medications for anxiety for 8yr old? *UPDATE*

[Indianamomof4]

Well, my difficult child had his psychiatry appointment. yesterday. He and I both feel that maybe since NONE of the medications he's tried for ADHD have been well tolerated (Concerta, Adderral, Straterra, the patch, and Straterra again, in that order), that maybe we're treating the wrong thing.

So, we're now looking at treating him for anxiety, but psychdoc said it's treated normally by an anti-depressant. Really? I didn't think that was so.

He won't prescribe until the pediatrician doctor views the report from the neuropsychologist and has her say, which is next Thursday.

Any of you have experience with anti-anxieties? If so, which ones? What kinds of side effects came with them?

Thank you so much.

 

[smallworld]

Your psychiatrist is correct. As a first-line treatment plan, most childhood anxiety is treated with SSRI antidepressants (for example, Prozac). Other medications that are sometimes prescribed are the atypical antipsychotics (for example, Risperdal and Seroquel), but they have a significant side-effect profile. Buspar is another medication that is sometimes used. The Benzodiazapines (for example, Xanax, Klonopin and Ativan) are sometimes prescribed in the short term, but they are not used long term for children because they can be addictive.

Good luck.

 

[Josie]

When my easy child was being treated for anxiety, we started with buspar. She had bad headaches from that so we tried a few SSRI's. She had side effects from those and around that time was put on amitriptyline for migraines. The amitriptyline worked well for her anxiety but it is not generally used for anxiety as far as I know.

I think for kids, anxiety is treated with the SSRI's first. I was told they do not like to use the benzos with children because they are so addictive.

 

[smallworld]

The tricyclic antidepressants (Amitriptyline and Nortriptyline) are sometimes used for anxiety, but there were a few cases of heart problems in children so they are generally not prescribed as first-line treatment. Any child taking a tricyclic should have regular heart monitoring.

 

[Indianamomof4]

What's a tricyclic? Also, what is Focalin?

 

[Marguerite]

This stuff is not good news for me - I've been planning on raising this issue again with difficult child 3's paediatrician, but everything you suggest has already been tried and we can't do it. He has adverse reactions to antidepressants and risperdal simply isn't effective enough. Plus, for us it's prohibitively expensive. it it worked, fair enough. But it doesn't. Not for us. Blast!

However, the benzos as short term - that could work for us. difficult child 3 is getting better at managing his anxiety, thanks to his sessions of cognitive behaviour therapy, we would only need the benzo when we know he's going to have a bad day (such as when we took him to Rotarua, when he was terrified of vulcanism - he was feeling nauseous and really ill all day, could not accept that he could feel this bad just from anxiety).

This is another wonderful example of someone's request being really helpful for others!

Marg

 

[smallworld]

Tricyclics are an older class of antidepressants that were used before SSRIs were introduced. Focalin, a refined version of Ritalin, is a stimulant used to treat ADHD.

 

[smallworld]

Marg, have you tried a tricyclic AD for difficult child 3? We may be going to that for my easy child/difficult child 3 because Prozac hasn't been all that effective. In addition, there are other atypical antipsychotics if Risperdal wasn't all that effective.

 

[Marguerite]

I'll have to dig back through the records. I do remember he tried Luvox and was allergic to it. He tried Zoloft and was manic. I think he's tried others too, with weird reactions.

I can't take either tricyclics or SSRIs, I get either manic or sedated to zombie level, even on the tiniest dose. I also reacted to pot very badly, the one time I actually ingested some (technically, it was assault because I didn't know I was eating HASH brownies). I had an over-the-top reaction and a three day weirdness. I also used to get very ill (sick on the stomach; gastric symptoms) just be being around someone who was smoking it. When I saw difficult child 3 having similar reactions, I have wondered ever since if it's a brain chemistry thing, he and I are just incompatible. I would be interested to find out if there is any connection to antidepressants and pot, in terms of brain pathways. But I WILL ask the paediatrician at the next appointment, we need something for his anxiety. We're also investigating something for easy child 2/difficult child 2, who to date has never taken any antidepressants. difficult child 1 has no trouble with Zoloft.

Marg

 

[Josie]

easy child has reacted one way or another to all 5 SSRI's she has tried (Prozac, Luvox, Lexapro, Paxil, and Zoloft). She might be reacting to Anafranil, a tricyclic. But she did really well on amitriptyline (another tricyclic). So there is hope a tricyclic would work when the SSRI's don't.

 

[Indianamomof4]

I feel like an idiot that I am so unfamiliar with these terms (Anafranil, amitriptyline). It's probably good to understand them and know what I'm talking about.

