Re: Ask Dr. Geller - Kathy S

[Guest guest]

(Go Dr Geller, working on a Sunday! His reply below)

kathy

if he is very symptomatic at zoloft 150 and he has been on this dose for over a

month, then it is unlikely that an increase to 200 will achieve the remission he

needs

if on the other hand its less than 4 weeks at 150mg, then worth increasing and

giving the full dose 8 weeks before a switch, most likely to an SNRI such as

Cymbalta at this stage

dg

>

> Dear Dr. Geller:

>

> I'm seeking your advice here.

>

> My 11-year-old son with OCD is undergoing a med switch from liquid prozac to

zoloft (pills). The reason for the switch was weight gain with prozac He went

from 60 pounds to 90 pounds in about 9 months. Otherwise, prozac was working

well for him. We tried at first to reduce the prozac amount, but the anxiety

came right back.

>

> Since the end of July he has reduced the prozac by 1 ML each week. Going from

32 MG to currently 1 MG. At the same time we started on the zoloft. 25 MG and

then increasing 25 MG each week. We are now at 150 MG.

>

> I'm writing because his anxiety is way up and his compulsions have returned

with a vengeance. The worst is at bedtime. His compulsions/bedtime routines have

dragged out from a couple of minutes to hours. The last time he was this bad was

when he was first diagnosed and not taking meds. He sees a therapist and

continues with ERP/CBT but it is no match for the increased anxiety.

>

> We last met with his doc two weeks ago when trouble was first brewing and we

agreed to ride it out. We meet with her again this week and I don't know what we

should do.

>

> Should we ride this out and hope zoloft will kick in (his final dosage level

may be 200mg)?

>

> Is this a sign zoloft isn't working and should we go back to prozac?

>

>

> Thanks,

>

> Kathy Sullivan

>

>