New symptoms with Lexapro reduction...

gcvmom

Here we go again!
The psychiatrist suggested I reduce difficult child 1's Lexapro in an effort to curb his over-the-top ODD-type behaviors when the stimulant wears off. For example, arguments would escalate to the point where he would either run away, break something, slam doors, throw things, or he would lie, seek out porn, steal things from family members, etc. Essentially it was as if the impulse control got REALLY out of control. psychiatrist thought that the Lexapro might be disinhibiting him.

Seemed like a fair enough supposition. At first I was going to wait until the school year ended because I didn't want his anxiety going bonkers. But I decided to go ahead and not wait. So he's been at 10mg now instead of 20mg for about three weeks now.

He does seem like his fuse is shorter now. And the other really big thing I've noticed is that he is picking at himself again. He does this a little bit anyway, but since reducing the Lexapro it is worse. He might have a small bump on his arm, like around a hair follicle, and he focuses on it and squeezes it until it's bleeding. His upper arm(s) now have a dozen or so scabs on them from the picking.

And lately he's been using tweezers to pick the flakey skin off his lizard. Or he claims the creature has thorns stuck in it and he's trying to remove them. He will sit there for a half hour and pick at the poor thing, despite my telling him to STOP.

He also picks at the zits on his face now, leaving scabs.

Most of this activity is in the evening after the stims are worn off.

I'm going to call the psychiatrist with an update on this, but wanted to toss it out to the experts in the trenches here.

Oh, and his hygeine hasn't really improved much, either. He still takes forever in the shower and comes out smelling no better than when he went in, often with hair that is still dry. I had to send him back in tonight to bathe again, threatening to do it for him myself if he didn't get it right (and reviewing the steps involved in the process with him lest he forget what he's supposed to be doing in there).

So WHAT is going on here?
 

smallworld

Moderator
I'm guessing that the stimulant is causing the picking (related to anxiety), which in turn was controlled by the higher dose of Lexapro and is now coming out in full force with the lower Lexapro dose. But that doesn't mean you should go back up on the Lexapro. How does he do with just the anti-anxiety medications and no stimulant?
 

gcvmom

Here we go again!
Without the stimulant he is obnoxious, intrusive, unfocused, distractible, forgetful, careless, sloppy, stubborn, uncooperative, destructive, quick to anger, impulsive, hyperactive, and generally a royal PITA. :D I think that covers it...

I could cut back on the stimulant and see if that helps. He's at 30mg on the patch. But at 20mg of Focalin (which is what he gets in the morning) he says he still feels hyper and unfocused, and in truth he isn't as "together" at that level as he is on the higher dosage.

I'll call the psychiatrist this morning and ask about it.
 

lovemysons

Well-Known Member
gcvmom,
I was on Lexapro (before my psychotic breakdown 2 yrs ago) and for about a year I ALSO had this need to pick at a pimple on my face. I did this regularly for about a year...ended up causing a permanent scar. It was a compulsion. Not only that but it didn't "hurt" it was like the Lexapro made me numb to physical pain.
I think there is something to this "picking and Lexapro" definitely some kind of corrolation there.
In addition, I also experienced "restless leg syndrome" on the Lexapro. I mean I could not stop moving my legs around when I got in bed to try and sleep...it was awful.

As it turns out...for me anyway, I have Bipolar...I think that the Lexapro may have played a role in my mania driven psychotic breakdown.

Anyway, I would definitely bring up these new side effects to the psychiatrist.

Tammy
 

gcvmom

Here we go again!
He also used to pick before he started Lexapro. If it wasn't his arms or hands, it was his head. But again, that could have been attributed to the stimulant -- he's been on stims since he was 5.

We added the Lexapro shortly after his Crohn's diagnosis so that he could get through all the medical procedures and tests he needed without having a panic attack and bolting. It was pretty awful then. There's panic disorder and agoraphobia on my side of the family.

He got much better about medical events on Lexapro, and he also got better about his fear of certain bugs and flying insects.
 

Josie

Active Member
My difficult child 1 used to take 20 mg of Lexapro. We weaned her off 5 mg at a time until we got to 5 mg. Then we did 2.5 mg. Even going at that pace, she had a shorter fuse starting around week 3 of the taper and it lasted a few weeks. The psychiatrist's plan was to reduce her dose every 2 months but sometimes we waited longer so we could enjoy being around her longer before we cut her dose again.
 

gcvmom

Here we go again!
Interesting that she was able to come off it completely.

psychiatrist's office called back and said he wants to switch difficult child 1 to Celexa. I think I will try reducing the stimulant first -- like over the weekend, before doing that. I know he's a different person than me, but when I took Celexa, it really didn't do a whole lot for my anxiety/depression which is why I was switched to a tricyclic. And it's funny, but the first time I noticed a difference in difficult child 1 was after he was put on imipramine (another tricyclic) for bed wetting -- he was a happier kid! After he stopped it, he became a grouch again and was more fearful of bugs, etc. That's one of the things (besides the whole medical phobia issue) that made me push for him to go on something for his anxiety. Then again, his grandmother does pretty well on Celexa. So I guess we'll wait a little bit and then see how he does.
 

totoro

Mom? What's a difficult child?
I am a picker and it is anxiety based. More anxious more picking... same with biting my nails, which abhor! I hate it. I will have them doing fine and then, bam... start on the cycle and can't stop. Same with picking, which I have been doing a bit more now because I am more anxious because I am stressed... etc.

I just love this stuff!!!

Funny I was just picking my face when I read this... busted! LOL
 

gcvmom

Here we go again!
Yeah, I'm guilty of the same thing but it's usually my heels when they get too dry/cracked. I've tried really hard this past year to take better care of myself and to stop doing that. So far, so good. Of course, it helps when the people around me are fairly stable, too! :p When I was little, it was my toenails, even if it caused me pain (and it often did). My dad really had us all walking on eggshells, and I'm sure that's why I did it.
 

Josie

Active Member
FWIW, difficult child 2 always picked her fingers around the nail. I started giving her inositol, a natural supplement, to see if it would help with her Obsessive Compulsive Disorder (OCD). I mentioned this to her new psychiatrist and he said he only saw inositol work on "pickers and pullers". I realized then that difficult child 2 has not been picking any more. I can't say for sure that it was the inositol, but I thought it was encouraging enough that I will keep giving it to her.
 

gcvmom

Here we go again!
Hey, if it helps, why not? What can it hurt? I'll keep that one in the back of my head to ask about next time we go in. How much does she take?
 

Josie

Active Member
She takes about 12 mg. I buy it online in a powder because that would be a lot of pills. For Obsessive Compulsive Disorder (OCD), she should be taking up to 18 mg, but it is hard to remember the mid-afternoon dose.

Her old psychiatrist said he had never heard of inositol helping any one. Of course, if it helped then they wouldn't need him so he probably wouldn't know. On my Obsessive Compulsive Disorder (OCD) group, it has helped some of the kids, so I thought I would try it.

Here is a link about it: http://westsuffolkpsych.homestead.com/inositol_and_ocd.html
 
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