Week 1 therapist/psychiatrist & Zoloft ??'s

[Janna]

We held our one week review today. therapist/psychiatrist/myself/D and our MH/MR worker.

D is doing MUCH better, thank God, with his initial anxiety of being placed. The first few days were very, very rocky, but the last several have been good. His spirits are much better, much happier - many gripes, but hey, that's part of the package.

Team initial goals (which will probably change over time) are good. Work on verbal/physical aggression, expressing feelings openly (coming to a peaceful resolution instead of anger/aggression), weekly individual counseling and weekly group therapy (to include anger management and stress management). Several others - some geared more toward socialization (Pervasive Developmental Disorder (PDD)-not otherwise specified stuff) and others geared toward the anger/aggression/explosive behaviors.

Axis has been tweaked a bit - still carrying Pervasive Developmental Disorder (PDD)-not otherwise specified primary, and the Bipolar is gone, changed to Intermittent Explosive Disorder (we've had this before). No mention of the ADHD, but concerns with the Anxiety Disorder-not otherwise specified (not sure if that's actually sticking on the Axis). Asperger is ruled out because of the Borderline Intellectual Functioning. The Asperger part, again - is all in who you ask LOL! At this point, it doesn't much matter, he's on the Spectrum for sure. Always knew that.

We're going to wean off the Seroquel due to massive concern of obesity (weight gain of 36 lbs in 4 months, he is in the 10th percentile for height, very short, and 160 lbs). Keeping the Buspar, for now (10 mg. AM/10 mg. PM). It's gonna be a whole new world with no AP in place, I think LOL!

The psychiatrist, again, mentioned Zoloft. Now, by everyone's judgement thus far, there doesn't seem to be an issue with depression in D. They also don't see mood swings or severe irritability. Thinking, I don't know that he's actually *irritiable* or if he's just intermittently explosive LOL! Really - he doesn't seem happy one minute then sad the next. Never weepy, crying incessently, etc. He is a very happy go lucky kid - with the exception of the anger side (and I do know the anger can present as depressive in kids - and it's only been a week - I just don't know how I really feel about the possibility he's depressed and they just don't see it).

So, people - tell me about your experiences with Zoloft. I think they are looking at this moreso for anxiety - which baffles me (I haven't looked at their website or prescribing info yet), but per psychiatrist - it is good for anxiety.

I know I have read here several people saying about their children having a "manic" reaction. Would you, if it's not stepping boundaries, please tell me *WHAT* you saw. Because, really - I'm very confused about what manic reactions should look like. You read about it from one person then read another's and they aren't even close to being the same LOL! So, if you say "my difficult child had a manic reaction" or "my difficult child spun into hypomania"....please tell me what that means. Hyper? Non stop talking? Like, what?

And if you've had good - I'd love to know that too. How about ages, doses, weight of difficult child?

I know, I know that every child is different, I'm just looking for opinions and facts from other people.

Overall, though - week 1 was positive! The thing I really like about their goals is, the goal must be met for a CONSECUTIVE amount of time. Meaning, say - 4 WEEKS STRAIGHT of "no anger and no aggression toward peers" to say, yes, we've seen change. So, if he does good for 3 days, LOL, because he can hold it together - that doesn't mean change. Which is good, because the last Residential Treatment Facility (RTF) said, "oh, he did great this weekend - he's ready to come home"!

Sheesh.

Hey, thank you!

 

[smallworld]

Janna, I'm running out the door to pick up M, but I'll be back on later to tell you exactly what happened when J had his manic reaction to Zoloft (it wasn't pretty).

All SSRIs like Zoloft are rxed for anxiety and depression. In fact, some psychiatrists think they work better for anxiety than depression.

 

[Janna]

I think that's what this psychiatrist thinks, too. Isn't Strattera an SSRI, also? We tried that way back when - sheesh, now I don't even recall what happened with that. Or is that something else? Couldn't have been too great, I don't think he was on it very long.

 

[TerryJ2]

Janna,
my difficult child didn't spin out of control, he just stayed up half the night playing video games or watching TV, or he woke up in the middle of the night doing it.
He was very talkative but friendly, and the teacher noticed that he was "jumping out of his skin" or something like that, and she said it was clear that it was nothing he could control.
His heart raced so hard that you could see it beating through is shirt.
And he felt dizzy, weak, and had a headache.
It took 3 or 4 days to get it out of his system. No long term effects.
I hope that helps.

 

[SearchingForRainbows]

Janna,

As of right now, I have no experience with Zoloft (of course this could change as difficult child 2 has been undergoing more extensive testing - I never know what to expect...) so am of no help whatsoever. I just want to let you know that I'm thinking of you and D and glad he had a good week overall. WFEN

 

[robinm1922]

My difficult child was on Zoloft when first diagnosis'ed - her info, she is 15 has depression, anxiety and little Obsessive Compulsive Disorder (OCD) started on 50 mg of zoloft. LOVED it then for what ever reason it stopped working. Up-ed her to 75mg without any difference. Now she is on Celexa and getting ready to change that next. I was really bummed when Zoloft stopped working. Her psychiatrist said the same thing that it would help her depression and anxiety.
I can't speak for anyone else but it gets my thumbs up, now if they could only figure out why medications just stop being effective that would be great!
Good luck,
Robin

 

[smallworld]

Hi again, Janna.

