Experience with Prozac and Natural Alternatives?

[PuddleJumper1]

This was recommended as a possibility for dd yesterday.

 

Dd16 has had a really bad year and a half physically. After multiple doctors I think we finally are close to some answers with a visit to Immunology yesterday. Her physical issues are very possibly rooted in low immune or autoimmune issues. As you might imagine her struggles have really taken a toll on her outlook and mood. She went from a very energetic, happy, bouncing kid to a subdued kid asking for a new body (she struggles with joint pain, extreme fatigue and recurrent infections). In many ways she has gone from Tigger to Eeyore and we all  really want the Tigger side back. The doctor yesterday suggested taking a med like Prozac for a short term might give her a boast to getting back to where she was while we deal with treating the physical issues. We are not at all opposed but we have no experience with this class/type of medication. We also really like to approach life from a more natural/homeopathic path wherever possible.

 

If you (or especially one of your children) have taken Prozac I'd love any insight or thoughts you would share. Do you love it? Has it been a help? Warnings we should know about?

 

If you have treated depression naturally I'd really love input and suggestions. This would be our first choice if it can be treated naturally. My little guy sees a homeopathic doctor for his special needs and she is an option but it will take a while to get a new patient appointment. 

 

I'm doing some research but BTDT experience is always the best. 

 

 

Thanks!

[maize]

I would be very cautious with SSRI's for a teenager, they can actually increase the risk of suicide in young people and can be difficult to wean off of. If you go this route, you want to do so under the direction of a psychiatrist with lots of experience treating adolescents. I say this as a person who is 100% in favor of medication as needed and used appropriately.

 

Some natural things you can try first: lots of omega 3's (fish oil), sunlight and vitamin D, B vitamins, exercise (maybe swimming? Whatever she can best tolerate and enjoy. Walking outside in the sun or gardening or...), meditation/mindfulness, a hobby that includes social engagement...

 

These are all things that can help increase general health and elevate mood. Oh, and since you mentioned multiple infections, she should be taking high quality probiotics and eating cultured and fermented foods to get her gut bacteria in balance if she has been on antibiotics. There seems to be a connection between gut health and mental health.

[PuddleJumper1]

I would be very cautious with SSRI's for a teenager, they can actually increase the risk of suicide in young people and can be difficult to wean off of. If you go this route, you want to do so under the direction of a psychiatrist with lots of experience treating adolescents. I say this as a person who is 100% in favor of medication as needed and used appropriately.

 

Some natural things you can try first: lots of omega 3's (fish oil), sunlight and vitamin D, B vitamins, exercise (maybe swimming? Whatever she can best tolerate and enjoy. Walking outside in the sun or gardening or...), meditation/mindfulness, a hobby that includes social engagement...

 

These are all things that can help increase general health and elevate mood. Oh, and since you mentioned multiple infections, she should be taking high quality probiotics and eating cultured and fermented foods to get her gut bacteria in balance if she has been on antibiotics. There seems to be a connection between gut health and mental health.

 

Thank you Maize!! I really appreciate your notes on SSRIs. 

 

Fish oil was one of the things mentioned as an alternative. I'm going to pick some up for her. Doctor mentioned D3 levels and tacked it on her blood orders to check her levels. She was very involved with my parent's horses before all this grounded her and we're going to try and work that back in slowly.

 

You are so correct on the gut health and mental health. Dh is a gut health mess. He was on his way to some pretty scary possibilities in mental health years ago before we discovered his multiple food issues. Changing up his diet made him a drastically new man. We are seriously thinking of giving dd a full trial of gluten free to see if it helps. Dh and older ds have celiac which has been ruled out for her multiple times but it might help. Just by living in this house she is very gluten restricted but not fully gf. 

[poppy]

There is a bug stigma against treating mental illness with medication. I hear it a lot. I think it's damaging , honestly, for people who are really struggling. Patients struggling with chronic pain are often not able to 'move more and meditate' anyway.

 

Prozac is very effective and it is safe , especially short term. Zoloft in another one that has been subscribed successfully with minimial side effects for decades, your kid has been through so much. Help her by giving her meds.

