Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 Wow, Gale. This is such a tough time for kids even without OCD. My daughter was a very angry teenager. Lots of fear and anxiety. I hope things settle down. Please keep us posted. .+'*'+.+'*'+. . *'+. .+'* * " ...just as I have loved you, you also are to love one another. " - 13: 34 | |My daughter, age 14, is on 40 mg. Paxil, for about 8 weeks, 2.5 mg. Zyprexa for about 3 |weeks, and just today added 250 mg. Depakote ER. We are still " testing " because although |her social anxiety, compulsions and rituals have lessened, her agitation and anger seem to |have escalated, along with has her cutting behavior. Her rapid mood swings are frightening |as is her impulsive behavior. I'm still at the scared-to-death stage . . . |She was about 82 pounds before Zyprexa, but is now about 93. (For her height she should be |heavier. Contamination fears were keeping her from eating properly.) | |--Gale in Illinois Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 My daughter, 13, is on 200 mg of Zoloft. I am wondering if anyone had failure at the highest dose of an antidepressant, did your psych then augment or switch to a different antidepressant entirely? Thank you. Kim Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 My daughter, 13, is on 200 mg of Zoloft. I am wondering if anyone had failure at the highest dose of an antidepressant, did your psych then augment or switch to a different antidepressant entirely? Thank you. Kim Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 Listers: One thing I noticed in the posts listing kids' SSRI doses is that many are taking sub-therapeutic doses, amounts too low to be expected to effectively treat OCD. In a couple of instances, the doses were lower even than those recommended to treat depression. It's known that SSRIs need to be dosed higher to reduce OCD symptoms, even in children. Unlike some other types of medication, SSRIs are not dosed by age, weight or height, and childhood OCD is not a junior version of the adult disorder. Though it is true that kids' reactions to these meds is individual, and sometimes people have the best effect at a very low or otherwise out of range dose, it seems unlikely to me that so many kids whose parents are on this list fall into this category. If anyone's child is still experiencing significant and impairing OCD symptoms despite taking an SSRI, you might consider that their dose needs to be raised into the range that has been shown to be effective against OCD. Some doctors may be overcautious when prescribing an SSRI for a child. This may be more of a problem when the doctor is not a child psychiatrist or child pharmacologist (a pediatrician for example.) Starting with a low dose, and increasing it very gradually to the target dose, is an effective way to avoid side effects of SSRIs. SSRIs available in liquid form make it easy to do this. The dose can be raised as little as one drop at a time. A reliable book that gives therapeutic ranges for various psychiatric meds and disorders in kids is " Straight Talk about Psychiatric Medications for Kids " by Wilens (I believe that is the author's name.) Another good and handy source of information is the pharmacist who fills your child's prescription. Of course the prescribing doctor should be willing and able to answer any questions regarding meds and doses suggested for your child. My child, 11 in early January, takes Zoloft 150 mg/day for OCD. Side effects initially were activation, sleep disturbance, and increased appetite which waned over time. She has taken this dose for over 4 years now. For three of those four years she also took 10 mg/day Paxil to augment the Zoloft. For three years she also took Risperdal in doses ranging from .25 mg/day to 1 mg/day for tics and impulsivity. Side effects, which continued, were drowsiness and increased appetite, though my daughter did not experience inappropriate weight gain. None of us likes having to give our kids these meds, yet if that decision has been made, IMO it makes sense to give enough of the medication to provide relief of symptoms. Otherwise you are taking whatever risks and enduring whatever side effects come with giving the medication, but your child is not getting the full potential benefit. My 2 cents, Kathy R. in Indiana ----- Original Message ----- > Anyway we can get a poll on what kind of meds are being used for what age > child and for what symptoms? I question the medication one of my kids is > on. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 Kathy, My daughter is on a low dosage of Zoloft(20mg)largely due to my determination to keep it low. When she first had her OCD " breakdown " , I was so desparate to help my child and waiting the 2 or 3 weeks to see a psychologist seemed a lifetime. Her pediatrician's office was the only place I could turn to ASAP. They were so confident that Zoloft would help, and although I knew I did not want my child on meds, I had to agree to try to get her to a point where she could accept and follow through the therapy. She started on 15 mg (liquid). They said I should call in a few days if there was absolutely no improvement, and I got the impression they didn't think there would be from such a low dosage. I did increase it to the 20 mg, then we saw the psychologist our insurance company sent us to and I decided she wasn't right for our needs. Shortly thereafter I talked with Dr. Wagner on the phone and right away my worst worries and fears were alleviated. I also felt that we could do this without increasing the Zoloft, no matter how tempting that was. I have a niece who conquered OCD without meds and knew it would be the hardest thing we as a family would ever do, but felt it would be worth it. I had several things in my favor - 1) completely understood what OCD was about and was 100% committed to helping herself; 2) 's young age(7)and her personality made her very open to therapy and she was eager to please those around her; 3) I had the the " best of the best " psychologist in Dr. Wagner and 4) was fine in school, no huge anxiety unlike at home. ****I know many people don't have these positives and meds can be the only hope.