Zoloft, Antibiotics, Vacation

[dcmom]

I didn't want to hijack another post, but this is what I am dealing with now.

 

DD 11- had a really rough pandas year. Exacerbation in Dec due to virus, then mid April almost fully recovered, had strep.

 

She is now in a decent place. Mood pretty good, eating, sleeping, mild ocd. NOT 100%.

 

She has been off of everything for about 4 weeks. Only taking probiotics (theralac 2x day) and vitamin D.

 

I am starting to feel somewhat confident that the daily antibiotics she has been on for 2 years, were not doing too much for symptom control, and in the end didn't prevent strep.

 

She did try zoloft at 12.5 mg in the spring, but we could not make a clear connection with improvement- however things were very changeable.

 

I am thinking of starting something- since she has stayed fairly stable for the last 2 mos. Should I try zoloft or antibiotics?

 

I am thinking zoloft.

 

We are going on vacation next week, so she should be better in general, but I know it takes a few weeks to kick in. Maybe I will start her on 12.5 mg this week. At what point do I consider raising the dose?

 

Thinking out loud- thoughts appreciated...

[MomWithOCDSon]

Well, as you know, we are fans of low-dose Zoloft. And if her behavior and mood are generally much improved, I'm not sure what else abx would do for her at this point. You?

 

When you say she's not yet 100%, what are the "hanger-ons" in terms of behaviors? Are they OCD-oriented? And the abx you were using before, was that azith or a beta-lactam, like augmentin or pen?

 

I'm sure you've seen all the posts of late about glutamate and how modulating it has been helpful to some of our kids. To my knowledge (admittedly still needing some rounding out), SSRIs don't work on glutamate, so if that happens to be at the root of our DD's lingering issues, the Zoloft may not help. And if her mood is generally good, then it doesn't sound as though she is necessarily in need of Zoloft's antidepressant characteristics.

 

Meanwhile, they're finding that beta-lactam abx do appear to work against glutamate, so something along the lines of augmentin or d-cycloserine might assist with the OCD.

 

If you do decide to try the Zoloft, I would stay at the original dose for a full 6 weeks; we've found activation when increasing the dose too quickly, and most doctors acknowledge that it can take up to 6 weeks for an SSRI dosage to reach its full efficacy (though, experientially, I would say you'll probably know within 3 to 4 weeks if it's helping, and sooner if it's doing something anti-beneficial). And depending upon your DD's age/issues, 12.5 mg. might be all she'll ever need to take things just that next notch toward the better.

 

Enjoy your vacation!

[dcmom]

Thanks Nancy!

 

We think she is allergic to penicillins- which leaves pen, amox, and augmentin out. (plan on doing challenge in Sept/oct)

 

She did zithromax- which did help her at initial onset, with symptoms. But, no longer seems to.

 

Her main issue is mild ocd. Everything has the ocd at its root. Even if she is occasionally moody- it seems to be caused by underlying ocd. Also, as of late, separation anxiety is an issue- which to me seems like part of the ocd spectrum.

 

Thankfully, she is participating in art camp, socializing with friends, and doing stuff without me. But it is harder for her than it should be- her nature it extremely confident and independent.

 

So- penicillins are out.

 

I have zoloft in my cabinet- but I hear you- and don't want to waste 3 to 6 weeks.

 

What could I use to work on glutamate- that is NOT a heavy hitter (she is just not bad enough)... Nancy? anyone?

 

Thx-

[MomWithOCDSon]

What could I use to work on glutamate- that is NOT a heavy hitter (she is just not bad enough)... Nancy? anyone?

 

Thx-

 

Vitamin B12 and NAC, that I know of. We're also using low-dose lamictal, but some might consider that a heavy-hitter.

[T_Mom]

Hi DCMom:)

Great to hear that you have had a respite from treatments! Wow! May it continue.

 

I cannot resist responding as your topic heading was a classic:

 

"Zoloft, Antibiotics, Vacation -- Off everything for the summer- what to try first? "

 

(I vote VACATION!)

 

I have nothing else "helpful" to add, but your post definitely made me smile--

Edited July 12, 2011 by T.Mom

[michiganpandas]

Hi...I know I have said before that your daughter sounds like she is in the exact same place as my daughter...we are just stuck with this ocd...fearful type of thinking especially of getting sick and some separation anxiety.

 

we are on nothing except zoloft 20mg....thinking of upping it to 25...and no more than 30....that is the possible plan...i just have not officially decided to implement it yet.

 

i do see improvement when we do specific targeting in a problem area with emdr therapy....http://www.emdr-therapy.com/emdr.html

we do also take vita d and omega 3....thinking of adding b-12 or b-6

 

CONSIDERING ivig...but, just afraid to shake things up

 

also....i am soooo embarrass to say this, but i have been giving her honey for the last couple of days and have actually had really good days since starting this...i know it probably has nothing to do with anything....i'm just trying ANYTHING! wouldn't that be awesome if it was that easy!

[dcmom]

yes michigan pandas- we are in the exact same place. Separation anxiety, and fear of vomiting are about all that is left. Otherwise, she is physically well, mostly happy, etc. BUT this ocd gets in the way, and harms self esteem (certainly).

 

She is 11, and NEVER had any anxiety prior to pandas hitting two years ago. SO- it is very difficult to see.

 

On the other hand, we have had a couple of REALLY dark times due to pandas- so. we are thankful to have our girl now. And I too am terrified of doing anything to mess it up.

 

Our plan:

 

no antibiotics this summer, unless: I change my mind , she gets sick, others around her are sick, or her symptoms increase.

continue on probiotics and vitamin d (she was low in Vit D)

stay off the zoloft

I added NAC this morning. I plan to do 1 600mg tablet 2x/day for two weeks, and then try upping to 2 tablets twice a day. Will see if this helps. Will add vitamin C, also.

We are also doing a three week ocd intensive in August.

 

We will re focus at the beginning of September to devise a plan for the school year (re antibiotics, and help for a possible exacerbation).

 

I hope all of this will enable her to get to school in the fall....