Anxiety

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Sleeplessof2

Guest
Hi folks--

Many of you welcomed me warmly when I joined back in April. I don't write much but read often. Today was the day I have been waiting for since April. We finally met with a new pshychiatrist. After a 2 hour conversation he concluded that difficult child has anxiety. He appreciated my opinion on avoiding any drugs, but offered these as options if we choose. Prozac,Paxil or Remeron. This is all new to us so we are once again reaching out to you all for advice. I'm looking for feedback on these drugs and also any good books about Anxiety specifically. I trusted this dr. and felt very comfortable with him (for once). I really think he nailed it too. It all makes sense. The visit was not covered on our insurance and left the office making a car payment but felt very good about it. As always, we apprecaite all views.
 

smallworld

Moderator
Did the psychiatrist give you reasons for why he was suggesting those three medications? What symptoms of anxiety is your difficult child displaying? For example, Remeron might be prescribed if a child is having trouble eating or sleeping.

FWIW, Paxil is NOT recommended for use in children. Google it and you'll see why. It can cause a strange disinhibition in children, even if they do not have an underlying bipolar disorder. It happened to my middle child, and it was very scary. Plus Paxil is very difficult to wean from once you're on it for a while.
 

tictoc

New Member
Sleepless,
I recommend the book, "Straight Talk About Psychiatric Medications for Kids," by Timothy Wilens. It has a good discussion of various medication options and their pros and cons.

Good luck.
 

susiestar

Roll With It
I am glad that you felt comfortable with the new psychiatrist. It is SO important to have a psychiatrist you can work with. What did difficult child think of him? How did they treat each other?

Did he give you any reasons why he suggested those specific medications? Anxiety is very common in difficult children and can cause many problems and/or make them worse. I know that prozac is approved for kids, as is zoloft. They both come in liquid form, or they about 6 years ago. ANY SSRI/SNRI can cause disinhibition in children. My daughter acted and sounded like she was stoned on both of them, though the zoloft was worse. She totally loved school and adored her teacher. She would have done almost anything to make her teacher happy. While on zoloft she lead her entire class in a conga line around the room when the teacher tried to get them to start a lesson after lunch. It was totally and completely out of character for her. It also is NOT uncommon. One psychiatrist told us that it is the most common "adverse" reaction to these medications.

Remeron is usually prescribed as a sleep aid because it is terribly sedating. If she has trouble sleeping it might be worth a try. But I would NOT give a dose at any time other than bedtime. At least not at first. When I was on it I took 1/8th of the lowest dose and still couldn't wake up after 14 hours of sleep.

There are a LOT of other medications and treatments for anxiety. You might google "anxiety treatment for children" for other ideas.

I hope you can find a way to help her. Anxiety can be terribly crippling.

(((hugs))) and Welcome Back!!!

ps. I would check with your insurance company to see if they will cover prescriptions written by an out of network doctor. We have had a few companies that would not cover anything prescribed by an out of network doctor. Not medications, lab work, imaging, therapy, or anything at all. If this is the case, ask the doctor to speak to your child's pediatrician to get the pediatrician to order medications and treatment.
 

GoingNorth

Crazy Cat Lady
Remeron also stimulates appetite to a noticeable degree. It is a weird medication as the lower the dose the more sedating it is. I take it for anxiety, sleep problems, and to counter loss of appetite from the Haldol
 

smallworld

Moderator
It is true that any SSRI/SNRI can cause disinhibition in children, but researchers at NIMH did a study and I believe Paxil and Effexor were twice as likely to cause disinhibition in children than Prozac or others. I'll have to see if I can dig up the study.
 

Marguerite

Active Member
We've tried antidepressants for anxiety with good results. difficult child 1 was put on Zoloft and has no problems with it (thank goodness). His wife also takes it - again, no problems. But there can be problems especially when someone first takes it.

difficult child 3 couldn't take Zoloft, he wouldn't sleep. He was 5 when it was prescribed. Then he was put on Luvox, but was allergic. Since then, no ADs for him.

easy child 2/difficult child 2 had stomach problems and was put on tryptanol for it. It doesn't get used as an AD any more, but it not only settled her stomach, it also calmed her anxiety. Then she didn't need it any more for her stomach and since then, has been a huge problem. Finally the doctor put her on Zoloft and she's so much better on it.

The drugs you mention - I don't have experience of those specifically. But medications in general to treat anxiety - I can highly recommend it.