 

Suicidal thoughts are a rare but very serious side effect, I am sure it will be on the doc's and your radar screen. No med is risk free, you just have to look for risk vs reward .

[Laurie4b]

The best natural cure for depression is exercise. With her joint pain, swimming might be the best option. Look for an indoor heated pool, preferably where they have an arthritis aquatics class because the pool temperature will be mid-80s which is good for the joints. Other exercises that don't stress joints might be the elliptical machine, and yoga or Pilates if there is an instructor who knows how to adapt movements. If there is a health center associated with a hospital in your area that is open to the community, those would be good places to look. G

 

Getting outside is good for depression. Green plants in the house help too.  I would encourage her to get 15-20 min of no sunscreen sun exposure around noon per day to get her Vit D production up. I think there is something about sun that also elevates our mood.

 

There is research that chocolate elevates mood. You want to choose dark chocolate and keep it at about an ounce. A healthy diet with lots of fruits and veges and including Omega 3 fish 2-3 times per week is also helpful.

 

 

[PuddleJumper1]

There is a bug stigma against treating mental illness with medication. I hear it a lot. I think it's damaging , honestly, for people who are really struggling. Patients struggling with chronic pain are often not able to 'move more and meditate' anyway.

 

Prozac is very effective and it is safe , especially short term. Zoloft in another one that has been subscribed successfully with minimial side effects for decades, your kid has been through so much. Help her by giving her meds.

 

Suicidal thoughts are a rare but very serious side effect, I am sure it will be on the doc's and your radar screen. No med is risk free, you just have to look for risk vs reward .

 

Thank you Poppy!  The doctor yesterday said he loves Prozac. There is a psych clinic at the same children's clinic that would oversee and monitor her treatment. We are definitely going to be doing something to help her in this area. At first yesterday she was resistant to the idea but on the way home she told me she thinks talking to someone about it would be a good thing. 

[PuddleJumper1]

The best natural cure for depression is exercise. With her joint pain, swimming might be the best option. Look for an indoor heated pool, preferably where they have an arthritis aquatics class because the pool temperature will be mid-80s which is good for the joints. Other exercises that don't stress joints might be the elliptical machine, and yoga or Pilates if there is an instructor who knows how to adapt movements. If there is a health center associated with a hospital in your area that is open to the community, those would be good places to look. G

 

Getting outside is good for depression. Green plants in the house help too.  I would encourage her to get 15-20 min of no sunscreen sun exposure around noon per day to get her Vit D production up. I think there is something about sun that also elevates our mood.

 

There is research that chocolate elevates mood. You want to choose dark chocolate and keep it at about an ounce. A healthy diet with lots of fruits and veges and including Omega 3 fish 2-3 times per week is also helpful.

 

Thanks Laurie! You've just reminded me that my dad mentioned that he is about to open their pool for the summer. We're in the south and things are starting to warm up around here. She loves swimming. Great idea! The horses she loves are at their house as well. We pretty much have built in therapy for her right there :)

 

She loves chocolate and will love that idea! Thankfully her diet is already pretty well based in fruits and veggies due to her dad's food issues. Picking up the fish oil today.

[poppy]

Op I just want to say you are very polite :)

My Grandma would be nodding and asking me why I can't be more like you - reply to everyone and thank them for the best bits. It makes me smile to think about it.

[wapiti]

.

[PuddleJumper1]

I will add to the caution to go slow and/or very low with an SSRI in this situation, if at all.  My ds has an immune/autoimmune-caused anxiety-related issue and in his type of case, the chance of overreaction (mania) to an SSRI is double that for regular patients (I can't recall, but it's something like 13%!).  Therefore we are avoiding them for as long as possible.  If we end up going that route in the long run, it would be starting at, literally, one-tenth of the usual dose.  A possible benefit from SSRIs that I'm interested in would be neurogenesis but I haven't looked into it lately.

 

As for natural alternatives, curcumin and NAC may be worth a look though often there are patient-specific details that might point toward another approach.  For natural alternatives, consider seeking the guidance of a naturopathic doc if you can find one well-recommended in your area.

