How do I know these meds are working??

[PrincessAriel]

Dd 10 is on sertraline (zoloft) for generalized anxiety disorder (also has PDD-NOS) . She has been on it since the end of last month. They increased the dose last week from one 25mg tablet to one and a half. I was supposed to call back this week to report how she was doing.

I think her anxiety is still strong, she still is freaking out about storms, clouds (even leaving the house when clouds are present), she is lying, teasing, crying, having meltdowns. She just isn't the same child anymore (even before the meds but worse now)

Tonight she had a major meltdown when we caught her lying to us about something (too long to explain) and she had to miss out on getting something she was looking forward to having. She threatened to run away, says bad things about herself, etc. There is NO reasoning with her at all. I don't think she really gets right vs wrong.

When I called today the nurse said the behavioral CNP (highly respected in our area) who does the prescribing was on vacation but that maybe we could get the dose increased by another provider (pediatrician).??? I was not OK with that option and now we wait another week to see her in office. She was supposed to follow up with her therapist, in the same practice, the week after beginning the meds but there were no openings, the next week the therapist was on vacation and this week we were gone til now. I feel kind of in a bind here with having started her on these meds (we have never used any in the past and I was wary to begin with) and I don't feel like we are getting enough support in this journey. I am totally frustrated, feel like I am trapped at home with my dd who is getting more difficult to be around (getting her out of the house is a major deal). We haven't even started school yet and I am dreading having to cope with her resistant behavior as it has already been tough in the past (she hates doing school) and now all this on top of it.

What should I be doing? How long does this med take to work? Any advice would be really appreciated. Thanks!

[Ottakee]

It can take a while for it to work but if things are getting WORSE, then I would look closely to see if the med might be making things worse. Zoloft can cause behavioral issues in kids and has a risk of suicide, psychosis, etc.

 

If the behavior worse again on the 1 1/2 than just the 1 and worse than nothing? If so, I would strongly suspect the meds.

 

It could be that a different class of meds would be better for her or even another med in the same class.

 

Have they tried anything like Risperdal for her? It is an antipsychotic but used for mood issues/anger/aggression/anxiety and I know a lot of people with kids on the spectrum find it very helpful.

 

The med game can be tough but it can be so rewarding when you find the right med/combo of meds and life is SOOO much better.

 

If you see an increasing concerning behaviors, please call them back (even on the weekend/evening) and explain your concerns and be very specific about how it is getting worse, what she is doing, etc. They might decide to taper the med slowly and have you see the doctor ASAP.

[NotSoObvious]

Zoloft can cause behavioral issues in kids and has a risk of suicide, psychosis, etc.

 

I've seen Zoloft do some scary things to kids. It made one of my first grade students extremely violent. It just doesn't work for all kids. Good luck.

[Renee in NC]

Docs don't know how a kid will react until they try the meds. She needs something different, not more. I had one who is GREAT on Vyvanse and another who was ready to kill us all.

 

The doctor (or some doctor) needs to see her ASAP - this is becoming a safety issue. There has to be someone on "backup" while her doc is on vacation.

 

We started seeing changes in the child on Lexapro within a couple of days. The only downside is that he is HYPER, so we are back to the doc Tuesday.:tongue_smilie:

[8filltheheart]

Honestly, the burden of going the med route falls squarely on your shoulders. It is scary. My ds was 14-16 while we experimented w/various meds and even at that age he couldn't identify that the meds were pushing him over the edge. I'll never forget the day I found him balled up in a corner carving 666 in his arm b/c he thought he was possessed. It was beyond terrifying.

 

If you think the meds are making her behaviors worse, do not dismiss it. It is impossible to predict how they will react w/different children. I can't remember which med it was, but it was one of the antidepressants that our ds reacted the most negatively too (he was given it for anxiety b/c he suffers from debilitating anxiety.)

