Zoloft fail...now what?


New Member
DS12 has ODD/ADHD/Anxiety/Depression. He had neuropsychologist testing done just over a year ago. Due to my husbands job we have moved 3x in the past year but this last one was a positive move in DS's eyes (hopefully we will be stable for a few years). The moves have also not helped with continuity of care in both therapy and medication management. He is currently taking 50mg Zoloft/3mg Intuniv/40mg Ritalin LA. Also taking Synthroid, Growth Hormones, and has a Supprelin implant (precocious puberty).
The Zoloft was started in March after his anxiety levels were affecting his ability to function. No issues titrating up to 50mg over two months. It wasn't quite enough to tackle the depression, hitting himself, and negative self talk but we were getting ready to move so the old psychiatric wanted to hold off. The 50mg had helped his anxiety.

We moved and in our new city (across the country) wait listed for several psychiatrists and FINALLY got an appointment. Zoloft increased to 75mg 3 weeks ago which has been a nightmare! Total crying meltdowns, hitting himself more, general negative talk, talking about wanting to harm himself and suicial talk. We dropped him back to 50mg and see the psychiatric again next week.

I refuse to go back up to 75mg of Zoloft but 50mg is not enough. He is paranoid that kids at camp/school hate him which ends up becoming a self fulfilling prophecy. He still has meltdowns and is short fused. He has thrown things at two different kids at day camp in the past two days when angered. He is no longer responsive to CBT either.

What is the next step? Would we try another antidepressant or do we move onto something else? Since the Dr is new we do not yet have any kind of rapport, I would like to be armed with info and experiences from others. I just want to make sure that whatever the dr proposes isn't totally out of standards.

I hate that so many others are going through this but so thankful I found this forum. This can be such a lonely journey.


Well-Known Member
I am sorry your son is going thru all of this. I have no suggestions on medication, except to see if your new psychiatrist will order DNA testing. They can take a swab and swipe inside the cheek, send it off, and in a week or so, they will know what liver enzymes he has and how it affects different medications. My daughter was missing an enzyme that metabolized the medication she was on, so it did no good.

Plus, she had twice as much of a different enzyme, so she metabolized too quickly and it was out of her system.

The report broke it down to which medications to try, which to use with caution, and what ones to use extreme caution. Just about everything she had had prescribed were in the extreme caution column!

Make sure this is a covered expense thru your insurance company first. Our mental health department had a special offer from a lab, and if insurance did not cover, the most they would charge the patient was $100. Which was good, as the bill was $4000 and insurance did not pay.


Ps, you can google DNA for medications and learn more...


Roll With It
I personally HATE Zoloft. Back when my son was put on it, several other moms here also had their sons put on it at the same time - coincidence, NOT us asking for it. Every single one of the boys pretty much lost it completely on Zoloft. Each boy had similar problems, but enough different to make us really wonder why they all totally lost control of their behavior on that one medication. Years later my hubby took it and said/did things that were completely out of character - he became truly mean and he is the most gentle, patient person I have ever met. I have noticed that girls seem to not go through this on this medication. Of course this is all COMPLETELY anecdotal information and NOT scientific or empirical data, and I cannot even think of a way to prove this,but I do not like this medication. And of course there are parents here who have sons who have done very well on Zoloft, but they are few enough that I wonder.

As to what is next, what do you think should be next? An anti anxiety medication? Be SUPER careful if they give him a benzo. Or another antidepressant? Could he be bipolar (MANY people with adhd/depression/anxiety diagnosis later are found to be bipolar)? If so, I urge you to avoid antidepressants and start working with mood stabilizers. Antidepressants can cause mania in people with bipolar, esp those who are not stable on mood stabilizers. Antidepressants are not bad at all, they can be super helpful, but I urge you to look into the types of antidepressants. I personally do well on SSRI's but as soon as I take an SNRI I go nuts. I end up with strange symptoms and withdrawal from them can be a problem. I think the tricyclics are maybe underused because they are old and cheap with very well known side effects. I like old medications with very well known side effects because I can look them up and know what to look out for as we trial a medication.

Sadly, all medications are trial and error. It takes far more time than most of us really have to titrate up to the effective dose and then wait until we see if it will work or not.