 

Obviously, treating the root cause immune/autoimmune stuff would be the way to go, and I totally get the desire for stop-gap measures to deal with the anxiety while you are addressing the immune/autoimmune and possible infections (I really don't want to even get into the infectious angle :tongue_smilie:).  I hope you have a good immunologist :) (also, big-picture, look to the immune system in the gut)

 

Thanks Wapiti! Very good info on SSRI and possible immune/autoimmune interaction. Will ask lots of questions before we go that route. My main concern is that dd has become so down - I'd hate to give her something that is going to push her further if even for a short term while she adjusts. I'm not familiar with neurogenesis. Adding that to my 'look up' list :)

 

Thankfully we have a homeopathic/naturopathic doctor on ds' team. She is very highly respected in her field. I think I'll make an appointment just so it's on the books. I'd imagine it will take awhile. 

 

Our immunologist is one of ds' long standing specialists. Dd is in great hands with him. Her GI and endocrinologist are also in the same clinic so they are all  in constant contact with each other's data and input.  Due to ds' special needs he has been followed by most of the specialties in the clinic for the better part of 12 years. Thankfully dd is seeing the same doctors so we've got an established relationship with them all which has made this situation much less stressful in that area. 

[PuddleJumper1]

Op I just want to say you are very polite :)

My Grandma would be nodding and asking me why I can't be more like you - reply to everyone and thank them for the best bits. It makes me smile to think about it.

 

Well, gosh  :blushing: ....thanks. Now you've made me smile :)

[Tiramisu]

I will add to the caution to go slow and/or very low with an SSRI in this situation, if at all.  My ds has an immune/autoimmune-caused anxiety-related issue and in his type of case, the chance of overreaction (mania) to an SSRI is double that for regular patients (I can't recall, but it's something like 13%!).  Therefore we are avoiding them for as long as possible.  If we end up going that route in the long run, it would be starting at, literally, one-tenth of the usual dose.  A possible benefit from SSRIs that I'm interested in would be neurogenesis but I haven't looked into it lately.

 

As for natural alternatives, curcumin and NAC may be worth a look though often there are patient-specific details that might point toward another approach.  For natural alternatives, consider seeking the guidance of a naturopathic doc if you can find one well-recommended in your area.

 

Obviously, treating the root cause immune/autoimmune stuff would be the way to go, and I totally get the desire for stop-gap measures to deal with the anxiety while you are addressing the immune/autoimmune and possible infections (I really don't want to even get into the infectious angle :tongue_smilie:).  I hope you have a good immunologist :) (also, big-picture, look to the immune system in the gut)

 

This is how our psychiatrist did it. She prescribed the lowest dose manufactured and had us break into fourths. It wasn't easy. 1/4 for three days. If not side effects, increase 1/4. Take for three days, if no side effects increase by 1/4 again. That went on until we got to one pill and stayed. She also believes in close monitoring, meeting every week or every two weeks until a stable point is reached.

 

What she said about the suicide risk is that when the media went crazy about the suicide risk and the number of teens taking these meds decreased, the suicide rate went up. That's only her reporting and I don't know what sources she is using for that information.

[Tiramisu]

BTDT with a child with medical problems. My oldest has a few medical issues that are associated with depression and anxiety. I was not open to meds and so she suffered for about 3 1/2 years until she herself asked one of her specialists for something to help. That doctor was the first to suggest that there was probably a physical cause and not an emotional one. She tried therapy, and even though she liked it and it may have helped her understanding of things and given her coping skills, it did not change how she felt.There was a night and day difference after she started meds. She did have to make a change when one med helped the anxiety but not the depression, but overall it was so much easier than I anticipated. I AM THANKFUL EVERY SINGLE DAY FOR MEDICAL TREATMENT FOR DEPRESSION and how it changed my dd's life. 

