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prozac for severe ocd in 12 year old


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Hi, My dd has been on antibiotics for PITANDS since the end of April. She has improved greatly but she still has severe OCD. She has not been able to benefit from CBT because her fearfulness of facing it has kept her anxiety very high. She does many normal things now but won't acknowledge her illness (except a few times to her sister) and barely speaks in therapy sessions. The psychologist asked that we allow for a psychiatric evaluation an the psychiatrists want her to take prozac to get her anxiety and what they described as depression down so she can work in cognitive-behavior therapy. Are there alternatives to prozac, I'm very nervous about starting her on it. But I am not sure what else to do. I am talking to her everyday about her illness and reassuring her that she is going to get better and how exciting it is that we know what is wrong now and can work toward getting better. Any counsel by those who may have experienced something like this would be appreciated. Thanks,Ellen

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Every child is different, but I will say that many, many parents on here (myself included) have seen horrific responses to prozac and luvox, and other related meds. My daughter turned in to a screaming, biting, kicking monster. I am not exaggerating. She got worse and worse on them . she finally weaned off after a several month trial of both meds.

Later, after a visit to a savvy rheumatologist, we discovered that my child has a deficiency in the Cytochrome p-450 system, which is how the bodies breaks down toxins (including medicines like prozac). I think, if I understand it correctly, the prozac was building and building up in her system. She became violent after about 2-3 weeks on the prozac, as the dose was increasing.

We did not have the same bad response to clomipramine (Anafranil). She took that for over a year, not sure if it helped much, though.

 

Anafranil is a different class of medication, and I think was one of the first medication approved for OCD.

 

My other daughter takes clomipramine for her PANDAS OCD. I honestly do not think it does much, but who knows. She is doing great anyways after pex & IVIG.

I know of an adult who was treated for depression with Prozac. He became violent and raging, to the point where he had to be commited to an inpatient psych unit and was diagnosed as bipolar. He is now realizing the connection and wondering if his absolute anger and violent outbursts were due to Prozac, which was supposed to fix him-- not send him psychotic and to a mental hospital!

I would think long and hard on it. I did see promising improvements when my daughter tried Riluzole, also. There is an NIH study (might be closed by now) for Riluzole and childhood OCD. Our PANDAS doc ordered it for my daughter, though. That may be an avenue for you.

Best wishes!

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Mine is one of a few families here who have found some help with PANDAS OCD through low-dose SSRIs and other medications. I have to stress the LOW DOSE part of the equation, though. Dr. Murphy has documented it in a peer-reviewed paper, and we have been through the trials ourselves of starting on too high a dose, or increasing it too rapidly, or increasing it too much, etc. Unfortunately, too often, psychs just don't get all the subtleties of PANDAS, and they think that, so long as a dose is "low" by standard, non-PANDAS criteria, then it should be low enough for our kids. But usually it's not; it needs to be halved, typically, and then take it from there, slowly.

 

I will say that we did not find Prozac to be helpful for our DS14, though, when it was originally prescribed, we did not know about PANDAS and chances are the dosage was too high.

 

Currently, my DS takes 75 mg. of Zoloft and 100 mg. of Lamictal; of the two, I'd say the Lamictal has made the most dramatic impact on his ability to manage his OCD and emotional lability. Combined, they've made it possible for DS to participate wholly in his ERP therapy and -- knock on wood -- he's doing very well these days.

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Hi, My dd has been on antibiotics for PITANDS since the end of April. She has improved greatly but she still has severe OCD. She has not been able to benefit from CBT because her fearfulness of facing it has kept her anxiety very high. She does many normal things now but won't acknowledge her illness (except a few times to her sister) and barely speaks in therapy sessions. The psychologist asked that we allow for a psychiatric evaluation an the psychiatrists want her to take prozac to get her anxiety and what they described as depression down so she can work in cognitive-behavior therapy. Are there alternatives to prozac, I'm very nervous about starting her on it. But I am not sure what else to do. I am talking to her everyday about her illness and reassuring her that she is going to get better and how exciting it is that we know what is wrong now and can work toward getting better. Any counsel by those who may have experienced something like this would be appreciated. Thanks,Ellen

 

My DS11 started Prozac in early June and has been taking it all summer. He has tolerated it well and done very well on it. He was only quirky OCD- not severe or debilitating. Only side effect has been teeth grinding at night. He was on 10 mg for 9 weeks then increased to 15 mg and he has been on that for almost 3 weeks. So far, so good. I plan to increase to final dose of 20 mg- going up slowly. His only other medication is Lamictal taken for underlying abnormal EEG- has never had a seizure, thankfully. He has been on Lamictal for a couple years and was worsening with OCD while on it(following Strep infections). So, unlike Nancy- it did not have the greatest impact for my son in that regard. Although, I do think it helped his anxiety and mood liability quite well.

 

Given the choice- Lamictal was probably a scarier decision than SSRI's. Great med if it works for your child, though. None of this is easy- it sounds as if your DD is getting very little from therapy. Self expression has probably been one of the greatest benefits my husband and I have noticed from Prozac for our son (unexpected result yet needed). I had expected it to only help for OCD but he does seem happier, more outgoing and able to verbalize better. OCD is quirky- ever changing. Gets rid of one thing, replaced by another. He is not too ritualistic, thankfully. OCD has been helped marginally with SSRI. However, I have weaned him of low dose Intuniv and low dose bedtime Klonopin this summer with no negative sequalae- so, replacing one med for two has been a positive.

 

Yes, there are many different SSRI's- sure there are many alternatives to Prozac within the class of meds. Unless, you are looking for other alternative solutions, altogether. My experience with any of the mood controllers is that it is a trial and learn type process. Start something- go slow, watch results and go from there. If negative- stop. Try something else. If positive- stick with it. Have to give it a few weeks to note response- may be a few bumps in the road to overcome before knowing if it going to work or not. My motto has always been start low and go slow...often, increase dosing slower than what the docs recommend so I can monitor results.

 

None of this is easy. It is hard to watch your child suffer. Even harder to pay for therapy that is not effective :P You sound as if you are at a cross roads- few choices left. However, I come to learn that none of these meds are magic bullets. They don't "fix" the child- rather, they bring down some of the barriers that allow normalcy/healing to take place.

 

Good luck in your decision.

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My DS (age 6.5 at the time) became suicidal on celexa, an ssri, after 2 months and one dose increase. He was then weaned off and started on lamictal. It did nothing for his ocd. It works very well for mood lability. We are currently trying to wean him from it.

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My DS (age 6.5 at the time) became suicidal on celexa, an ssri, after 2 months and one dose increase. He was then weaned off and started on lamictal. It did nothing for his ocd. It works very well for mood lability. We are currently trying to wean him from it.

 

It is my understanding that celexa is not FDA approved for kids nor should even be considered for children that young. Glad he did better on Lamictal.

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