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General Parenting
another medication bites the dust
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<blockquote data-quote="smallworld" data-source="post: 170527" data-attributes="member: 2423"><p>Hi pepperidge, I'm sorry things didn't work out with Zoloft. If you had stayed with a lower dose (before you hit 50 mg), were things acceptable or did you still feel he needed more medication to address his issues?</p><p> </p><p>I'm going to recommend something unconventional. Because your difficult child exhibited disinhibition rather than mania, you might want to try another AD. According to Dr. Daniel Pine at NIMH, disinhibition is a side effect, not an indication of bipolarity. He recommends trying two SSRIs before ruling out the whole class. Both Celexa and Lexapro are supposed to be "softer" SSRIs than Zoloft or Prozac, which can be stimulating. If you don't feel comfortable trialing another SSRI -- we didn't with M because she became disinhibited on Prozac and her siblings had already had manic reactions to just about every SSRI out there -- you might want to consider an AD in a different class, such as a tricylic or Remeron, which is in a class of its own. M has not become disinhibited on Remeron, although it's still not addressing all of her issues so we may be heading toward a mood stabilizer at some point. </p><p> </p><p>In addition, has your difficult child ever tried Seroquel? Our neuro says it is a "softer" AP than some of the others. It also addresses anxiety at relatively low doses -- 25 mg to 200 mg. J had terrible akathisia and dystonia on Risperdal, but has been able to tolerate high doses of Seroquel (up to 800 mg) with zero side effects (save sedation).</p><p> </p><p>Good luck. I know this is frustrating. What is recommended in terms of interventions for kids with Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE)?</p></blockquote><p></p>
[QUOTE="smallworld, post: 170527, member: 2423"] Hi pepperidge, I'm sorry things didn't work out with Zoloft. If you had stayed with a lower dose (before you hit 50 mg), were things acceptable or did you still feel he needed more medication to address his issues? I'm going to recommend something unconventional. Because your difficult child exhibited disinhibition rather than mania, you might want to try another AD. According to Dr. Daniel Pine at NIMH, disinhibition is a side effect, not an indication of bipolarity. He recommends trying two SSRIs before ruling out the whole class. Both Celexa and Lexapro are supposed to be "softer" SSRIs than Zoloft or Prozac, which can be stimulating. If you don't feel comfortable trialing another SSRI -- we didn't with M because she became disinhibited on Prozac and her siblings had already had manic reactions to just about every SSRI out there -- you might want to consider an AD in a different class, such as a tricylic or Remeron, which is in a class of its own. M has not become disinhibited on Remeron, although it's still not addressing all of her issues so we may be heading toward a mood stabilizer at some point. In addition, has your difficult child ever tried Seroquel? Our neuro says it is a "softer" AP than some of the others. It also addresses anxiety at relatively low doses -- 25 mg to 200 mg. J had terrible akathisia and dystonia on Risperdal, but has been able to tolerate high doses of Seroquel (up to 800 mg) with zero side effects (save sedation). Good luck. I know this is frustrating. What is recommended in terms of interventions for kids with Fetal Alcohol Syndrome (FAS)/Fetal Alcohol Effects (FAE)? [/QUOTE]
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another medication bites the dust
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