Thanks For All The Advice...And We've Decided

[Janna]

that we are going to try one more medication. One more and if it doesn't work, Dylan's treatment will continue and finish unmedicated.

Luvox - 25 mg tabs.

Yeah, I read where they just keep saying on the website "You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old". They put that there, alot, more than once.

psychiatrist has two other Pervasive Developmental Disorder (PDD)'ers on it, one is Tourettes, so he can't really compare him with Dyl, but the other is Pervasive Developmental Disorder (PDD), little lower functioning, but doing well.

Although Dylan isn't Obsessive Compulsive Disorder (OCD), many of his thoughts and triggers are Obsessive Compulsive Disorder (OCD) like. I would almost consider him to be Obsessive Compulsive Disorder (OCD) when it comes to alot of things, but I don't know that he actually fits all the criteria. I told psychiatrist I thought Dylan needed a chill out pill, haha....something that would make him think "it's all good", all the time, but they don't make a pill like that :thumbsdown:

I'm not excited about trialing this, but anxious to see how he does. Although what works for most kids does NOT work for my son, well....maybe this one will work.

I did mention Focalin. psychiatrist said nahhhh. I mentioned Propanolol too, and he said no way, Jose.

SRL, thanks for the tips on the other thread. I've bookmarked/noted everything. I'm going to check into those other things more.

 

[slsh]

Janna - if it makes you feel any better, thank you was on Luvox several years ago for anxiety issues and I think it was a good medication for him. I know the big black box warnings are scary, but as with so many of the medications our kids must take, there's a trial and error thing going on. You and staff know enough to watch him closely for suicidal stuff. I hope you have good results like we did with it.

Just out of curiosity (and because thank you's on it :wink: ), why was psychiatrist so against propranolol?

 

[Janna]

Sue,

Our psychiatrist's reason (which, before I get yelled at by anyone, is his reason, and may not necessarily be the thoughts of EVERY psychiatrist - feel like I need a disclaimer sometimes LOL) for not wanting to trial that with Dylan is because he says that Propanolol is used in kids that have extremely severe issues with things like outbursts, raging, etc.

It's funny how Dylan used to be pretty severe, at least in my eyes, but as of late, he's getting alot better with that. I find it really interesting how much he's changed in the past 8-12 months, and how much of that raging just died out.

Anyway, that was his thing...and because Dylan hasn't yet (although, he may still....) displayed any type of raging or tantruming, he wasn't willing to try it. I think it's been the better part of 2 years since we've seen anything extreme. Probably just jinxed myself LOL!

I dunno if that makes sense LOL! I was more centered on the Luvox, and thanks, you make me feel a tad better.

 

[smallworld]

Janna, your psychiatrist is entitled to his opinion about the blood-pressure medication Propranolol, but I had to chuckle at his reasoning. My son's been on it for 4 years for migraines (it's worked wonders for him). When he had his manic reaction to Zoloft 2 years ago, Propranolol did NOTHING for his raging. Besides migraines, Propranolol's other off-label use is for stage fright. I don't know many people with stage fright who are intense ragers -- LOL!

Seriously, I hope the Luvox makes a difference in Dylan's anxiety. The only thing you can do is try.

 

[Marguerite]

I hope Luvox works for Dylan. difficult child 3's doctor tried Zoloft on him when he was 5, it seemed to help a lot but because it severely hampered his sleeping, the resultant lack of sleep had difficult child 3 (and me!) almost manic and as a result, undermined the benefits. But difficult child 3 does seem to have problems with anti-depressants and weird reactions.

We tried Luvox when difficult child 3 was 8, it didn't seem to be making much difference after one day, and then he developed an allergic reaction (classic urticaria). I'm told this is rare.

So for now, difficult child 3 is off antidepressants, we're not even going to go there. I get weird reactions too, maybe he's like me. difficult child 1 seems to have no trouble with Zoloft, he's been on it for 8 years.

Good luck.

Marg

 

[slsh]

"extremely severe issues with things like outbursts, raging, etc." Hmmm... just to be sure, I went and looked that up in the dictionary and yep, thank you's pre-propranolol picture is right there. :rofl: It's really quite good news that Dylan isn't a candidate.

Keep us updated on the Luvox thing.

 

[oceans]

Good Luck Janna! I hope that it helps him. You can only try!

 

[Sara PA]

Watch for the hypomania that can come at the beginning and the slow slide into anger, anxiety, aggression, hostility that can come around three months or so.

Watch for the worst, hope for the best.

 

[TerryJ2]

I've got my fingers crossed!

:thumb:

 

[Wiped Out]

Janna,
I hope the new medication helps! Hugs.