**** I now regret ever starting the Zoloft, since we now have to stay on it for at least a year, I was told. For me, I am hoping with all my heart that is NOT helping, and that all my daughter's progress is through our hard work using CBT and ERP. I want to get her weaned off it the first chance I get. She has done amazingly well, and in fact Dr. Wagner has decided she no longer needs to see her on a regular basis (after 9 sessions). I believe now has the lifelong tools and mental strength that she needs to battle OCD. What's even more amazing is that I never thought she'd be able to do the therapy so well - she has always been one to give up on anything that she can't master within 5 minutes! Plus she has always cried at the drop of a hat, soooo sensitive and, quite frankly, not mentally tough at all. I know I am going on and on, but I feel so strongly about resisting meds in certain cases. I read over and over from this list that you have to constantly re-adjust the meds, change or add new ones, which sounds like a nightmare to me. I am also not convinced how " safe " anything is when used for years and years. Who knows 20 years down the road what they caused, it's my understanding that they haven't used these meds on children for very long. Again, this is my personal conviction, I do not criticize anyone for doing what they need to do to save their children. I also know that my tune may change when hits puberty, I am scared to death of what that will do to her OCD. I am also curious about something. I have noticed from previous messages that you seem to be a big supporter of ERP and meds used in conjunction. Yet I was surprised to also read a week or so ago that your daughter still has big issues with clothing. I'm wondering as to why ERP was not successful in this area? I'm sure given the age she's at, it must be much more difficult to practice it now, but was it done successfully earlier on? nna NY > Listers: One thing I noticed in the posts listing kids' SSRI doses is that > many are taking sub-therapeutic doses, amounts too low to be expected to > effectively treat OCD. In a couple of instances, the doses were lower even > than those recommended to treat depression. It's known that SSRIs need to > be dosed higher to reduce OCD symptoms, even in children. Unlike some other > types of medication, SSRIs are not dosed by age, weight or height, and > childhood OCD is not a junior version of the adult disorder. Though it is > true that kids' reactions to these meds is individual, and sometimes people > have the best effect at a very low or otherwise out of range dose, it seems > unlikely to me that so many kids whose parents are on this list fall into > this category. > > If anyone's child is still experiencing significant and impairing OCD > symptoms despite taking an SSRI, you might consider that their dose needs to > be raised into the range that has been shown to be effective against OCD. > Some doctors may be overcautious when prescribing an SSRI for a child. This > may be more of a problem when the doctor is not a child psychiatrist or > child pharmacologist (a pediatrician for example.) Starting with a low > dose, and increasing it very gradually to the target dose, is an effective > way to avoid side effects of SSRIs. SSRIs available in liquid form make it > easy to do this. The dose can be raised as little as one drop at a time. > > A reliable book that gives therapeutic ranges for various psychiatric meds > and disorders in kids is " Straight Talk about Psychiatric Medications for > Kids " by Wilens (I believe that is the author's name.) Another good and > handy source of information is the pharmacist who fills your child's > prescription. Of course the prescribing doctor should be willing and able > to answer any questions regarding meds and doses suggested for your child. > > My child, 11 in early January, takes Zoloft 150 mg/day for OCD. Side > effects initially were activation, sleep disturbance, and increased appetite > which waned over time. She has taken this dose for over 4 years now. For > three of those four years she also took 10 mg/day Paxil to augment the > Zoloft. For three years she also took Risperdal in doses ranging from .25 > mg/day to 1 mg/day for tics and impulsivity. Side effects, which continued, > were drowsiness and increased appetite, though my daughter did not > experience inappropriate weight gain. > > None of us likes having to give our kids these meds, yet if that decision > has been made, IMO it makes sense to give enough of the medication to > provide relief of symptoms. Otherwise you are taking whatever risks and > enduring whatever side effects come with giving the medication, but your > child is not getting the full potential benefit. > > My 2 cents, > Kathy R. in Indiana > > ----- Original Message ----- > From: " adair " <adair@t...