Flare or reaction to med?

[JoyBop]

This is very perplexing. DS was doing so well. He had recently had his meds adjusted it seemed to be working like magic! He still struggled with fears and Ocd but functioning very well, sleeping, and acting like himself. On Saturday that all changed. He is now having temper tantrums, is very agitated and hyperactive and makes these awful faces while trying to kick and punch us. We call them PANDA faces. We have seen this all before and it was after 5 weeks of Prozac. We took him off and he got better but that was also when we added abx so who knows?

 

He had been on 12.5mg of Zoloft since June and was doing fine. Not sure how much it helped but seemed to take the edge off and he tolerated it well. 2 weeks ago we upped it to 25 mg and he seemed to be tolerating it awesome. Again, not much improvement, but a little. Then Saturday it all hit the fan. How do you know if its a flare or a reaction to something else? Motrin has always helped keep his tantrums under control but nothing is helping him now.

 

Tomorrow he's only getting 12.5 mg of Zoloft again and we will see if it is helpful.

 

Does anyone have any insight here?

[PowPow]

I believe Zoloft takes time to buildup, doesn't it? If it has only been 2 weeks since the increase, then perhaps the 25 mg is just now starting to wreak havoc. Why did you increase it? I would definitely go back to 12.5 and stay there for a while to see if it returns to the decent baseline he was at before.

 

Psych medications are a bit intimidating in their ability to cause so much effect on the brain, positive and negative.

[pr40]

or he could have caught an infection? there are so many bugs around at this time of year when school begins and kids come together again

[qannie47]

I think these one step forward, two steps back days can drive all of us parents nuts! In speaking to Dr. K yesterday, he seemed unimpressed with my ds's recent "pop up" flare. For our situation, it seems it is something that we all have to get used to, as long as he returns back to baseline after a couple of days...easier said then done. Another thought, years ago, I was on a SRI for depression. I do recall that while it provided relief, there were great fluctuations in day to day mood. It makes sense that these type of aides can be imperfect because, while they can help, they probably are unable to mimic an otherwise well balanced brain chemistry.

[JoyBop]

Pow wow his PANDAS psychiatrist doubles the dose bc he was in such a small dose and Ocd requires a much higher dose. It takes about 5 weeks to get the initial dose in buy far less for increases so timing would suggest it could be a med problem.

 

Pr40 you are so right. Out doctors office is seeing tons of strep which makes this even more complicated. I'm hoping for the med reaction and not the infection bc meds we can control.

 

qannie yes it is frustrating! Thanks for sharing your ssri experience.

 

We are going to keep him on the lower dose and see how things pan out. Our other doc (now in maternity leave) had left the Zoloft alone but increased the intunive thinking that was the lesser evil. But he was falling asleep in school everyday so our other dr tweaked the other meds and cut the intunive back down. It was magic for two weeks but is a disaster now. But with all the infections at school I'm really confused. To make matters worse I haven't even MET with his new school psychologist and this is just stressing me out.

 

Thanks for the support and ideas everyone. Keep them coming.

[Mayzoo]

I do not recall how old your kiddo is. Can you check to see if his throat is inflamed or red? My kiddo will let me look sometimes. Depending on his weight, 12.5mg may have been the better dose. Yes, it takes up to six weeks to see effects from a new introduction of an SSRI, and a few weeks to see the difference an increase or decrease makes.

 

We saw a great improvement in anxiety (fears) when we introduced Melissa Lemon Balm 500mg twice a day (morning and night). I was pleased enough with my kiddos improvement that I took her off her Zoloft, which was only minimally helping anyway. I was actually able to spin in a circle without risk of knocking down my kiddo who had been my shadow for MONTHS on end. It even helped reduce nightmares at night.

[peglem]

Its possible, too that the increase of zoloft has over a few weeks depleted folic acid/B12 and other netrients that are needed to function. From here: http://www.alive.com/articles/view/19578/common_drugs_deplete_nutrients

Common Drugs Deplete Nutrients by Daniel T. Wagner, RPh, MBA

 

Antidepressant Drugs

• Includes drugs used to stimulate the mood of a depressed patient. Some are used in eating disorders, treating obesity, and panic disorders. Drugs include tricyclic and SSRI medicines such as Amitriptyline, Elavil. Trazodone, Desipramine, Pamelor, Nortriptyline, Serzone, Paxil, Prozac, Zoloft and Imipramine.
• B-Complex Vitamins: Additional B-\itamins are critical when taking antidepressants for short or extended periods. Vitamin B₁₂ and folic acid are especially necessary. There may also be an additional need for riboflavin (B₂).
• Selenium: Stores of selenium are compromised with extended use of these drugs. A suggested supplementation dose would be 50 to 100 micrograms daily.
• Zinc: Depletion of this antioxidant can slow wound healing reduce the sense of taste. Supplement with a dose of 10-35 mg per day.
• L-Gluthathione: An important amino acid that decreases free radicals and helps to protect your liver.
• Calcium/Magnesium: Take for nutritional support, along with additional minerals.
• Vitamin C

[JoyBop]

DS is 8 and weighs 74 pounds. He is getting at least some lemon balm because he takes Nordic naturals omega 3s which have some lemon balm in them though in not sure how much.

 

Today was another tough day. Dealing with the school was no walk in the park either. I could t even get the school psychologist on the phone but she did email me and offer me an appointment 12 days from now. What a joke!! My PCP write a very compelling letter asking for many accommodations. That should help.

 

Peglem. That san interesting article. Could two weeks of a medication really cause depletion that quickly?

 

Also wondering now about ability. Our doc is considering it but I'm not sure I want to go through this again. On a positive note I have been absolutely blown away by the outstanding patient care at MGH. Never in my life have I had such attentive and compassionate doctors. I am truly grateful for that !

Edited September 25, 2013 by JoyBop

[peglem]

Well, B vitamins and folic acid are not stored in your body, so, especially if you have an MTHFR mutation, I think this is something that is often overlooked because the depletion is not immediate when you 1st start a medication so the dots don't get connected. I'm not expert on this at all- just something to consider.

.

Peglem. That san interesting article. Could two weeks of a medication really cause depletion that quickly?