Guest guest Posted December 4, 2004 Report Share Posted December 4, 2004 Kathy, that is interesting that you brought that up...I have had this debate in my mind for quite some time...My 8 year old is on 25mg of Zoloft. She has been doing so for a little over a year. She had a very sudden onset (suspected PANDAS) over 2 years ago. Her symptoms were bad thoughts. She was treated for her strep at that time and her symptoms went away. Months later her symptoms came back, as suddenly, but not quite as bad (thoughts not quite as frequent). At that time our doctor put her on Zoloft and her symptoms went away. I have often wondered though whether or not it was the Zoloft that helped the thoughts go away, because I realize now, 25 mg is a pretty low dosage. I struggle like all of us with treating our children with meds, but if I know that the meds are truly helping the OCD, I have no problem with my daughter taking them. I have had this discussion with different doctors, whether I should try taking my daughter off the Zoloft. She has not had any bad thoughts for over a year, although she is a pretty anxious child, she seems to be doing just fine. Just within the last month, her psych. and I decided to increase her Straterra intake (because of her growth over the last year) and take her off the Zoloft. Even the psych said I did not even need to " wean " her off the Zoloft because it was such a low dosage (we took her off " cold turkey). Well within 2 days of the med changes my daughter was having really bad stomachaches and nausea. After 8 days of the stomach problems arising, we brought her back to her original meds of 25mg of Zoloft and 25mg of Straterra (vs no Zoloft and 50mg of Straterra). I just assumed that the stomach issues were related to the med changes, and didn't feel like it was worth the med change right now. Her stomach was better for about a week and now even back on her original dosage, she is having stomachaches and nausea again. Sooooo, now I am thinking maybe she has the stomach problems because of her anxieties (a lot of things going on at school). So, 1 month ago I wanted her off the Zoloft, and now I am wondering if the Zoloft should be increased to help her anxieties. Am I all over the place or what? Anyway, I completely agree with what you are saying, that if our children are going to be taking the meds, the absolutely should be on the right dosage. How do I know that my daughter needs an increase? Are there questions I should be asking myself or her? Thanks for your ear Kathy! Re: Medications? 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. 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 Kathy, that is interesting that you brought that up...I have had this debate in my mind for quite some time...My 8 year old is on 25mg of Zoloft. She has been doing so for a little over a year. She had a very sudden onset (suspected PANDAS) over 2 years ago. Her symptoms were bad thoughts. She was treated for her strep at that time and her symptoms went away. Months later her symptoms came back, as suddenly, but not quite as bad (thoughts not quite as frequent). At that time our doctor put her on Zoloft and her symptoms went away. I have often wondered though whether or not it was the Zoloft that helped the thoughts go away, because I realize now, 25 mg is a pretty low dosage. I struggle like all of us with treating our children with meds, but if I know that the meds are truly helping the OCD, I have no problem with my daughter taking them. I have had this discussion with different doctors, whether I should try taking my daughter off the Zoloft. She has not had any bad thoughts for over a year, although she is a pretty anxious child, she seems to be doing just fine. Just within the last month, her psych. and I decided to increase her Straterra intake (because of her growth over the last year) and take her off the Zoloft. Even the psych said I did not even need to " wean " her off the Zoloft because it was such a low dosage (we took her off " cold turkey). Well within 2 days of the med changes my daughter was having really bad stomachaches and nausea. After 8 days of the stomach problems arising, we brought her back to her original meds of 25mg of Zoloft and 25mg of Straterra (vs no Zoloft and 50mg of Straterra). I just assumed that the stomach issues were related to the med changes, and didn't feel like it was worth the med change right now. Her stomach was better for about a week and now even back on her original dosage, she is having stomachaches and nausea again. Sooooo, now I am thinking maybe she has the stomach problems because of her anxieties (a lot of things going on at school). So, 1 month ago I wanted her off the Zoloft, and now I am wondering if the Zoloft should be increased to help her anxieties. Am I all over the place or what? Anyway, I completely agree with what you are saying, that if our children are going to be taking the meds, the absolutely should be on the right dosage. How do I know that my daughter needs an increase? Are there questions I should be asking myself or her? Thanks for your ear Kathy! Re: Medications? 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. 