> > > > Anyway we can get a poll on what kind of meds are being used for what age > > child and for what symptoms? I question the medication one of my kids is > > on. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 Kathy, My daughter is on a low dosage of Zoloft(20mg)largely due to my determination to keep it low. When she first had her OCD " breakdown " , I was so desparate to help my child and waiting the 2 or 3 weeks to see a psychologist seemed a lifetime. Her pediatrician's office was the only place I could turn to ASAP. They were so confident that Zoloft would help, and although I knew I did not want my child on meds, I had to agree to try to get her to a point where she could accept and follow through the therapy. She started on 15 mg (liquid). They said I should call in a few days if there was absolutely no improvement, and I got the impression they didn't think there would be from such a low dosage. I did increase it to the 20 mg, then we saw the psychologist our insurance company sent us to and I decided she wasn't right for our needs. Shortly thereafter I talked with Dr. Wagner on the phone and right away my worst worries and fears were alleviated. I also felt that we could do this without increasing the Zoloft, no matter how tempting that was. I have a niece who conquered OCD without meds and knew it would be the hardest thing we as a family would ever do, but felt it would be worth it. I had several things in my favor - 1) completely understood what OCD was about and was 100% committed to helping herself; 2) 's young age(7)and her personality made her very open to therapy and she was eager to please those around her; 3) I had the the " best of the best " psychologist in Dr. Wagner and 4) was fine in school, no huge anxiety unlike at home. ****I know many people don't have these positives and meds can be the only hope.**** I now regret ever starting the Zoloft, since we now have to stay on it for at least a year, I was told. For me, I am hoping with all my heart that is NOT helping, and that all my daughter's progress is through our hard work using CBT and ERP. I want to get her weaned off it the first chance I get. She has done amazingly well, and in fact Dr. Wagner has decided she no longer needs to see her on a regular basis (after 9 sessions). I believe now has the lifelong tools and mental strength that she needs to battle OCD. What's even more amazing is that I never thought she'd be able to do the therapy so well - she has always been one to give up on anything that she can't master within 5 minutes! Plus she has always cried at the drop of a hat, soooo sensitive and, quite frankly, not mentally tough at all. I know I am going on and on, but I feel so strongly about resisting meds in certain cases. I read over and over from this list that you have to constantly re-adjust the meds, change or add new ones, which sounds like a nightmare to me. I am also not convinced how " safe " anything is when used for years and years. Who knows 20 years down the road what they caused, it's my understanding that they haven't used these meds on children for very long. Again, this is my personal conviction, I do not criticize anyone for doing what they need to do to save their children. I also know that my tune may change when hits puberty, I am scared to death of what that will do to her OCD. I am also curious about something. I have noticed from previous messages that you seem to be a big supporter of ERP and meds used in conjunction. Yet I was surprised to also read a week or so ago that your daughter still has big issues with clothing. I'm wondering as to why ERP was not successful in this area? I'm sure given the age she's at, it must be much more difficult to practice it now, but was it done successfully earlier on? nna NY > Listers: One thing I noticed in the posts listing kids' SSRI doses is that > many are taking sub-therapeutic doses, amounts too low to be expected to > effectively treat OCD. In a couple of instances, the doses were lower even > than those recommended to treat depression. It's known that SSRIs need to > be dosed higher to reduce OCD symptoms, even in children. Unlike some other > types of medication, SSRIs are not dosed by age, weight or height, and > childhood OCD is not a junior version of the adult disorder. Though it is > true that kids' reactions to these meds is individual, and sometimes people > have the best effect at a very low or otherwise out of range dose, it seems > unlikely to me that so many kids whose parents are on this list fall into > this category. > > If anyone's child is still experiencing significant and impairing OCD > symptoms despite taking an SSRI, you might consider that their dose needs to > be raised into the range that has been shown to be effective against OCD. > Some doctors may be overcautious when prescribing an SSRI for a child. This > may be more of a problem when the doctor is not a child psychiatrist or > child pharmacologist (a pediatrician for example.) Starting with a low > dose, and increasing it very gradually to the target dose, is an effective > way to avoid side effects of SSRIs. SSRIs available in liquid form make it > easy to do this. The dose can be raised as little as one drop at a time. > > A reliable book that gives therapeutic ranges for various psychiatric meds > and disorders in kids is " Straight Talk about Psychiatric Medications for > Kids " by Wilens (I believe that is the author's name.) Another good and > handy