[poppy]

BTDT with a child with medical problems. My oldest has a few medical issues that are associated with associated with depression and anxiety. I was not open to meds and so she suffered for about 3 1/2 years until she herself asked one of her specialists for something to help. That doctor was the first to suggest that there was probably a physical cause and not an emotional one. She tried therapy, and even though she liked it and it may have helped her understanding of things and given her coping skills, it did not change how she felt.There was a night and day difference after she started meds. She did have to make a change when one med helped the anxiety but not the depression, but overall it was so much easier than I anticipated. I AM THANKFUL EVERY SINGLE DAY FOR MEDICAL TREATMENT FOR DEPRESSION and how it changed my dd's life. 

 

When I encourage meds, it's not because I'm anti-exercise or because I just think it's a fabulous idea to take pills to make problems go away. It's because I, and so many other people I know, suffered for years in an effort to avoid medications.   Spending all that time and mental energy researching, trying one thing after another, and failing (while vaguely ashamed to fail, while still experiencing all the original problems.....) is a real regret of mine.

[Tiramisu]

When I encourage meds, it's not because I'm anti-exercise or because I just think it's a fabulous idea to take pills to make problems go away. It's because I, and so many other people I know, suffered for years in an effort to avoid medications.   Spending all that time and mental energy researching, trying one thing after another, and failing (while vaguely ashamed to fail, while still experiencing all the original problems.....) is a real regret of mine.

 

Something that I also found interesting is that some physical problems seemed to improve with treatment for depression, and not purely subjective symptoms either. My theory is that there is a true neuro-chemical imbalance that an SSRI can correct in some people and once that happens the body can work better. And it may also give resistance to stress so that stress-induced problems can be alleviated. 

[SparklyUnicorn]

I took it when I was 22 for about a year.  It helped a great deal.  I didn't have any major side affects (other than zero libido, but for a 16 year old you might find that desirable..LOL).  It doesn't make you feel hyper or high or anything like that.  I have not taken it since.  If I needed it, I'd take it again in a heart beat. 

 

Frankly, that while I believe eating right, etc. can have a good affect on overall health, I don't believe in herbal remedies for stuff like depression. 

[SparklyUnicorn]

Oh and think about it, stuff like "exercise" isn't useful when one is depressed.  How do you exercise when you are depressed?  You need to start feeling better first.  It's pretty difficult to find that kind of motivation. 

 

 

[maize]

Oh and think about it, stuff like "exercise" isn't useful when one is depressed. How do you exercise when you are depressed? You need to start feeling better first. It's pretty difficult to find that kind of motivation.

This depends though on the circumstances and level of depression. A person who can hardly get out of bed probably needs medication to become functional, but someone who is feeling down but still mostly functioning in life might benefit greatly from activities that naturally increase neurotransmitter levels and raise mood.

 

We have some significant genetic tendencies towards anxiety, depression and other mental health challenges in the family, and I have seen things work out both ways. Medication can be a huge blessing, but sometimes supplement support and lifestyle changes are sufficient. Adding an activity that involves regular vigorous physical exercise in a social setting was transformational for one child's mental health in my home. If that hadn't worked medication would have been the next option.

[Tiramisu]

This depends though on the circumstances and level of depression. A person who can hardly get out of bed probably needs medication to become functional, but someone who is feeling down but still mostly functioning in life might benefit greatly from activities that naturally increase neurotransmitter levels and raise mood.

 

We have some significant genetic tendencies towards anxiety, depression and other mental health challenges in the family, and I have seen things work out both ways. Medication can be a huge blessing, but sometimes supplement support and lifestyle changes are sufficient. Adding an activity that involves regular vigorous physical exercise in a social setting was transformational for one child's mental health in my home. If that hadn't worked medication would have been the next option.

 

I'm in a definite low right now, probably my genetic tendency with a lot of recent stessors. But the number one factor in getting to this point was not continuing my normal exercise routine. I know if I can get back into my routine I will better be able to deal with all the things that are going on right now (illness in family members, homeschooling difficulties). But am I doing it? No. 

[fourcatmom]

PuddleJumper - I am wondering if you ever decided to start your dd on the prozac? My 13 yo dd was prescribed it yesterday for post concussive syndrome and or PTSD following her horse related concussion back in early December. She complains of headaches and nausea and other things everyday. She has now been referred to a specialized TBI clinic but her appoitnment is not for another week and half.