Marg
 
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Sleeplessof2

Guest
Thanks guys---knew I could count on you. He does have sleep disorders so that's why I think he prescrbd the Remeron. All very intersting info. I saw one mention of a book does anyone else have any other ideas of good books on anxiety? Thanks.
 

BusynMember

Well-Known Member
I have a diagnosis that includes gneralized anxiety disorder, panic attacks and panic disorder.I can tell you right off the bat that anxiety almost never is the only problem going on. It either goes hand-in-hand with depression or autistic spectrum disorder (Aspergers?). It is a symptom, but rarely the entire issue.

I've been on a slew of medications including Prozac (made me worse), Paxil (practically cured me) and I don't have a clue why he is suggesting Remeron, but I haven't heard of others having much good luck with it (plus you gain a ton of weight, but all antidepressants can cause weight gain). There isn't any way we can suggest a medication since all people react differently to medications. I couldn't take Zoloft...after two weeks I ended up in the hospital with a toxic reaction. Just monitor him carefully. in my opinion a neuropsychologist evaluation is better than a psychiatric evaluation because they do intensive testing...6-10 hours...and tend to find the underlying causes of the problems. Back to the anxiety, it is important for the child to learn how to quiet himself too. medications alone won't solve everything. From over thirty years seeing psychiatrists for me and my sons, I've learned that psychiatrists rarely try much beyond pushing medication and changing the medication and trying to fix things through just medication. Again, I like NeuroPsychs better for diagnosing. If you go with a psychiatrist you need to expect it to be mostly about switching medications or monitoring medications. Often they misdiagnose because it's not an exact science. Just keep your mind open and see if your child seems better or worse or the same. Doctors aren't Gods, although sometimes they think they are...haha!

From one who has been there ;) Good luck, whatever you decide to do.
 
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smallworld

Moderator
My daughter has an eating disorder (choking phobia) so she is on Remeron with excellent results. She also sleeps like a rock.

A book I've found beneficial is Helping Your Anxious Child by Ronald Rapee et al.
 

TerryJ2

Well-Known Member
I'd definitely go with-MWM. There is more going on here.

I also, in my humble opinion, do not like Prozac, because I know too many people who have had issues with-it, either headaches etc., or forgetfulness. If I had to choose between those two, I'd go with-Zoloft.
But my impression is that Remeron is better for kids. I could be wrong.

At least you've got a start. One thing I have done is that when I express a lot of doubt about a medication, saying that difficult child might get sick, and I hate to spend all that money and then only use 4 pills, all of a sudden, the dr comes up with-2 mo's worth of free samples.
It's worth a try!
 

Andy

Active Member
My difficult child was older (11 years old) when he was diagnosed with Anxiety Disorder. His issues went into deep self-harm thoughts that although not suicidal could have found him dead if he followed through with them. His anxiety was so prominent that nothing else was diagnosed at the time. Prozac was a miracle drug for him. I refused to look at Zoloft because a friend of ours with a child the same age became suicidal on Zoloft and because his pediatrician was too quick for us to try it with a "Hmmm, I don't know what this is. I THINK it is anxiety. Here, have him take Zoloft as I direct and everything will be fine." Hmm, nope, not giving any child a medication like Zoloft based on a "I don't know, I think." Anyway, you have heard others here who have had success with it and maybe it would have been o.k. for my difficult child.

Our goal from the very beginning was to become medication free. difficult child needed to learn tools to control his anxiety but needed medication until he could handle them. He is still on an anxiety medication but we just reduced the dosage - his psychiatrist believes the symptoms he is starting to display is an indication that the medication is at too high of a dose - difficult child is not needing it. We will see!

Each medication affects each person so differently. What works so well for one will not work on another. Thus the difficulty in finding the right one. We have been fortunate that each medication given has been what difficult child needed for the time (even one that did become a disinhibitent which I kept him on for just a few months to get him through school our first year of he!!).

Take what everyone has said, do your research, and ask for the one that seems the best for your child. I do not know Remeron but if others have had success in kids with sleeping problems, that might be my choice for your child though I don't know enough about him to even begin to choose.

It is scary to start your child on a new medication. However, if the doctor does it well and you are very alert to changes in your child's behavior, it will be o.k. My difficult child's doctor will start my difficult child out on a lower dose just to look for side effects and slowly increase it until it is where we need to be. Sometimes I have asked for an increase before the alloted time always with difficult child and the doctor's blessings. If you doctor does this and asks you to report back in one or two weeks, do not hesitate to call back even sooner if you see ANYTHING that you are not comfortable with. Just be aware that any medication given can change over time (increase dosage or become ineffective causing you to look at a different medication).