source of information is the pharmacist who fills your child's > prescription. Of course the prescribing doctor should be willing and able > to answer any questions regarding meds and doses suggested for your child. > > My child, 11 in early January, takes Zoloft 150 mg/day for OCD. Side > effects initially were activation, sleep disturbance, and increased appetite > which waned over time. She has taken this dose for over 4 years now. For > three of those four years she also took 10 mg/day Paxil to augment the > Zoloft. For three years she also took Risperdal in doses ranging from .25 > mg/day to 1 mg/day for tics and impulsivity. Side effects, which continued, > were drowsiness and increased appetite, though my daughter did not > experience inappropriate weight gain. > > None of us likes having to give our kids these meds, yet if that decision > has been made, IMO it makes sense to give enough of the medication to > provide relief of symptoms. Otherwise you are taking whatever risks and > enduring whatever side effects come with giving the medication, but your > child is not getting the full potential benefit. > > My 2 cents, > Kathy R. in Indiana > > ----- Original Message ----- > From: " adair " <adair@t...> > > > Anyway we can get a poll on what kind of meds are being used for what age > > child and for what symptoms? I question the medication one of my kids is > > on. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 Hi nna, I did not mean to challenge anyone's decision about medications or dosing. Instead, I meant my post for those whose children are struggling and suffering despite medication, and who might not have been aware that SSRIs typically need to be given in larger doses, even to children, to be effective against OCD. Lots and lots of parents refuse medication for their children and rightly so: CBT/ERP is the first intervention of choice recommended by experts to treat OCD in children. SSRIs are number two, to be added if a trial of CBT/ERP is ineffective or only partly effective. Some experts have indicated that the combo of therapy plus meds *may* be the quickest route to reducing OCD symptoms, which is why I sometimes include this info in posts in reply to those whose kids are miserable and dysfunctional and the whole family is in disarray. My own daughter experienced an abrupt onset of severe OCD similar to what you describe happening to , at age four. Given her age and the area we live in, it was a number of years before I was able to find a therapist to treat her, so she was started on SSRI medication. " Old timers " on the list will remember that for those years, I functioned as my child's ERP therapist, and I will always be thankful for those here who answered my questions and helped me craft effective exposures for my child. Even following expert CBT/ERP later on, however, attempts to reduce her SSRI below a certain point resulted in anxiety and a resurgence of obsessions and compulsions. But we *were* able to withdraw the Paxil augmentation, and later the Risperdal. I was very disappointed because I too hoped that therapy alone would keep my child comfortable, functional and stable. Due to this, she continues to take a therapeutic dose of Zoloft and probably will for the foreseeable future. You wrote: > I am also curious about something. I have noticed from previous > messages that you seem to be a big supporter of ERP and meds used in > conjunction. Yet I was surprised to also read a week or so ago that > your daughter still has big issues with clothing. I'm wondering as > to why ERP was not successful in this area? I'm sure given the age > she's at, it must be much more difficult to practice it now, but was > it done successfully earlier on? *****Both therapy and meds have proved necessary for my child to enjoy the lowest possible symptom level. My daughter does remain on Zoloft following therapy, plus practices an ERP lifestyle--we all do by now. Re the clothing problems, ERP was and is very effective against my child's clothing problems. She is not *still* having big clothing problems, but instead, again--she had several years in there when clothing issues were very low and manageable. I believe her clothing issues have resurfaced recently in a big way due to the tremendous growth spurt she has experienced--nothing fits, everything had to be replaced over a short period of time. Under normal growing circumstances, she would have one or two new things to use ERP on to get used to. Recently, she's had everything: shoes, socks, underwear, the sudden need for a bra, sanitary supplies, plus tops and pants, and winter outerwear, and I think she got a bit overwhelmed. She willingly practices ERP with clothing items, she always has, because she herself wants to be able to wear things comfortably. So that is one thing at least that her age has not complicated (yet :-) But you are right that as she's gotten older, she's generally less willing to share about her OCD symptoms, and she resists when I suggest that something is an OCD problem and maybe it's time to start working on it. I wish you and all the best in trampling the OCD monster. She does certainly have many plusses on her side (I'm *very* jealous of her psychologist LOL), especially in having such an informed and supportive mother :-) Take care, Kathy R. in Indiana p.s. FWIW I have noticed no changes in my daughter's OCD symptom level as she has moved into puberty. ----- Original Message ----- > Kathy, > > My daughter is on a low dosage of