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 Kathy, that is interesting that you brought that up...I have had this debate in my mind for quite some time...My 8 year old is on 25mg of Zoloft. She has been doing so for a little over a year. She had a very sudden onset (suspected PANDAS) over 2 years ago. Her symptoms were bad thoughts. She was treated for her strep at that time and her symptoms went away. Months later her symptoms came back, as suddenly, but not quite as bad (thoughts not quite as frequent). At that time our doctor put her on Zoloft and her symptoms went away. I have often wondered though whether or not it was the Zoloft that helped the thoughts go away, because I realize now, 25 mg is a pretty low dosage. I struggle like all of us with treating our children with meds, but if I know that the meds are truly helping the OCD, I have no problem with my daughter taking them. I have had this discussion with different doctors, whether I should try taking my daughter off the Zoloft. She has not had any bad thoughts for over a year, although she is a pretty anxious child, she seems to be doing just fine. Just within the last month, her psych. and I decided to increase her Straterra intake (because of her growth over the last year) and take her off the Zoloft. Even the psych said I did not even need to " wean " her off the Zoloft because it was such a low dosage (we took her off " cold turkey). Well within 2 days of the med changes my daughter was having really bad stomachaches and nausea. After 8 days of the stomach problems arising, we brought her back to her original meds of 25mg of Zoloft and 25mg of Straterra (vs no Zoloft and 50mg of Straterra). I just assumed that the stomach issues were related to the med changes, and didn't feel like it was worth the med change right now. Her stomach was better for about a week and now even back on her original dosage, she is having stomachaches and nausea again. Sooooo, now I am thinking maybe she has the stomach problems because of her anxieties (a lot of things going on at school). So, 1 month ago I wanted her off the Zoloft, and now I am wondering if the Zoloft should be increased to help her anxieties. Am I all over the place or what? Anyway, I completely agree with what you are saying, that if our children are going to be taking the meds, the absolutely should be on the right dosage. How do I know that my daughter needs an increase? Are there questions I should be asking myself or her? Thanks for your ear Kathy! Re: Medications? 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. 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 5, 2004 Report Share Posted December 5, 2004 I know this was addressed to Kathy, hope you don't mind my " butting in " ... My daughter is on 20mg of Zoloft, and yet both her pediatrician and the pharmacist have made it pretty clear to me that we do NOT want to stop cold turkey and I need to make sure my prescription doesn't lapse. Whether they are being overly cautious or not I don't know, but I'm not taking any chances! nna. NY > Kathy, that is interesting that you brought that up...I have had this > debate in my mind for quite some time...My 8 year old is on 25mg of > Zoloft. She has been doing so for a little over a year. She had a very > sudden onset (suspected PANDAS) over 2 years ago. Her symptoms were bad > thoughts. She was treated for her strep at that time and her symptoms > went away. Months later her symptoms came back, as suddenly, but not > quite as bad (thoughts not quite as frequent). At that time our doctor > put her on Zoloft and her symptoms went away. I have often wondered > though whether or not it was the Zoloft that helped the thoughts go > away, because I realize now, 25 mg is a pretty low dosage. I struggle > like all of us with treating our children with meds, but if I know that > the meds are truly helping the OCD, I have no problem with my daughter > taking them. > > I have had this discussion with different doctors, whether I should try > taking my daughter off the Zoloft. She has not had any bad thoughts for > over a year, although she is a pretty anxious child, she seems to be > doing just fine. Just within the last month, her psych. and I decided > to increase her Straterra intake (because of her growth over the last > year) and take her off the Zoloft. Even the psych said I did not even > need to " wean " her off the Zoloft because it was such a low dosage (we > took her off " cold turkey). Well within 2 days of the med changes my > daughter was having really bad stomachaches and nausea. After 8 days of > the stomach problems arising, we brought her back to her original meds > of 25mg of Zoloft and 25mg of Straterra (vs no Zoloft and 50mg of > Straterra). I just assumed that the stomach issues were related to the > med changes, and didn't feel like it was worth the med change right now. > Her stomach was better for about a week and now even back on her > original dosage, she is having stomachaches and nausea again. Sooooo, > now I am thinking maybe she has the stomach problems because of her > anxieties (a lot of things going on at school). So, 1 month ago I > wanted her off the Zoloft, and now I am wondering if the Zoloft should > be increased to help her anxieties. Am I all over the place or what? > > Anyway, I completely agree with what you are saying, that if our > children are going to be taking the meds, the absolutely should be on > the right dosage. How do I know that my daughter needs an increase? > Are there questions I should be asking myself or her? > > Thanks for your ear Kathy! > > > Re: Medications? > > > 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. > > > > > 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@y... , louisharkins@h... , > louisharkins@g... . > > > Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.