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Zoloft / antipsychotics

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My ds 14 is currently seeing a psychologist and he is on 50 mg. of Zoloft. He

has been doing CBT/ERP for almost a year now and his OCD has improved quite a

bit. We recently upped his dose of Zoloft from 37.5 mg to 50 mg. This was due

to his issues with school, and more specifically, with a certain kid at school.

He feels this kid is talking/laughing about him. Last year this kid said weird

things to him and once would not let him by him in the hallway. Also he fears

for his safety, kid has said stuff about gun/knife in reference to my ds

(according to ds, not sure if this is real or perceived). My ds has had

paranoid thoughts before - thinking someone is following us while driving, fears

about gangs, burglers, etc. Anyway, his dr. said if these paranoid thoughts did

not go away, they would put him on an anti-psychotic med. as well. Isn't even

50 mg. of Zoloft a fairly low dose, why wouldn't they first try higher doses of

Zoloft? - he has not had any side effects with that yet. Could paranoid thoughts

be byproducts of OCD? I guess I am not understanding difference between

paranoid thoughts and OCD thoughts/fears? The dr. said they were concerned

because his thoughts tend more toward being harmed by others and OCD thoughts

were more fears of harming others or bad thoughts.

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