 

You need to educate yourself on what symptoms to look for. I would recommend starting a journal and recording observable data as well as asking her questions and recording her answers (even if her answer is that she doesn't know.) Over time, things can all blend and blur and you can end up continually second-guessing yourself. I ended up feeling completely immobilized b/c I started not knowing if I was over-reacting or under-reacting to little things. (The big things were BIG and I would not wait a minute.) If you have a relationship with a pharmacist, then they are also a great source of information. (I really preferred getting meds like this from a small private type pharmacy like the Medicine Shoppe vs. a large chain type place like Walmart.)

 

:grouphug:

[Scarlett]

Dd 10 is on sertraline (zoloft) for generalized anxiety disorder (also has PDD-NOS) . She has been on it since the end of last month. They increased the dose last week from one 25mg tablet to one and a half. I was supposed to call back this week to report how she was doing.

I think her anxiety is still strong, she still is freaking out about storms, clouds (even leaving the house when clouds are present), she is lying, teasing, crying, having meltdowns. She just isn't the same child anymore (even before the meds but worse now)

Tonight she had a major meltdown when we caught her lying to us about something (too long to explain) and she had to miss out on getting something she was looking forward to having. She threatened to run away, says bad things about herself, etc. There is NO reasoning with her at all. I don't think she really gets right vs wrong.

When I called today the nurse said the behavioral CNP (highly respected in our area) who does the prescribing was on vacation but that maybe we could get the dose increased by another provider (pediatrician).??? I was not OK with that option and now we wait another week to see her in office. She was supposed to follow up with her therapist, in the same practice, the week after beginning the meds but there were no openings, the next week the therapist was on vacation and this week we were gone til now. I feel kind of in a bind here with having started her on these meds (we have never used any in the past and I was wary to begin with) and I don't feel like we are getting enough support in this journey. I am totally frustrated, feel like I am trapped at home with my dd who is getting more difficult to be around (getting her out of the house is a major deal). We haven't even started school yet and I am dreading having to cope with her resistant behavior as it has already been tough in the past (she hates doing school) and now all this on top of it.

What should I be doing? How long does this med take to work? Any advice would be really appreciated. Thanks!

 

Curious how your dd is doing? Did they change her meds?

[PrincessAriel]

Thanks, so nice of you to ask. After talking to both the psychologist and CNP, they suggested adding in guanfacine because they felt that now that she wasn't as anxious, the autistic features from her PDD-NOS were coming out a lot more, which made her behavior seem rather odd at times. We did have some problems the first weekend on the guanfacine, as the recommended dose was too much too soon. She actually had ringing ears, weak legs, sleeping all weekend, etc. They cut it back to one fourth of a 1 mg tablet twice a day and she is now doing a LOT better. I came to appreciate what the meds were really doing for her after we missed a day accidentally and she was in really rough shape by dinner time. She can now continue with her therapy and actually learn some techniques for dealing with the anxiety. Right now, she is at the right dose for her and we are all much happier!:001_smile:

[Misty]

Zoloft worked rather quickly for my two girls with severe anxiety and OCD. I would say within a few days. They are no longer on Zoloft as we have decided to go with other treatments. But it did work for them when we so desperately needed it two years ago.

 

You might look into PANDAS. Sometimes when anxiety doesn't respond to SSRI's, it's a sign of an autoimmune/bacterial issue where the antibodies are "attacking" the brain. Has your daughter ever had strep throat? Sometimes kids have multiple issues going on alongside the Autism.

[Scarlett]

Thanks, so nice of you to ask. After talking to both the psychologist and CNP, they suggested adding in guanfacine because they felt that now that she wasn't as anxious, the autistic features from her PDD-NOS were coming out a lot more, which made her behavior seem rather odd at times. We did have some problems the first weekend on the guanfacine, as the recommended dose was too much too soon. She actually had ringing ears, weak legs, sleeping all weekend, etc. They cut it back to one fourth of a 1 mg tablet twice a day and she is now doing a LOT better. I came to appreciate what the meds were really doing for her after we missed a day accidentally and she was in really rough shape by dinner time. She can now continue with her therapy and actually learn some techniques for dealing with the anxiety. Right now, she is at the right dose for her and we are all much happier!:001_smile:

 

Good! So glad things are better.