Zoloft(20mg)largely due to > my determination to keep it low. When she first had her > OCD " breakdown " , I was so desparate to help my child and waiting the > 2 or 3 weeks to see a psychologist seemed a lifetime. Her > pediatrician's office was the only place I could turn to ASAP. They > were so confident that Zoloft would help, and although I knew I did > not want my child on meds, I had to agree to try to get her to a > point where she could accept and follow through the therapy. She > started on 15 mg (liquid). They said I should call in a few days if > there was absolutely no improvement, and I got the impression they > didn't think there would be from such a low dosage. > > I did increase it to the 20 mg, then we saw the psychologist our > insurance company sent us to and I decided she wasn't right for our > needs. Shortly thereafter I talked with Dr. Wagner on the phone and > right away my worst worries and fears were alleviated. I also felt > that we could do this without increasing the Zoloft, no matter how > tempting that was. I have a niece who conquered OCD without meds and > knew it would be the hardest thing we as a family would ever do, but > felt it would be worth it. > > I had several things in my favor - 1) completely understood > what OCD was about and was 100% committed to helping herself; 2) > 's young age(7)and her personality made her very open to > therapy and she was eager to please those around her; 3) I had the > the " best of the best " psychologist in Dr. Wagner and 4) was > fine in school, no huge anxiety unlike at home. ****I know many > people don't have these positives and meds can be the only hope.**** > > I now regret ever starting the Zoloft, since we now have to stay on > it for at least a year, I was told. For me, I am hoping with all my > heart that is NOT helping, and that all my daughter's progress is > through our hard work using CBT and ERP. I want to get her weaned > off it the first chance I get. She has done amazingly well, and in > fact Dr. Wagner has decided she no longer needs to see her on a > regular basis (after 9 sessions). I believe now has the > lifelong tools and mental strength that she needs to battle OCD. > What's even more amazing is that I never thought she'd be able to do > the therapy so well - she has always been one to give up on anything > that she can't master within 5 minutes! Plus she has always cried at > the drop of a hat, soooo sensitive and, quite frankly, not mentally > tough at all. > > I know I am going on and on, but I feel so strongly about resisting > meds in certain cases. I read over and over from this list that you > have to constantly re-adjust the meds, change or add new ones, which > sounds like a nightmare to me. I am also not convinced how " safe " > anything is when used for years and years. Who knows 20 years down > the road what they caused, it's my understanding that they haven't > used these meds on children for very long. Again, this is my > personal conviction, I do not criticize anyone for doing what they > need to do to save their children. I also know that my tune may > change when hits puberty, I am scared to death of what that > will do to her OCD. > > I am also curious about something. I have noticed from previous > messages that you seem to be a big supporter of ERP and meds used in > conjunction. Yet I was surprised to also read a week or so ago that > your daughter still has big issues with clothing. I'm wondering as > to why ERP was not successful in this area? I'm sure given the age > she's at, it must be much more difficult to practice it now, but was > it done successfully earlier on? > > nna > > NY Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 Hi nna, I did not mean to challenge anyone's decision about medications or dosing. Instead, I meant my post for those whose children are struggling and suffering despite medication, and who might not have been aware that SSRIs typically need to be given in larger doses, even to children, to be effective against OCD. Lots and lots of parents refuse medication for their children and rightly so: CBT/ERP is the first intervention of choice recommended by experts to treat OCD in children. SSRIs are number two, to be added if a trial of CBT/ERP is ineffective or only partly effective. Some experts have indicated that the combo of therapy plus meds *may* be the quickest route to reducing OCD symptoms, which is why I sometimes include this info in posts in reply to those whose kids are miserable and dysfunctional and the whole family is in disarray. My own daughter experienced an abrupt onset of severe OCD similar to what you describe happening to , at age four. Given her age and the area we live in, it was a number of years before I was able to find a therapist to treat her, so she was started on SSRI medication. " Old timers " on the list will remember that for those years, I functioned as my child's ERP therapist, and I will always be thankful for those here who answered my questions and helped me craft effective exposures for my child. Even following expert CBT/ERP later on, however, attempts to reduce her SSRI below a certain point resulted in anxiety and a resurgence of obsessions and compulsions. But we *were* able to withdraw the Paxil augmentation, and later the Risperdal. I was very disappointed because I too hoped that therapy alone would keep my child comfortable, functional and stable. Due to this, she continues to take a therapeutic dose of Zoloft and probably will for the