 

[bby31288]

My difficult child was on Zoloft for her anxiety. It worked ok, a lot of weight gain for her, almost 50 lbs. We had been waiting to get into the child p-doctor and our appointment arrived we had long talks about medications and she switched her to wellbutrin XL. It worked great. The weight is slowly coming off, and her anxiety has improved immensely. It was like gee, I thought the Zoloft worked ok. This was a much better fit for her. I should add that the Dr. started her out on the regular medication, not the sustained release to make sure she tolerated it well we did that for a month before changing over to the sustained release.

 

[Indianamomof4]

really? My difficult child is a skinny rail, so I'm not worried about the weight gain. How funny, back in the day when I was married I was on Wellbutrin. I never noticed a change in myself, really, other than the limited sex I was having was actually better. LOL I think the problem was less about depression and more about I hated the man I was married to!!

So these are safe for kids? That scares me since he's so young.

 

[Indianamomof4]

By the way Warrior Mom... I'll trade some boys for your girls!! :laugh: My house is always full of wrestling and testosterone challenges. I can't imagine what it will be like in 5 years when they're 15, 13, and 10. Yikes.

 

[Josie]

It is scary to put a child on medications like these. To me, the possible risks from these medicines were outweighed by the risks and the quality of life my child had without the medications.

 

[BusynMember]

I want to throw in (from one whose diagnosis is bipolar II/anxiety disorder/panic disorder/mild Obsessive Compulsive Disorder (OCD)) that anxiety rarely stands by itself as a diagnosis. Anxiety and panic attacks were a huge part of my mood disorder. At one time I could almost not leave the house without having a flaming panic attack. I definitely needed more than just an AD. In fact, many AD's including tricyclics, either made me MORE nervous or gave me such horrible side effects I was forced to quit. Tricyclics were much harder for me to tolerate than SSRIs. Not only was I constantly hungry and thirsty and tired, but I finally had toxic reactions to both which ended up in completely psychotic episodes, wholly induced by the medications. I'm not saying this will happen if you go tricyclics, but I hated them. Nortriptylene was better, not as heavyhanded, but it didn't do much for my depression/anxiety. Prozac and Zoloft made me more nervous. I had to take benzodiazapens. Rather than addictive, my psychiatrist calls them habit forming. You are only technically addicted to them if you keep needing more and TAKE more to get a buzz. For me, I just take a low dose and I can function. I haven't had a panic attack in well over ten years.

 

[ML]

My son was diagnosed with separation, social and general anxiety about 9 months ago (along with ADHD). I finally decided that his quality of life was so bad (as was mine) that it warranted the risks of trying *something*. First we tried prozac (about six months ago) and it made him very hyper, more angry and aggitated. After giving up on that it took me another three months to give celexa a try. This was six weeks ago and I have to say that difficult child's anxiety is about 50 percent better. This may be as good as it gets but it's livable. Before, not so much. My choke chain leash was very short.

He still has the executive functioning deficits and the attitude. He still has the short fuse but he recovers faster and the meltdowns are less. No miracles here but I'm grateful for the slight improvement.

MicheleL

 

[Marguerite]

I feel like an idiot that I am so unfamiliar with these terms (Anafranil, amitriptyline). It's probably good to understand them and know what I'm talking about.

Don't feel too bad - you can always Google them for either the company's product information, or Wikipedia. I often have to because product names can be different in Australia, or often a product simply hasn't been released in Australia yet. Products released into the US have been thoroughly tested and results submitted to FDA. But in Australia, our own equivalent to FDA requires testing to be done all over again; a lot of companies who are happy to just have the US market don't bother about Australia for a while, our smaller population makes it not worth the expense, often until the patent is about to expire, then other companies do the extra bit of research and make more profit, because they didn't have the development costs as well. It means we can wait for ten years sometimes.

Example - Australia only got Concerta in the last year.

Marg

 

[Sara PA]

Keep in mind that anxiety is a common side effect to antidepressants even though some are approved for treating adults with anxiety.

 

[Indianamomof4]

Here is an update... sans medicine, I haven't seen that aggressiveness yet. I don't know what to think. People have commented that he seems "different". He's complained of headaches every other day or so, but no complaints from school right now, but I am going to call this week to see what's up.

I have been trying behavior management with him, and will admit that listening to that program The Total Transformation has helped a lot. The guy makes so much sense.

Granted, he's still hyper. He still makes noise all the time and smells everything, but nothing too crazy.

I got the report from the neropsych. It's nothing I really didn't know. He pretty much summed it up that he is clearly ADHD with ODD and Obsessive Compulsive Disorder (OCD) components. He also said he cannot rule out a mild form of Asperger's (though he has none of the social issues related to that disorder). He recommended behavior modification therapy.

I'm going to seriously think about medicine--and talk to the teacher. If she doesn't seem to think the ADHD is out of control, and he's learning and not too disruptive, I may not do anything but seek a behavioral psychologist and have weekly sessions.