Re: Ask Dr. - REPLY to Christie

[Guest guest]

Wow it sounds like you've had a real struggle. Although I haven't met your son,

I can discuss some of the issues you raise in general terms. OCD and ADHD often

do occur within the same individual, and OCD worsens during times of stress. In

response to OCD worsening, I'd be more inclined to increase an SSRI such as

fluoxetine than to decrease it (which may lead to more worsening)--- since he

did not tolerate an increase to 40mg, an increase to 30mg could be

considered.... alternatively switching to another SSRI medication may also help

in the future..... buspirone has not been proven effective for OCD....

I hope this is helpful.

Best,

>

> 2 years ago our son (now 14) was diagnosed with OCD and an anxiety disorder.

Doctor put him on 20mg of prozac and we've been pretty good until about two

months ago. He is a freshman in HS and worries about everything. He is super

afraid of making mistakes, so classes are stressful. We started the wrestling

season in December and this put on extra pressure. With his OCD, we do not see

rituals. Just intrusive thoughts, guilt, the need for reassurance, and lots of

anxiety. Family MD said to double his dosage of Prozac to 40mg. We did this in

December for about 3 weeks, but I noticed more anxiety. Doctor sent us to a

psych. This doctor talked with our son for about a half hour and diagnosed him

with ADD. Said he also has OCD and anxiety to help keep his life in control.

We had never noticed the ADD before, but therapist said makes sense to her since

maybe he tries so hard to be " perfect " and uses up other chemicals in brain -

which result in OCD and anxiety. Psych. prescribed Concerta for the ADD. He

didn't think he would need an antidepressant, so told us to half his Prozac to

10mg and use busbar (as needed). After about a week of this, I called psych and

told him that son had so much anxiety. Was having intrusive thoughts again.

Felt overwelmed and trapped. His suggestion was to stop the Prozac, put him on

Abilify, put him on Klonopin and keep him on Concerta. After much thought, my

husband and I decided that we didn't want to do this many changes until we got

thru the wrestling season. We put him back on 20mg a day of the Prozac, kept

him on the Concerta and are using the busbar as needed. He seems to be doing

just " okay " . Still seems " worried " . Calls me for reassurance. My question for

doctor (and parents) is, have you noticed an increase in anxiety if prozac is

increased too high? Would it help to maybe just increase to 30 mg instead of

40mg since we've had success in the past. Or do medications just stop working

after awhile. He is growing and going thru puberty. OR - would switching him

to Zoloft be a better choice? I've noticed many on this board have used Zoloft.

Are my worries about Abilify and Klonopin justified? Thank you for any

reassurances you can give.

>

[Guest guest]

Yes this was helpful!  Thank you!  When you say Buspirone has not been proven

effective with OCD, will it help with his anxiety?

 

Christie

 

To:

Sent: Tuesday, February 7, 2012 7:47 PM

Subject: Re: Ask Dr. - REPLY to Christie

 

Wow it sounds like you've had a real struggle. Although I haven't met your son,

I can discuss some of the issues you raise in general terms. OCD and ADHD often

do occur within the same individual, and OCD worsens during times of stress. In

response to OCD worsening, I'd be more inclined to increase an SSRI such as

fluoxetine than to decrease it (which may lead to more worsening)--- since he

did not tolerate an increase to 40mg, an increase to 30mg could be

considered.... alternatively switching to another SSRI medication may also help

in the future..... buspirone has not been proven effective for OCD....

I hope this is helpful.

Best,

>

> 2 years ago our son (now 14) was diagnosed with OCD and an anxiety disorder.

Doctor put him on 20mg of prozac and we've been pretty good until about two

months ago. He is a freshman in HS and worries about everything. He is super

afraid of making mistakes, so classes are stressful. We started the wrestling

season in December and this put on extra pressure. With his OCD, we do not see

rituals. Just intrusive thoughts, guilt, the need for reassurance, and lots of

anxiety. Family MD said to double his dosage of Prozac to 40mg. We did this in

December for about 3 weeks, but I noticed more anxiety. Doctor sent us to a

psych. This doctor talked with our son for about a half hour and diagnosed him

with ADD. Said he also has OCD and anxiety to help keep his life in control. We

had never noticed the ADD before, but therapist said makes sense to her since

maybe he tries so hard to be " perfect " and uses up other chemicals in brain -

which result in OCD and

anxiety. Psych. prescribed Concerta for the ADD. He didn't think he would need

an antidepressant, so told us to half his Prozac to 10mg and use busbar (as

needed). After about a week of this, I called psych and told him that son had so

much anxiety. Was having intrusive thoughts again. Felt overwelmed and trapped.

