Another skin picking thought...

Discussion in 'General Parenting' started by gcvmom, Oct 2, 2009.

  1. gcvmom

    gcvmom Here we go again!

    difficult child 1 is still picking at his upper arms, and now one of his knees has scabs on it from picking.

    Something jogged my memory about a medication he was taking up until the start of the summer which was right around when the skin picking took off. We dropped the Elavil (a tricyclic) he was taking for his IBS because I wanted to see if he'd do o.k. without it now that the stress of school was over. I never even thought about the possibility this medication could have been helping him in other areas.

    I'm going to ask the psychiatrist, but do you think that just that low dose (10mg) of Elavil he was on could help curb the picking? He was on it for a little over a year. I don't recall him picking before then (except for a looong time ago before he started Lexapro (which was changed to Celexa this summer).

    Just wondering out loud.

    And FWIW, when we had him on a low dose of imipramine in early elementary school for enuresis, he did GREAT. His irritability went away and he was less anxious. Maybe that could just be a better class of medication for him....

    More to chew on.
  2. flutterby

    flutterby Fly away!

    You could certainly give it a try; start at a low dose and work up if needed.
  3. gcvmom

    gcvmom Here we go again!

    I guess it can't hurt to put him back on it and see how he does. I'm really getting alarmed at the scars he's going to leave if this doesn't stop.
  4. flutterby

    flutterby Fly away!

    Skin picking, I think, is an Obsessive Compulsive Disorder (OCD) thing - which is an anxiety thing. (Don't you love my technical terms?) So, it seems like elavil would be a good choce to start with.
  5. flutterby

    flutterby Fly away!

    Oh...and since he's already on an AD, you'll probably want to keep it at a low dose (the elavil) anyway. You have to be concerned about serotonin syndrome. I do ok with 20mg lexapro and 10mg elavil.

    If psychiatrist isn't comfortable with that, and you noticed he didn't pick on Lexapro, you may need to switch back to lexapro from celexa. They are very similar medications, but lexapro is better at some things than celexa.
  6. gcvmom

    gcvmom Here we go again!

    Heather, he was on 10mg Elavil before when he was taking 20mg Lexapro and did fine. We'll try that again.
  7. smallworld

    smallworld Moderator

    Just wanted to add that tricyclics fell out of favor when SSRIs were introduced because they can have rare cardiac side effects (and are lethal when overdosed). But according to our psychiatrists, tricyclics can be excellent medications in certain situations, particularly for anxiety. In my family, we react poorly to SSRIs and respond very favorably to tricyclics.

    I have been on either Nortriptyline or Amitriptyline for most of the last 4 years for migraines, IBS, insomnia and stress. In mid-September I went in for major reconstructive foot surgery, and my husband said he had never seen me so calm facing such a stressful situation. I know it's because I'm taking 15 mg Amitriptyline.

    This is all my long way of saying that I agree difficult child 1's skin picking could clear up by putting him back on Elavil (and it'll help his IBS, too).
  8. totoro

    totoro Mom? What's a GFG?

    Besides all of the medical reasons you should look into... if none of the medications seem to have an effect, have you ever looked into n-acetyl cysteine?
    It has just been given the thumbs up for the treatment of Trichotillomania, but has shown a positive affect in previous studies for other Obsessive Compulsive Disorder (OCD) and anxiety symptoms.

    Here is an excerpt from a medical trial-
    * There is no FDA approved treatment for the condition, but previous clinical studies have shown that glutamatergic modulators, such as N-acetylcysteine, may be effective in treatment of repetitive or compulsive disorders.

    N-acetylcysteine is a hepatoprotective antioxidant that is converted to cystine, a substrate for the glutamate-cystine antiporter.

    The researchers wrote that it may reduce compulsive behavior by restoring the extracellular glutamate concentration in the nucleus accumbens, the portion of the brain thought to play a key role in reward, laughter, pleasure, addiction, and fear.
    The dosage is 1200-2400 mg a day, just depends on how you respond. K's psychiatrist has her on it. She just started this week. I am starting it also, so we will see!
    I tend to pick and chew my nails obsessively and when anxiety is worse all of my Obsessive Compulsive Disorder (OCD) like things get worse.
    K has been pulling out her eyelashes and biting herself and hitting herself.

    So we are giving it a try.
    But these are things she has always done when anxious or unstable. In some form or another.
    I put all of these things in the same grouping, cutting, biting, scratching, hitting, self injury etc. It is all forms of relief, anxiety control, instability or medications. being whacked for people.