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Re: Penn. Yes, I stayed in a hotel with my daughter while she was being

treated.

Studies have shown that the intensive out patient programs are no less effective

than the residential. What they do at Penn is build a hierarchy of exposures

with the patient in the first couple of days and by day three they are doing

things that you never thought possible. The patients are given " homework " for

the time that they are not at the center. They really do a lot of exposure work

during those weeks. We live in NJ and were able to go home on the weekends, and

my daughter had to continue her exposure work at home.

She truly was given her life back. Now that she's back at school, she struggles

at times, but has the proper tools to push back. It's never easy with this

dreaded disorder, but ERP is the best treatment we have, and when implemented

properly can be a lifesaver.

Good luck with whatever you decide.

Terry

> Terry and Bonnie, thank you. As far as his experience on meds goes, when he

had a bad episode five years ago the doctor placed him on (eventually) 30 mg of

Lexapro and 25-50 of Seroquel. It worked really well for four plus years. After

being on it for a while, few if any side effects remained, only that the

Seroquel made him sleepy. Around a year ago, he started dating someone he really

cared about and instead of making him happy, it seemed to make him anxious and

depressed. He just didn't feel he was good enough to hold on to her- -I'm not

sure if it was an OCD thought or depression. We took him to see a CBT specialist

in our area, and he pointed out all of his thinking errors/automatic negative

thoughts and it helped some, as did the school counselor. We wondered weather

the medication had stopped working, since we've heard that happens sometimes. We

decided, along with our son and pdoc, to try changing to a different med during

the last half of the

> summer, when he didn't have much going  on. Luvox didn't work, and wasn't

being absorbed at all by him. Pdoc started wondering if he is a poor

metabolizer, decided to try Prozac because it has very predictable blood plasma

levels at a given dose. Also, we were still thinking that Lexapro was no longer

effective. He had developed some very strong OCD thoughts as well as depression

while taking 30mg of Lexapro, augmented by Seroquel. So, we weren't ready to

back to that. After starting Prozac at 10mg, went to 20mg fairly quickly and

stayed there for a while, then 40, now 50. Also, pdoc wanted us to go to 100 mg

Seroquel, all taken at bedtime. While the ensuing blood test showed that he was

within range for the given dose, he was at the low end of the range and from our

observations, still deteriorating. Pdoc had said that it might take 60 or 80 mg

to have an effect on the OCD. The goal is to use Prozac only and taper off the

Seroquel once Prozac reaches

> a therapeutic dose. However, the week before Christmas break he basically

stopped going to school, then stopped getting out of bed. His thoughts are

primarily body-focused and he has what is called Overvalued Ideations- -he

doesn't believe that his thoughts are OCD. He CANNOT be talked out of his

beliefs about injuries and permanent damage being wrought upon his joints if he

sits in a hard chair, for instance. We have now tried adding 2.5 mg of Abilify

at night. That has helped a bit, and I suppose the Prozac is still building in

his system. Last time we tried Abilify it was when he was taking fluvoxamine. We

did 5 mg of Abilify and had the restless leg syndrome side effect. So far, he

hasn't developed that side effect from the 2.5 mg.  We are having some bright

spots sprinkled in among the bad days. He is at school right now!!!! He is

miserable and called me between class- -I'm not sure if he'll make it the whole

day.

>  

> So, the question in my mind is: did the Lexapro stop working or did the

girlfriend and the stress of senior year/college do him in? The pdoc says that

the SSRI's do stop working sometimes and no one has figured out why this

happens. But I can tell you that senior year is a real killer. There is so much

to do and so much pressure on these kids. Had I known what I know now, I would

have changed meds earlier and pushed him to take an easier schedule.

>  

> If we can't keep him in school, we may have to go with an intensive program.

Thank you for the info regarding the Penn program. Are they only there for two

hours a day? I'm wondering if two hours a day for three and a half weeks is

enough for my son. I guess if you're from out of town you stay in a hotel

together with your child during that time?....

>  

> I've also heard some good things since my last post about the Houston OCD

Center (formerly Menninger). However, they don't take insurance. They will help

you negotiate with the insurance company but the patient is responsible for

direct payment, in advance.

>  

> Worried Mom

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