His suggestion was to stop the Prozac, put him on Abilify, put him on Klonopin

and keep him on Concerta. After much thought, my husband and I decided that we

didn't want to do this many changes until we got thru the wrestling season. We

put him back on 20mg a day of the Prozac, kept him on the Concerta and are using

the busbar as needed. He seems to be doing just " okay " . Still seems " worried " .

Calls me for reassurance. My question for doctor (and parents) is, have you

noticed an increase in anxiety if prozac is increased too high? Would it help to

maybe just increase to 30 mg instead of 40mg since we've had success in the

past. Or do

medications just stop working after awhile. He is growing and going thru

puberty. OR - would switching him to Zoloft be a better choice? I've noticed

many on this board have used Zoloft. Are my worries about Abilify and Klonopin

justified? Thank you for any reassurances you can give.

>

[Guest guest]

Yes this was helpful!  Thank you!  When you say Buspirone has not been proven

effective with OCD, will it help with his anxiety?

 

Christie

 

To:

Sent: Tuesday, February 7, 2012 7:47 PM

Subject: Re: Ask Dr. - REPLY to Christie

 

Wow it sounds like you've had a real struggle. Although I haven't met your son,

I can discuss some of the issues you raise in general terms. OCD and ADHD often

do occur within the same individual, and OCD worsens during times of stress. In

response to OCD worsening, I'd be more inclined to increase an SSRI such as

fluoxetine than to decrease it (which may lead to more worsening)--- since he

did not tolerate an increase to 40mg, an increase to 30mg could be

considered.... alternatively switching to another SSRI medication may also help

in the future..... buspirone has not been proven effective for OCD....

I hope this is helpful.

Best,

>

> 2 years ago our son (now 14) was diagnosed with OCD and an anxiety disorder.

Doctor put him on 20mg of prozac and we've been pretty good until about two

months ago. He is a freshman in HS and worries about everything. He is super

afraid of making mistakes, so classes are stressful. We started the wrestling

season in December and this put on extra pressure. With his OCD, we do not see

rituals. Just intrusive thoughts, guilt, the need for reassurance, and lots of

anxiety. Family MD said to double his dosage of Prozac to 40mg. We did this in

December for about 3 weeks, but I noticed more anxiety. Doctor sent us to a

psych. This doctor talked with our son for about a half hour and diagnosed him

with ADD. Said he also has OCD and anxiety to help keep his life in control. We

had never noticed the ADD before, but therapist said makes sense to her since

maybe he tries so hard to be " perfect " and uses up other chemicals in brain -

which result in OCD and

anxiety. Psych. prescribed Concerta for the ADD. He didn't think he would need

an antidepressant, so told us to half his Prozac to 10mg and use busbar (as

needed). After about a week of this, I called psych and told him that son had so

much anxiety. Was having intrusive thoughts again. Felt overwelmed and trapped.

His suggestion was to stop the Prozac, put him on Abilify, put him on Klonopin

and keep him on Concerta. After much thought, my husband and I decided that we

didn't want to do this many changes until we got thru the wrestling season. We

put him back on 20mg a day of the Prozac, kept him on the Concerta and are using

the busbar as needed. He seems to be doing just " okay " . Still seems " worried " .

Calls me for reassurance. My question for doctor (and parents) is, have you

noticed an increase in anxiety if prozac is increased too high? Would it help to

maybe just increase to 30 mg instead of 40mg since we've had success in the

past. Or do

medications just stop working after awhile. He is growing and going thru

puberty. OR - would switching him to Zoloft be a better choice? I've noticed

many on this board have used Zoloft. Are my worries about Abilify and Klonopin

justified? Thank you for any reassurances you can give.

>