Having a doctor who will work with you is so important. Your difficult child's doctor must listen to your concerns since you really do know your child better. My difficult child has since been put on a medication that decreases his appetite. That was a concern to me because he does not need to start loosing weight. His psychiatrist listened to my concerns and we discussed options around it. It puts me at ease knowing that difficult child is really the top priority for psychiatrist's input.
 

susiestar

Roll With It
I would fight tooth and nail before a family member of mine was put on effexor. It is one of the hardest SSRI/SNRI medications to take and to stop taking. It does help many people but the side effects are just too much for it to be a sensible choice, esp for it to be the first medication you try.

Not only is weight gain a problem, it is one of the minor problems - at least in my opinion. Effexor has a very short half-life (meaning that the body can clear out half the medication in a very short time) and if you take your dose even one hour late you are likely to feel withdrawal symptoms. You can find a whole list of them by googling "effexor withdrawal". One of the side effects is called brain shivers. It is hard to describe but it literally is like an electric jolt in your brain. It can happen if you turn your head quickly, but movement is not needed to feel it. It can also increase anxiety. I have always been a fairly social person. Never had a problem going anywhere, with or without a group. A couple of weeks on effexor and I was almost unable to leave the house. I was also afraid to be around people, no matter how well I knew them. It was truly awful.

Stopping the effexor was brutal. I felt like I had the flu. Even though the medication leaves the body fairly rapidly the withdrawal still lasts for several weeks. Your body has to get used to not having the medication and it is not a short process.

There are many people, including members here, who take effexor and have minimal problems or the problems go away after a couple of weeks on the medication. Knowing that, I would still want to try quite a few other medications before I tried effexor.

There are non-medication therapies for anxiety. If there is any PTSD component to her anxiety EMDR therapy is excellent for treating it. You can google EMDR therapy to find therapists who use it. Biofeedback is highly effective for anxiety in many cases. One member here bought a gadget called a stress eraser for her son. It is a little rectangular box that you put a finger in. Then you work on relaxing and deep breathing by watching the cues on the little screen. This website has a video that tells more about it.

http://stresseraser.com/stresseraser-refurbished/?gclid=CJaixJyrvaICFRbyDAod3yVX6Q

You can also search for biofeedback devices on amazon.com.

Meditation is another great way to treat anxiety. My husband has used guided meditation for years to help with all sorts of things. He got me hooked on it while we were still dating and now our younger two also love it. Guided meditation has you listen to a voice talk you through various breathing exercises, relaxation techniques and thoughts. It can help you calm down or even go to sleep. I often use the meditations when I am fighting a migraine.

It may sound strange, but does your difficult child ever listen to audiobooks? Many people find them calming. Years and years ago my father read several Uncle Wiggily books onto tapes for my oldest (who was a toddler at the time). Something about his voice is incredibly soothing. It not only soothed my savage difficult child, it also worked on other people. We could not play them in the car except with headphones because they relaxed husband and I too much! Gpa was a jr high teacher at the time and tried the tapes with some of the students in his school who had anxiety and other problems. It was amazingly effective at helping the students to calm down or stay calm. While I cannot send my dad's tapes to you, you could find other audiobooks to try. Mary Pope Osborne reads the Magic Tree House books and they are very soothing to listen to. They also appeal to both boys and girls. (If you are not aware of them, they feature a brother and sister who find a magic treehouse and travel all through time to help make sure the right things happen. They are well researched and your son is at about the right age for them, or at least the age when my youngest liked them.) They are available on amazon in sets. The first 8 books in the series are about $20 on CD from amazon.

You might also look for audiobooks read by the dad from Happy Days. Not sure of his name off the tip of my tongue, but we used to have a couple of audiobooks read by him that were calming to my kids.
 

Andy

Active Member
You can get stresserasers through a GNC store. They were not on the shelf at our small town store. I had gone onto their website and looked up the info, took it to the store employees and they ordered it for me. When it came, I signed up for their membership club to get I think 15% off of all products for a year including this item.

I don't feel comfortable getting things through the mail so this was a great option for me. If you don't have a GNC store close by, find a website for any health store you do have and see if they carry the stresseraser.
 

TerryJ2

Well-Known Member
"Hmmm, I don't know what this is. I THINK it is anxiety. Here, have him take Zoloft as I direct and everything will be fine."

I hate it when doctors do that.

Interesting, all of us here have had or have known someone who has had a bad experience with-nearly every drug. Sorry to make it so confusing, Sleepless!
 
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