foreseeable future. You wrote: > I am also curious about something. I have noticed from previous > messages that you seem to be a big supporter of ERP and meds used in > conjunction. Yet I was surprised to also read a week or so ago that > your daughter still has big issues with clothing. I'm wondering as > to why ERP was not successful in this area? I'm sure given the age > she's at, it must be much more difficult to practice it now, but was > it done successfully earlier on? *****Both therapy and meds have proved necessary for my child to enjoy the lowest possible symptom level. My daughter does remain on Zoloft following therapy, plus practices an ERP lifestyle--we all do by now. Re the clothing problems, ERP was and is very effective against my child's clothing problems. She is not *still* having big clothing problems, but instead, again--she had several years in there when clothing issues were very low and manageable. I believe her clothing issues have resurfaced recently in a big way due to the tremendous growth spurt she has experienced--nothing fits, everything had to be replaced over a short period of time. Under normal growing circumstances, she would have one or two new things to use ERP on to get used to. Recently, she's had everything: shoes, socks, underwear, the sudden need for a bra, sanitary supplies, plus tops and pants, and winter outerwear, and I think she got a bit overwhelmed. She willingly practices ERP with clothing items, she always has, because she herself wants to be able to wear things comfortably. So that is one thing at least that her age has not complicated (yet :-) But you are right that as she's gotten older, she's generally less willing to share about her OCD symptoms, and she resists when I suggest that something is an OCD problem and maybe it's time to start working on it. I wish you and all the best in trampling the OCD monster. She does certainly have many plusses on her side (I'm *very* jealous of her psychologist LOL), especially in having such an informed and supportive mother :-) Take care, Kathy R. in Indiana p.s. FWIW I have noticed no changes in my daughter's OCD symptom level as she has moved into puberty. ----- Original Message ----- > Kathy, > > My daughter is on a low dosage of Zoloft(20mg)largely due to > my determination to keep it low. When she first had her > OCD " breakdown " , I was so desparate to help my child and waiting the > 2 or 3 weeks to see a psychologist seemed a lifetime. Her > pediatrician's office was the only place I could turn to ASAP. They > were so confident that Zoloft would help, and although I knew I did > not want my child on meds, I had to agree to try to get her to a > point where she could accept and follow through the therapy. She > started on 15 mg (liquid). They said I should call in a few days if > there was absolutely no improvement, and I got the impression they > didn't think there would be from such a low dosage. > > I did increase it to the 20 mg, then we saw the psychologist our > insurance company sent us to and I decided she wasn't right for our > needs. Shortly thereafter I talked with Dr. Wagner on the phone and > right away my worst worries and fears were alleviated. I also felt > that we could do this without increasing the Zoloft, no matter how > tempting that was. I have a niece who conquered OCD without meds and > knew it would be the hardest thing we as a family would ever do, but > felt it would be worth it. > > I had several things in my favor - 1) completely understood > what OCD was about and was 100% committed to helping herself; 2) > 's young age(7)and her personality made her very open to > therapy and she was eager to please those around her; 3) I had the > the " best of the best " psychologist in Dr. Wagner and 4) was > fine in school, no huge anxiety unlike at home. ****I know many > people don't have these positives and meds can be the only hope.**** > > I now regret ever starting the Zoloft, since we now have to stay on > it for at least a year, I was told. For me, I am hoping with all my > heart that is NOT helping, and that all my daughter's progress is > through our hard work using CBT and ERP. I want to get her weaned > off it the first chance I get. She has done amazingly well, and in > fact Dr. Wagner has decided she no longer needs to see her on a > regular basis (after 9 sessions). I believe now has the > lifelong tools and mental strength that she needs to battle OCD. > What's even more amazing is that I never thought she'd be able to do > the therapy so well - she has always been one to give up on anything > that she can't master within 5 minutes! Plus she has always cried at > the drop of a hat, soooo sensitive and, quite frankly, not mentally > tough at all. > > I know I am going on and on, but I feel so strongly about resisting > meds in certain cases. I read over and over from this list that you > have to constantly re-adjust the meds, change or add new ones, which > sounds like a nightmare to me. I am also not convinced how " safe " > anything is when used for years and years. Who knows 20 years down > the road what they caused, it's my understanding that they haven't > used these meds on children for very long. Again, this is my > personal conviction, I do not criticize anyone for doing what they > need to do to save their children. I also know that my tune may > change when hits puberty, I am scared to death of what that > will do to her OCD. > > I am also curious about something. I have noticed from