My son J was 12 when he trialed Zoloft. We started very low -- 6.25 mg -- and titrated up to 25 mg (the manufacturer's recommended starting dose) over two weeks. On the evening of the three-week mark exactly, he became agitated. He started yelling and swinging at anything in his path. He swept books off shelves, papers off tables and knicknacks off surfaces. The house looked completely trashed. My husband suffered a bruised rib from trying to restrain J. You have to understand that this is not generally an aggressive kid so we were totally floored when this episode occurred and knew it was related to Zoloft. Even though we discontinued Zoloft that night, the anger, aggression and destruction continued for many weeks until his psychiatrist decided to rx Depakote, which did settle him down after 6 weeks at a therapeutic dose.

We've been told by several psychiatrists (including the NIMH researchers) that SSRI-induced manic reactions typically occur at the three-week and three-month mark. They generally do not settle down when the medication is removed and typically require some sort of medical intervention. Side effects, on the other hand, typically occur at the start of treatment and generally subside once the medication is discontinued.

Good luck with the Zoloft if you decide to try it.

 

[totoro]

I tried Zoloft about 2 years ago. I wouldn't say I had a manic reaction to it.
It worked OK in the beginning but after a 6 month or maybe longer period it just didn't touch my anxiety and my Mania and agitation were getting worse. But I can't say if it was due to the Zoloft?
They stayed when the Zoloft was Difficult Child'd. They were there prior to the Zoloft.
I liked it for awhile though.

I also wasn't working with a psychiatrist at the time so she was not comfortable adding other medications on top of it or going too high with the dosage. Which was good I guess.

 

[Wiped Out]

Janna,
I'm glad D is settling in. My easy child is on the generic of Zoloft. She has never been manic on it but I'm not sure if it had some play in her recent weekend of depression.

 

[pepperidge]

Janna,

my oldest with high anxiety and tendency towards depression was put on Prozac (not Zoloft but similar). He became totally disinhibited after a few weeks. (he started at 5 mg, a low dose) We had to double his ADHD medications to get his frontal lobe working. Disinhibited as in stuffing bread into the VCR, totally silly out of control, starting a little fire outside, stealing...things that we had never seen before. I will never give him another SSRI. Lamictal has been a godsend along with a low dose of Risperdal and low dose of Adderall. Oh and how could I forget, his first psychiatrist put him on Lexapro at 5 mg for 3 days, then 10 mg (a healthy dose, especially for a medication sensitive underweight 3 rd grader, this was before I become a warrior mom). The minute he went up to the 10 mg dose he was literally turning over desks in his classroom. Not a child given to disruptive behavior at all in school. Good psychiatrists we have seen subsequently were not suprised by what happened and are not given to prescribing SSRIs easily.

my youngest with fetal alchohol, anger issues, somewhat obsessive tendencies, some anxiety was prescribed Zoloft to help him chill out. he was on for a few months or so--my notetaking has gotten worse over time. While I dont remember any obvious terrible effects, didn't seem to help his anger at all and maybe made it worse. I'm trying a low dose now of 5_hTP to see if that will do some good. maybe a bit. He had a really bad reaction to Tenex. He's been on 15 different medications I think, none have really helped very much.

 

[Janna]

We tried the 5_HTP. I did that because the M.T. at the Autism social skills playgroup said it was really good as a "chill pill".

Just didn't do anything. I mean, nada....and we had him on for about 2 months.

Chris, I'd love to know if you have any benefit, and what dose. Let me know when that time comes. Maybe I need to give him extra, extra LOL!

Thank you for all the input. I'm not really comfy yet with this. I have time, which is good. They are going to wean off the Seroquel, then I assume watch. I don't go back to see psychiatrist again until April 2nd. I think, then, we'll discuss medications again.

It's going to be hard for them because they are not going to see behaviors I saw, for I'm guesstimating 3-4 months. D is excellent at honeymooning and holding it together. Additionally, he seems to be the "easiest" one there, for lack of a better word. You have kids tantruming, raging, screaming, cursing, out of control from sun up to sun down - and a kid that does it once in a while out of frustration, the latter tends to be drowned out, and that's what will happen.

Until he gets the sh*Tourette's Syndrome of all the other kids doing the above, and wigs out. THEN, that'll be something.

I still think I'm gonna push for Lamictal. I don't care if they removed the BiPolar (BP) diagnosis or not.

 

['Chelle]

My difficult child was on zoloft for a couple years, has been off for a couple, and just today picked up a new rx for it as he's been having lots of difficulties since mid-Jan. My difficult child did very well on it the first time. It was primarily for the anxiety and Obsessive Compulsive Disorder (OCD) symptoms he had, as well he gets this "flat" mood. I think it helped him be able to learn how to cope with things, especially school. We had no problems, and I'm hoping it will help him out of whatever is bothering him now and back to the good progress he'd made. difficult child's rx starts at 25mg and over about 3 weeks goes up to 100mg. The pharmacist did say that after about 2-3 weeks is when you see the upswing of mood/energy, and any bad effects generally show up then - manic, suicidal ideation. My difficult child didn't have any of that when taking it before.