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<blockquote data-quote="smallworld" data-source="post: 318870" data-attributes="member: 2423"><p>Thank you for all your feedback. I really appreciate it.</p><p> </p><p>A didn't have school yesterday (Veterans Day). Although she's been complaining of residual headache and dizziness, she made it to school today. She also began her after-school yoga class this afternoon, which seemed to energize and focus her for homework tonight. Her psychiatrist is glad she chose to do yoga for mental health reasons.</p><p> </p><p>A's not in a new school this year -- she attends a small (300 student) private school that goes from 7th through 12th grades. But her class added 25 new students this year, and the academic demands increased, which has definitely added to her anxiety. She played JV soccer this fall and definitely felt a part of things. Her lack of motivation may have begun around the time the soccer season ended.</p><p> </p><p>A doesn't seem concerned that she hasn't gotten her period because she knows that her delayed puberty will allow her to grow taller. She's much more concerned about her short stature (4'10"). She hasn't expressed concern that J is away or that we will send her away (she's no where near the difficult child her brother is). She just got her first term grades; they were all As and Bs and she seemed pleased.</p><p> </p><p>Heather, I think you hit the nail on the head. A has been so steady in her moods for so long that any change brings me back to that dark time in 4th grade when she could hardly get herself to school. I so fear that she will spiral down that I want to do anything possible to stop it as soon as I see the warning signs.</p><p> </p><p>A has been in weekly therapy since age 10. I think it helps somewhat. Her psychiatrist -- a young woman who is easy to talk to -- practices integrated care, which means she sees A for both medication management and weekly psychotherapy. A likes and trusts her, but she tends to be a bit reserved about her feelings. I think she's getting better about sharing; it's just taking her a while to open up. Her psychiatrist says this is not uncommon for girls her age.</p><p> </p><p>In terms of medications, I have to admit I have PTSD about SSRIs in general and Lexapro in particular. I realize they're different kids, but two years ago exactly, we increased J's Lexapro to 10 mg, and he ended up in a day treatment program for 6 weeks. I know from their reactions that too much Serotonin is bad for my kids, but I don't know how much is too much for A. Would 10 mg put her over the edge? That's the million-dollar question.</p><p> </p><p>J takes 400 mg Lamictal, and our neuro says A can go that high if we need to as long as she doesn't suffer from balance or gait issues. Today her mood seemed a bit brighter so maybe we're getting somewhere with the recent Lamictal increase. Time will tell. </p><p> </p><p>Increasing Seroquel is an option, although we've been trying to limit APs in our kids' medication mixes because of their long-term side-efffect profile. We just successfully weaned J from Seroquel, and we're about to take M off Zyprexa. I'd like to avoid exposing A to increasing AP doses if we can help it. </p><p> </p><p>gcvmom, Propranolol is not an option for A because it's contraindicated for kids with asthma. We had wanted her to start it for migraine prevention (it works great for J), but our neuro wouldn't allow it because she has several asthma attacks a year. </p><p> </p><p>Thanks again for your thoughts.</p></blockquote><p></p>
[QUOTE="smallworld, post: 318870, member: 2423"] Thank you for all your feedback. I really appreciate it. A didn't have school yesterday (Veterans Day). Although she's been complaining of residual headache and dizziness, she made it to school today. She also began her after-school yoga class this afternoon, which seemed to energize and focus her for homework tonight. Her psychiatrist is glad she chose to do yoga for mental health reasons. A's not in a new school this year -- she attends a small (300 student) private school that goes from 7th through 12th grades. But her class added 25 new students this year, and the academic demands increased, which has definitely added to her anxiety. She played JV soccer this fall and definitely felt a part of things. Her lack of motivation may have begun around the time the soccer season ended. A doesn't seem concerned that she hasn't gotten her period because she knows that her delayed puberty will allow her to grow taller. She's much more concerned about her short stature (4'10"). She hasn't expressed concern that J is away or that we will send her away (she's no where near the difficult child her brother is). She just got her first term grades; they were all As and Bs and she seemed pleased. Heather, I think you hit the nail on the head. A has been so steady in her moods for so long that any change brings me back to that dark time in 4th grade when she could hardly get herself to school. I so fear that she will spiral down that I want to do anything possible to stop it as soon as I see the warning signs. A has been in weekly therapy since age 10. I think it helps somewhat. Her psychiatrist -- a young woman who is easy to talk to -- practices integrated care, which means she sees A for both medication management and weekly psychotherapy. A likes and trusts her, but she tends to be a bit reserved about her feelings. I think she's getting better about sharing; it's just taking her a while to open up. Her psychiatrist says this is not uncommon for girls her age. In terms of medications, I have to admit I have PTSD about SSRIs in general and Lexapro in particular. I realize they're different kids, but two years ago exactly, we increased J's Lexapro to 10 mg, and he ended up in a day treatment program for 6 weeks. I know from their reactions that too much Serotonin is bad for my kids, but I don't know how much is too much for A. Would 10 mg put her over the edge? That's the million-dollar question. J takes 400 mg Lamictal, and our neuro says A can go that high if we need to as long as she doesn't suffer from balance or gait issues. Today her mood seemed a bit brighter so maybe we're getting somewhere with the recent Lamictal increase. Time will tell. Increasing Seroquel is an option, although we've been trying to limit APs in our kids' medication mixes because of their long-term side-efffect profile. We just successfully weaned J from Seroquel, and we're about to take M off Zyprexa. I'd like to avoid exposing A to increasing AP doses if we can help it. gcvmom, Propranolol is not an option for A because it's contraindicated for kids with asthma. We had wanted her to start it for migraine prevention (it works great for J), but our neuro wouldn't allow it because she has several asthma attacks a year. Thanks again for your thoughts. [/QUOTE]
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