previous > messages that you seem to be a big supporter of ERP and meds used in > conjunction. Yet I was surprised to also read a week or so ago that > your daughter still has big issues with clothing. I'm wondering as > to why ERP was not successful in this area? I'm sure given the age > she's at, it must be much more difficult to practice it now, but was > it done successfully earlier on? > > nna > > NY Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 Hi nna, I did not mean to challenge anyone's decision about medications or dosing. Instead, I meant my post for those whose children are struggling and suffering despite medication, and who might not have been aware that SSRIs typically need to be given in larger doses, even to children, to be effective against OCD. Lots and lots of parents refuse medication for their children and rightly so: CBT/ERP is the first intervention of choice recommended by experts to treat OCD in children. SSRIs are number two, to be added if a trial of CBT/ERP is ineffective or only partly effective. Some experts have indicated that the combo of therapy plus meds *may* be the quickest route to reducing OCD symptoms, which is why I sometimes include this info in posts in reply to those whose kids are miserable and dysfunctional and the whole family is in disarray. My own daughter experienced an abrupt onset of severe OCD similar to what you describe happening to , at age four. Given her age and the area we live in, it was a number of years before I was able to find a therapist to treat her, so she was started on SSRI medication. " Old timers " on the list will remember that for those years, I functioned as my child's ERP therapist, and I will always be thankful for those here who answered my questions and helped me craft effective exposures for my child. Even following expert CBT/ERP later on, however, attempts to reduce her SSRI below a certain point resulted in anxiety and a resurgence of obsessions and compulsions. But we *were* able to withdraw the Paxil augmentation, and later the Risperdal. I was very disappointed because I too hoped that therapy alone would keep my child comfortable, functional and stable. Due to this, she continues to take a therapeutic dose of Zoloft and probably will for the foreseeable future. You wrote: > I am also curious about something. I have noticed from previous > messages that you seem to be a big supporter of ERP and meds used in > conjunction. Yet I was surprised to also read a week or so ago that > your daughter still has big issues with clothing. I'm wondering as > to why ERP was not successful in this area? I'm sure given the age > she's at, it must be much more difficult to practice it now, but was > it done successfully earlier on? *****Both therapy and meds have proved necessary for my child to enjoy the lowest possible symptom level. My daughter does remain on Zoloft following therapy, plus practices an ERP lifestyle--we all do by now. Re the clothing problems, ERP was and is very effective against my child's clothing problems. She is not *still* having big clothing problems, but instead, again--she had several years in there when clothing issues were very low and manageable. I believe her clothing issues have resurfaced recently in a big way due to the tremendous growth spurt she has experienced--nothing fits, everything had to be replaced over a short period of time. Under normal growing circumstances, she would have one or two new things to use ERP on to get used to. Recently, she's had everything: shoes, socks, underwear, the sudden need for a bra, sanitary supplies, plus tops and pants, and winter outerwear, and I think she got a bit overwhelmed. She willingly practices ERP with clothing items, she always has, because she herself wants to be able to wear things comfortably. So that is one thing at least that her age has not complicated (yet :-) But you are right that as she's gotten older, she's generally less willing to share about her OCD symptoms, and she resists when I suggest that something is an OCD problem and maybe it's time to start working on it. I wish you and all the best in trampling the OCD monster. She does certainly have many plusses on her side (I'm *very* jealous of her psychologist LOL), especially in having such an informed and supportive mother :-) Take care, Kathy R. in Indiana p.s. FWIW I have noticed no changes in my daughter's OCD symptom level as she has moved into puberty. ----- Original Message ----- > Kathy, > > My daughter is on a low dosage of Zoloft(20mg)largely due to > my determination to keep it low. When she first had her > OCD " breakdown " , I was so desparate to help my child and waiting the > 2 or 3 weeks to see a psychologist seemed a lifetime. Her > pediatrician's office was the only place I could turn to ASAP. They > were so confident that Zoloft would help, and although I knew I did > not want my child on meds, I had to agree to try to get her to a > point where she could accept and follow through the therapy. She > started on 15 mg (liquid). They said I should call in a few days if > there was absolutely no improvement, and I got the impression they > didn't think there would be from such a low dosage. > > I did increase it to the 20 mg, then we saw the psychologist our > insurance company sent us to and I decided she wasn't right for our > needs. Shortly thereafter I talked with Dr. Wagner on the phone and > right away my worst worries and fears were alleviated. I also felt > that we could do this without increasing the Zoloft, no matter how > tempting that was. I have a niece who conquered OCD without meds and > knew it would be the hardest thing we as a family would ever do, but > felt it would be worth it. > > I had several things in my favor - 1) completely understood > what OCD was about and was 100% committed to helping herself; 2) > 's young age(7)and her personality made her very open to > therapy and she was eager to please those around her; 3) I had the > the " best of the best " psychologist in Dr. Wagner and 4) was > fine in school, no huge anxiety unlike at home. ****I know many > people don't have these positives and meds can be the only hope.