At six my son was put on Zyloft 12.5 mg, at first things did seem to get better, he was able to go to school without crying, seemed happier and his complete control of laundry went away. At exactly 30 days he was a mess. Manic, out of control, spinning objects for 8 hrs a day, and crying jags. Psychiatrist told me to take him off which we did, within a week he was back to where he was before Zyloft. We tried again, same thing happened but quicker this time, Psychiatrist said to increase to 25mg, that lasted maybe 1 week, it was unbelievable every (pans) symptom went through the roof and he had a lot of symptoms. This was long before I had ever heard of pandas/pans. We moved on to Luvox, really bad, then prozac all at low starting dose, ALL created huge problems. Prozac start with 5 mg, when I reduced it to 2mg behaviours leveled off. That is what got me down the road of pans/ pandas (the atypical reaction to SSRIs). Swedo says 1/4 or 1/10 of regular starting dose for pandas kids is a good place to start. I agree. Some can do more but my son (who is not on SSRIs anymore) is not one of them.