Guest guest Posted November 3, 2004 Report Share Posted November 3, 2004 Kathy: I noted your comment about augmenting and yes, I think I will suggest this. Thank goodness our doctors are very open to suggestions. You have so much wisdom in these OCD matters. What would you suggest we use for augmentation? There are so many options. I really appreciate you, Kathy! Your daughter is doing well, but you continue on this list and offer great encouragement and advice to all. Thanks, P.S. I am making contacts with Shands Clinic in Gainesville, Fl. in case hospitalization is needed. They evidently have a children's residence hospital called Vista with a highly recommended Dr.Kim White. Have you (or anyone else out there) heard of either? It appears that Dr. Tonya , who you recommended, does not work at the hospital, and I haven't found out if she's taking patients at the present--of course, it would be a 5-6 hour commute for us. Re: Zoloft question , has your child's doctor considered adding a small amount of a second SSRI rather than increasing the dose of the first SSRI? This augmentation approach worked well for my daughter and stopped the cycle of improvement, poopout, raise the dose, only to eventually have to switch SSRIs because she was taking the maximum suggested dose of the pooping-out one. Kathy R. in Indiana p.s. my daughter also takes Zoloft --> 150mg./day ----- Original Message ----- > Kathy: > > Would you mind sharing what dosage Zoloft your daughter is on to effective treat her OCD? Have you had the experience we have? When we increase the dosage, we fairly quickly gain new ground only to plummet within 2-3 weeks with an episode of severe depression, at which time an increase is made and the cycle continues. > > I feel like Zoloft is my best friend and worst enemy. > > 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., Aureen Pinto Wagner, Ph.D., and Dan Geller, M.D. 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 November 4, 2004 Report Share Posted November 4, 2004 Hi , thanks for the compliment :-) But please remember I am not a doctor, what I write is a combo of what I've read, and my experience with my child and what her doctor has chosen to do. Kellen's doctor augmented her 150mg Zoloft with 10mg Paxil. She was 5, about to turn 6 at the time, and Zoloft was the fourth SSRI trialed and the only one her doctor used augmentation with. She took this combo for about four years, we were able to drop the Paxil about a year ago. Augmentation is not a first-line approach but instead is typically used when a number of SSRIs have been tried and have failed to control symptoms. I think which SSRI is chosen for augmentation has to do with the child's particular response, Zoloft increased my child's hyper and inattentive behaviors and so Paxil was chosen I believe due to it being more sedating in many people. There is (or at least was) a flow chart by OCD treatment experts in the files section, this discusses when and how augmentation with a second SSRI is suggested by these experts. If you can't find it write me and I will try to scare up a copy for you. Dr. Tonya is (or was) a researcher at the Brain Institute, a part of Shands in Gainesville, and was taking private patients at least a couple of years ago. As I wrote before (to you?) we were very impressed with her, her knowledge, the way she was with our young daughter, to the degree that we considered moving to Florida so she could be our child's doctor. Of course it is a personal decision whether to pursue a doctor who is so many hours away from you, but she did consult with my child's ped. pdoc gratis twice. Perhaps she could or would see you infrequently, but have a hand in your child's treatment as well. I do not know Dr. White, but according to Dr. Aureen Pinto-Wagner adviser to this list, doctors and therapists associated with teaching hospitals are generally among the best with up to the minute training in treating OCD. We certainly found this to be true. Take care, good luck, Kathy R. in Indiana ----- Original Message ----- > Kathy: > > I noted your comment about augmenting and yes, I think I will suggest this. Thank goodness our doctors are very open to suggestions. You have so much wisdom in these OCD matters. What would you suggest we use for augmentation? There are so many options. > > I really appreciate you, Kathy! Your daughter is doing well, but you continue on this list and offer great encouragement and advice to all. > > Thanks, > > > P.S. I am making contacts with Shands Clinic in Gainesville, Fl. in case hospitalization is needed. They evidently have a children's residence hospital called Vista with a highly recommended Dr.Kim White. Have you (or anyone else out there) heard of either? It appears that Dr. Tonya , who you recommended, does not work at the hospital, and I haven't found out if she's taking patients at the present--of course, it would be a 5-6 hour commute for us. