Re: Question about augmenting Luvox with a neuroleptic

[Guest guest]

Hi Shira,

My son, age 16, has been on Luvox (250mg) and Risperdal (now .5mg, but was

1.5mg) for two years without any negative effects. He has OCD and ADHD

inattentive, so he also takes Concerta (54mg). This past summer we began

lowering the Risperdal with the intent of eventually weaning him off.

Lee in CA

Question about augmenting Luvox with a neuroleptic

Hi,

Does anyone have experience with what my 11-year-old son's psychiatrist

calls " augmentation " of his 150 mg of Luvox with Abilify or Risperdal

(sp?)? I am so worried about using a medication like Abilify, which I read

has a great number of side effects. My son has numerous OCD and ADHD

symptoms, and has been struggling since last April.

Thanks so much,

Shira

[Guest guest]

There are limits on increasing SSRI's. Some people though

do not respond to one SSRI and do better on another. And I think

the researchers in anxiety write that if the person only

partially responds to one to try another. Yet I know

from our own experience our daughter's psychiatrist

wants to trial Abilify not trial another SSRI.

The Mayo Clinic even has a test to see how patients may respond

to SSRI's. Our therapist did have a patient that went there

and was told to switch meds to another SSRI.

Now what Dr. Hollander has written in his clinical trials

is that if an anxious/obsessed person has boarderline pyschosis those are the

people that respond to anti-psychotic drugs better.

And he writes that if the person has a certain kind of

EEG profile they may respond better to anti-convulsant

drugs.

So many kids with autism are given abilify or rispedal in

low doses and there have been clinical trials with many

of this class of drugs on young autistic kids (that all have

very obsessive behaviors). Yet there is not a lot of solid

evidence says Dr. Hollander " Clinical Treatment of Autism " that this class of

medication should be used except for reducing

aggressive out of control behaviors. Yet it is being used and

perhaps some people do respond.

I found Dr. Hollander's books very helpful, he lists clinical

trials of children on these medications and the side effects

and benefits. I found them very educational and I feel a little more

empowered in asking questions and making decisions. Depending

on how severe the issues I might " trial " one of these drugs

for my daughter. We are on zoloft at the max dose for autism.

I am trying to figure out if we trial a higher dose of OCD

pediatric patients.

It is hard to figure this out.

Pam

>

> Hi,

> Does anyone have experience with what my 11-year-old son's psychiatrist

> calls " augmentation " of his 150 mg of Luvox with Abilify or Risperdal

> (sp?)? I am so worried about using a medication like Abilify, which I read

> has a great number of side effects. My son has numerous OCD and ADHD

> symptoms, and has been struggling since last April.

>

> Thanks so much,

> Shira

>

>

>

[Guest guest]

Lee,

Did your doctor find that the Luvox wasn't enough to reduce your son's OCD

symptoms, and that's why he tried Risperdal?

Thanks so much,

Shira

>

>

>

> Hi Shira,

> My son, age 16, has been on Luvox (250mg) and Risperdal (now .5mg, but was

> 1.5mg) for two years without any negative effects. He has OCD and ADHD

> inattentive, so he also takes Concerta (54mg). This past summer we began

> lowering the Risperdal with the intent of eventually weaning him off.

> Lee in CA

>

> Question about augmenting Luvox with a

> neuroleptic

>

> Hi,

> Does anyone have experience with what my 11-year-old son's psychiatrist

> calls " augmentation " of his 150 mg of Luvox with Abilify or Risperdal

> (sp?)? I am so worried about using a medication like Abilify, which I read

> has a great number of side effects. My son has numerous OCD and ADHD

> symptoms, and has been struggling since last April.

>

> Thanks so much,

> Shira

>

>

[Guest guest]

Shira,

Short answer is yes. At the time he was hospitalized at . He had

intrusive thoughts OCD and his stress/anxiety level was so intense that until

the Risperdal was added he was unable to get anywhere with the therapy.

Lee

Question about augmenting Luvox with a

neuroleptic

Hi,

Does anyone have experience with what my 11-year-old son's psychiatrist

calls " augmentation " of his 150 mg of Luvox with Abilify or Risperdal

(sp?)? I am so worried about using a medication like Abilify, which I read

has a great number of side effects. My son has numerous OCD and ADHD

symptoms, and has been struggling since last April.