**** > > I now regret ever starting the Zoloft, since we now have to stay on > it for at least a year, I was told. For me, I am hoping with all my > heart that is NOT helping, and that all my daughter's progress is > through our hard work using CBT and ERP. I want to get her weaned > off it the first chance I get. She has done amazingly well, and in > fact Dr. Wagner has decided she no longer needs to see her on a > regular basis (after 9 sessions). I believe now has the > lifelong tools and mental strength that she needs to battle OCD. > What's even more amazing is that I never thought she'd be able to do > the therapy so well - she has always been one to give up on anything > that she can't master within 5 minutes! Plus she has always cried at > the drop of a hat, soooo sensitive and, quite frankly, not mentally > tough at all. > > I know I am going on and on, but I feel so strongly about resisting > meds in certain cases. I read over and over from this list that you > have to constantly re-adjust the meds, change or add new ones, which > sounds like a nightmare to me. I am also not convinced how " safe " > anything is when used for years and years. Who knows 20 years down > the road what they caused, it's my understanding that they haven't > used these meds on children for very long. Again, this is my > personal conviction, I do not criticize anyone for doing what they > need to do to save their children. I also know that my tune may > change when hits puberty, I am scared to death of what that > will do to her OCD. > > I am also curious about something. I have noticed from previous > messages that you seem to be a big supporter of ERP and meds used in > conjunction. Yet I was surprised to also read a week or so ago that > your daughter still has big issues with clothing. I'm wondering as > to why ERP was not successful in this area? I'm sure given the age > she's at, it must be much more difficult to practice it now, but was > it done successfully earlier on? > > nna > > NY Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 What are CBT/ERP, please? .+'*'+.+'*'+. . *'+. .+'* * Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 What are CBT/ERP, please? .+'*'+.+'*'+. . *'+. .+'* * Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 My 8 year old daughter is on 25mg of Zoloft for OCD and 25mg of Straterra for ADHD. Medications? Anyway we can get a poll on what kind of meds are being used for what age child and for what symptoms? I question the medication one of my kids is on. .+'*'+.+'*'+. . *'+. .+'* * Our list archives, bookmarks, files, and chat feature may be accessed at: http://health.groups.yahoo.com/group// . 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 December 4, 2004 Report Share Posted December 4, 2004 Hi Kim, my child trialed three SSRIs before we struck on Zoloft, which she has stuck with. With the first three, her pdoc preferred to switch to a different SSRI when she neared the top dose without significant relief. With Zoloft, which helped yet not enough, he preferred to augment with a small dose of a second SSRI, Paxil. I think I remember reading that augmentation should be tried after a number of failed trials of single SSRIs, though I can not remember the source. I also don't remember why this approach was suggested...sorry :-( HTH, Kathy R. in Indiana ----- Original Message ----- > My daughter, 13, is on 200 mg of Zoloft. I am wondering if anyone had > failure at the highest dose of an antidepressant, did your psych then augment or > switch to a different antidepressant entirely? Thank you. Kim Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 5, 2004 Report Share Posted December 5, 2004 Kim, I was told that you need to gradually go up to the highest dose, then slowly wean off and move to another SSRI and gradually work your way up again. This sounds like agony and would take forever! But that's what my niece went through, my brother and sister-in-law did this for a year and even after all that nothing worked. However, this was before they started augmenting, so I don't mean to discourage you. The reason for this trial of all the SSRI's is that they all react differently with different people, you never know which one might do the trick. nna NY > My daughter, 13, is on 200 mg of Zoloft. I am wondering if anyone had > failure at the highest dose of an antidepressant, did your psych then augment or > switch to a different antidepressant entirely? Thank you. Kim > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 7, 2004 Report Share Posted December 7, 2004 When my oldest daughter found no relief with Zoloft (high dose) we switched to Luvox. Her sister had been successfully taking Luvox for about a year. Kelley in NV Quote Link to comment Share on other sites More sharing options...
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