid for my

daughter. Since the meds she has not been herself, and she still worries

quite a bit so we are not seeing any real benefit. Help! - Angie, WV

[Guest guest]

Hi Angie,

I know exactly what you are talking about. My son Skyler who is also

9 years old has had trouble with just about every med he has tried.

He has had numerous side effects ranging from the garden variety all

the way to mania/suicidal thoughts. THis is unlike his usual

personality also. HIs doctor says that some kids are sensitive to

meds in this way. He has had trouble on Adderall, Strattera and

possisbly Celexa (which is in the SSRI family). Most meds he has

tried are for ADHD. THe celexa was for anxiety/OCD. I don't have

any advice for you as we are still trying to swim upstream with this

problem. However, I certainly empathize. It is so hard to see your

children suffer. I hope you find an answer soon.

Best Wishes

Robin

Mother to Skyler

[Guest guest]

,

My son's therapist mentioned to me that the drug, Straterra, normally used for

ADD, is being shown to help OCD. I'm not sure it's been approved for use to

treat OCD, and I haven't researched it yet, but you might keep that in mind.