Thanks so much,

Shira

[Guest guest]

Hi Shira,

My son is 9 and started with ocd symptoms at age 4. He has tried 4

SSRI'S(Prozac, Paxil, Luvox and Celexa) and he has had a bad effect with all of

them. We then tried Risperdol which made him like a zombie, than went to

Seroquel, which worked for  awhile than petered out. We than went to Abilify

which again workded, than petered out. He has been on no psychiatric meds for

quite some time and is not doing well at all. The only time he seems to get

some relief is when he is on an antipsycotic

As others have stated,everyone is different and has different reactions to meds,

and what works for one will not work for another.

These meds are all scary to give to our kids, but I believe their quality of

life is what we have to take into consideration.

The only reaction my son had with Seroquel and Abilify was weight gain.

 

My daughter has been on zoloft for 9 years and just recently stopped it. Over

the years we have augmented her zoloft with several

antipsychotics.Abilify,Risperdol, Seroquel,Geodon,etc, .We never saw anything

but a worsening of her symptoms from those meds, so it truly is  trial and

error (unfortunately)

I wish you luck!!

Judy 

Subject: Question about augmenting Luvox with a neuroleptic

To:

Date: Tuesday, January 11, 2011, 10:39 PM

 

Hi,

Does anyone have experience with what my 11-year-old son's psychiatrist

calls " augmentation " of his 150 mg of Luvox with Abilify or Risperdal

(sp?)? I am so worried about using a medication like Abilify, which I read

has a great number of side effects. My son has numerous OCD and ADHD

symptoms, and has been struggling since last April.

Thanks so much,

Shira

[Guest guest]

Hi Shira,

As Judy says it is individual. Our experience was very bad, but probably

because the ssri dose our son was on was too high at the time(we learned after

the fact). The problems we were experiencing - anger, behavior - were mostly

due to too high dose of ssri, and adding risperdal to address these issues did

not help, but instead tipped the load further and resulted in our son being

hospitalized within 5 days.

The risperdal triggered serious compulsions, and eventually psychosis, in

combination with the ssri. This is not at all typical, and in fact the opposite

of what you would expect, as it is a mood stabilizer - but that's my kid with

medications, not typical... We went on to try all anti-psychotics with no better

result. This is so individual, period. I share this, not to frighten you,

because many people use risperidal and it is helpful, it is just so individual.

I also learned after, that some people lack an enzyme(?) that allows certain

drugs to be metabolized, of which risperidal is one. The only way you find

this out is by trying it, unfortunately. I understand there is testing of a

kind, but not sure if this would show up. Again, I share this, so that if you

do try this out you watch carefully and keep a journal of effects perhaps, which

is always a good idea anyway.

In terms of augmenting an ssri, there are mixed results with studies on this,

with not a lot showing vast improvement, from what I read. Still, many doctors

like to try this just to see. I have heard more positive results with using the

neuroleptics/antipsychotics to help deal with behavior. I have read that

risperidal can increase or trigger compulsions substantially(our experience) -

so I would watch for this in case.

Just wondering why they do not try going higher on the luvox first, or even

adding another ssri, or slowly switching ssri's? Other than the OCD not

improving how is your son, ie behavior etc? I wonder too about the ADHD and if

this is something to consider in terms of medications. These combinations of

disorders can become very tricky when it comes to medications.

Is your son able to do ERP therapy and actively doing this? Have you seen any

improvement at all since last April? You are also going into the more

challenging ages, teens around the corner....these ages can be resistant to ERP

therapy in particular. Do you think this may be a factor at all? It's really

hard to know what the sticking points are most of the time.

You can post your question to Dr. Geller, the psychiatrist on this list, and he

will be able to give you an expert opinion on the effectiveness of augmentation.

Just put " Ask Dr.Geller " in the subject line of your post.

Warmly,

Barb

>

> Hi,

> Does anyone have experience with what my 11-year-old son's psychiatrist

> calls " augmentation " of his 150 mg of Luvox with Abilify or Risperdal

> (sp?)? I am so worried about using a medication like Abilify, which I read

> has a great number of side effects. My son has numerous OCD and ADHD

> symptoms, and has been struggling since last April.

>

> Thanks so much,

> Shira

>

>

>