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2004 Report Share Posted November 4, 2004 Hi , thanks for the compliment :-) But please remember I am not a doctor, what I write is a combo of what I've read, and my experience with my child and what her doctor has chosen to do. Kellen's doctor augmented her 150mg Zoloft with 10mg Paxil. She was 5, about to turn 6 at the time, and Zoloft was the fourth SSRI trialed and the only one her doctor used augmentation with. She took this combo for about four years, we were able to drop the Paxil about a year ago. Augmentation is not a first-line approach but instead is typically used when a number of SSRIs have been tried and have failed to control symptoms. I think which SSRI is chosen for augmentation has to do with the child's particular response, Zoloft increased my child's hyper and inattentive behaviors and so Paxil was chosen I believe due to it being more sedating in many people. There is (or at least was) a flow chart by OCD treatment experts in the files section, this discusses when and how augmentation with a second SSRI is suggested by these experts. If you can't find it write me and I will try to scare up a copy for you. Dr. Tonya is (or was) a researcher at the Brain Institute, a part of Shands in Gainesville, and was taking private patients at least a couple of years ago. As I wrote before (to you?) we were very impressed with her, her knowledge, the way she was with our young daughter, to the degree that we considered moving to Florida so she could be our child's doctor. Of course it is a personal decision whether to pursue a doctor who is so many hours away from you, but she did consult with my child's ped. pdoc gratis twice. Perhaps she could or would see you infrequently, but have a hand in your child's treatment as well. I do not know Dr. White, but according to Dr. Aureen Pinto-Wagner adviser to this list, doctors and therapists associated with teaching hospitals are generally among the best with up to the minute training in treating OCD. We certainly found this to be true. Take care, good luck, Kathy R. in Indiana ----- Original Message ----- > Kathy: > > I noted your comment about augmenting and yes, I think I will suggest this. Thank goodness our doctors are very open to suggestions. You have so much wisdom in these OCD matters. What would you suggest we use for augmentation? There are so many options. > > I really appreciate you, Kathy! Your daughter is doing well, but you continue on this list and offer great encouragement and advice to all. > > Thanks, > > > P.S. I am making contacts with Shands Clinic in Gainesville, Fl. in case hospitalization is needed. They evidently have a children's residence hospital called Vista with a highly recommended Dr.Kim White. Have you (or anyone else out there) heard of either? It appears that Dr. Tonya , who you recommended, does not work at the hospital, and I haven't found out if she's taking patients at the present--of course, it would be a 5-6 hour commute for us. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 4, 2004 Report Share Posted November 4, 2004 Hi , thanks for the compliment :-) But please remember I am not a doctor, what I write is a combo of what I've read, and my experience with my child and what her doctor has chosen to do. Kellen's doctor augmented her 150mg Zoloft with 10mg Paxil. She was 5, about to turn 6 at the time, and Zoloft was the fourth SSRI trialed and the only one her doctor used augmentation with. She took this combo for about four years, we were able to drop the Paxil about a year ago. Augmentation is not a first-line approach but instead is typically used when a number of SSRIs have been tried and have failed to control symptoms. I think which SSRI is chosen for augmentation has to do with the child's particular response, Zoloft increased my child's hyper and inattentive behaviors and so Paxil was chosen I believe due to it being more sedating in many people. There is (or at least was) a flow chart by OCD treatment experts in the files section, this discusses when and how augmentation with a second SSRI is suggested by these experts. If you can't find it write me and I will try to scare up a copy for you. Dr. Tonya is (or was) a researcher at the Brain Institute, a part of Shands in Gainesville, and was taking private patients at least a couple of years ago. As I wrote before (to you?) we were very impressed with her, her knowledge, the way she was with our young daughter, to the degree that we considered moving to Florida so she could be our child's doctor. Of course it is a personal decision whether to pursue a doctor who is so many hours away from you, but she did consult with my child's ped. pdoc gratis twice. Perhaps she could or would see you infrequently, but have a hand in your child's treatment as well. I do not know Dr. White, but according to Dr. Aureen Pinto-Wagner adviser to this list, doctors and therapists associated with teaching hospitals are generally among the best with up to the minute training in treating OCD. We certainly found this to be true. Take care, good luck, Kathy R. in Indiana ----- Original Message ----- > Kathy: > > I noted your comment about augmenting and yes, I think I will suggest this. Thank goodness our doctors are very open to suggestions. You have so much wisdom in these OCD matters. What would you suggest we use for augmentation? There are so many options. > > I really appreciate you, Kathy! Your daughter is doing well, but you continue on this list and offer great encouragement and advice to all. > > Thanks, > > > P.S. I am making contacts with Shands Clinic in Gainesville, Fl. in case hospitalization is needed. They evidently have a children's residence hospital called Vista with a highly recommended Dr.Kim White. Have you (or anyone else out there) heard of either? It appears that Dr. Tonya , who you recommended, does not work at the hospital, and I haven't found out if she's taking patients at the present--of course, it would be a 5-6 hour commute for us. Quote Link to comment Share on other sites More sharing options...
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