 

[Janna]

No, SW, he didn't indicate it would help with raging at all. I think you misunderstood, or I just didn't put it out there correctly. We were discussing ADHD medications and issues with Dylan, and I mentioned it to be used for ADHD, not realizing what type of drug it was (I thought it was some type of stimulant).

When I mentioned that to him, he said that he knew it was used for children that had ADHD symptoms but also had the extreme outbursts and such (I guess he was saying, after all the other stimulants failed, maybe some kiddos tried this).

We only talked about it for 3 seconds LOL!

Sara, do you know, the 3 month thing, is that as the dosage increases, or is that because it takes this long to stabilize or what? I wonder, too, if you'd know (or anyone)...because I thought Dylan had pretty good luck on the Wellbutrin (again, psychiatrist tried this for ADHD, but it didn't help ADHD, but Dylan DID seem much happier), maybe that's a good sign for this one? I dunno.

Thanks guys. I hope it works, too.

 

[Sara PA]

Back when I was treated for epilepsy, the doctors would talk about the 3 week/3 month/3 year thing. For whatever reason, those were like milestones in judging how a paritular drug was working. The same pattern seems to carry out in the treatments for other neurobiological disorders. It's just a general rule of thumb that seems to be valid for reasons I don't understand. Interestingly, most drug studies last just about 3 weeks. What happens at three months is usually considered "long term" and covered by post marketing reporting (which is rarely done).

There is the theory that most doctors prescribe too much medication because they are looking for a quick fix. One person I know in England has a doctor who insists that there are fewer side effects and better results in the long run if the patient takes 1/4 of the recommended dosage. The person I know says that he was not happy with the results from his antidepressant when he was taking the full dose but, with this doctor, has found that less is more and that he is very happy with the results taking just a fraction of what he had been taking.

How long was Dylan on the Wellbutrin when he seemed much happier and when did he start seeming much happier? My son was much happier on both the Effexor and the Celexa and the much happier started within hours of taking the first dose. That's antidepressant induced hypomania and it is not a good thing. Anyone who is much happier within hours or days of starting an antidepressant is displaying an adverse reaction. I'd bet the farm that person will be going down the slippery slope to mood swing into anger and hostility by three months.

 

[Josie]

Janna,

My easy child/difficult child was on this for about 6 weeks last summer. It did help her anxiety and Obsessive Compulsive Disorder (OCD) but it also made her very impulsive and she was taken off from it.

I just did a quick search on Wellbutrin and it works on norepinephrine and dopamine while Luvox works on serotonin. So the experience on Wellbutrin is irrelevant, I would guess.

I hope the Luvox works for Dylan.

 

[Steely]

Anyone who is much happier within hours or days of starting an antidepressant is displaying an adverse reaction. I'd bet the farm that person will be going down the slippery slope to mood swing into anger and hostility by three months.

I am going to have to personally disagree with you on this one Sara. Maybe this holds true for some people, but I know a lot of people, myself included, that feel immediately better from 1-2 doses of a new anti-depressant, or an increase in an anti-depressant. I, myself, have never spiraled anywhere on anti-depressants, other than upward, to feeling better in a steady, calm, lifesaving way. So, I guess maybe we are all different?

 

[Sara PA]

I am going to have to personally disagree with you on this one Sara. Maybe this holds true for some people, but I know a lot of people, myself included, that feel immediately better from 1-2 doses of a new anti-depressant, or an increase in an anti-depressant. I, myself, have never spiraled anywhere on anti-depressants, other than upward, to feeling better in a steady, calm, lifesaving way. So, I guess maybe we are all different?

I must admit that I have heard this from other adults. I tend to forget about adults. My bad. Let me qualify that to "Show me a kid who is much happier within hours or days of starting an antidepressant and I'd bet the farm that person will be going down the slippery slope to mood swing into anger and hostility by three months."

 

[smallworld]

And sometimes it can happen within days. My son trialed Effexor XR, and after 5 days he reported he was "too happy." By day 8 he became aggressive with his sisters, and we discontinued the medication.

 

[Sara PA]

Wellbutrin is a weak uptake inhibitor for norephinephrin, dopamine and serotonin.

 

[LittleDudesMom]

Janna,

glad you have a plan in place. Everything crossed, and prayers, that this has a positive outcome.

Happy Holidays :rudolph:

Sharon

 

[witzend]

Interesting, Sara. Are there any studies on this theory, or is this anecdotal from people you have spoken with?

 

[Sara PA]

Pretty much anecdotal. For the most part, the drug companies don't release studies that have less than positive results and seldom run studies longer than 8 weeks unless a drug is approved for the particular indication. So if there are studies that show these results, they probably aren't public. But there are reasons antidepressant have those warnings and, generally speaking, aren't approved for use by children and adolescents and one of them isn't because the clinical testing hasn't been done.