 

Any information you can share? TIA ;) It hard to move forward with it when the parmacist upon giving me the medication says that I need to be careful because it can make them committ suiside. :confused:

[MamaSheep]

My only regret about putting my son on Prozac is that I didn't do it sooner. Seriously. Changed his life. The one side effect we've seen with him is that he sleeps more, which in his case is a very good thing. 

As a person with chronic depression issues myself, I want to point out that different depression medications have different effects for different people. For me, Prozac sort of greys everything out so it doesn't matter as much--the dark scary stuff doesn't matter as much, but neither does the happy stuff, or the stuff that really SHOULD bother you. But it's not like that for my son, apparently.  Celexa made me faint the one time we tried that, but for my son it just didn't work as well as the Prozac. Wellbutrin seems to be my Goldilocks drug for when I need chemical assistance. For general upkeep once I've crawled out of "the pit" again, exercise, good nutrition, plenty of sunshine, a clean home, a little socialization, etc. generally do the job if I keep on top of them. My husband is good about helping me monitor and giving me a more objective perspective on whether I really am just not feeling social today, or if my avoidance of social time is a warning signal (because in the early stages, it's genuinely hard for me to tell). So yes, all of those things might help, but if it's as big a problem as it sounds like, medication can be a real blessing. And most people really do only need it temporarily to get them over the hump so they can start doing those other things that will help them feel better. But as someone else pointed out, when the depression has set firmly in, it's not realistic to expect the person to be able to do all those things. You would not believe the force of will it can take to pry your own body out of bed and make yourself go sit outside on the porch cursing the sunshine for five minutes because you know it will be good for you. And actually getting dressed and finding something to eat can seem as insurmountable as climbing mount Everest. Like your body actually weighs more than you can lift, and you don't even remember what hunger feels like, so why bother with food. 

I also want to say that joint pain and fatigue can be part of the depression, and depression meds can actually help lessen those things. 

But yes, when you start a new depression medication, or ANY new medication, you want to keep a close eye out for side effects. Usually with Prozac the doctor will start at a very low dose and work up from there until they find the right dose for that person. It takes a couple of weeks for Prozac to build up in the system and reach its full effect, so generally you don't raise the dose for at least two weeks, but if you start seeing undesirable side effects before that, you can reduce the dose or stop the medication (under a doctor's supervision, of course). Also with Prozac, both the side effects (if there are any) and the desired medicinal effects come on gradually as the medication builds up, and they generally go away completely once the medication is stopped, so it's pretty easy to nip problems in the bud. 

One other thing I might suggest, as far as non-drug treatment would be to think about grief counselling. Grief isn't quite the same thing as depression, but can manifest in similar ways. And grief and depression can both occur at the same time. If the physical problems your daughter is dealing with are looking like they'll be a long-term, or permanent thing, she may be experiencing some real grief over what "could have been." Chronic illness or disability can feel very much like a death, even if you don't necessarily make the connection. It's a loss of yourself, who you always meant to be, the life you were "supposed" to have. And since there's no tangible, visible loss, it's sometimes hard to even figure out what that awful feeling you're experiencing is. Somehow, knowing that you're grieving a loss can make it easier to work through the process (and there is an actual, definable process, though we each go through it in our own unique ways). And when you don't know that's what's happening, it can be really scary, and you can get stuck, and a little guidance from a counselor can be very helpful. Just something else to consider. 

Hugs to you and your daughter. I hope you find a good solution that works for your family. 
 

[MamaSheep]

P.S. If it hasn't already been done, make sure they check her thyroid levels, and vitamin D levels. And there are a few other physical things like that that can sort of mimic depression. Prozac won't do the job if what she really needs is a thyroid boost. 

[Rebecca]

I did not read any replies so forgive me if this has been said... my husband and I have had true success using SAM - e. It is a mood lifter and clinically proven to help joint pain. I would definitely try it. We also have some experience with St. Johns Wort and SAM - e has just been so much better.

 

HTH

[gardenmom5]

This was recommended as a possibility for dd yesterday.

 

Dd16 has had a really bad year and a half physically. After multiple doctors I think we finally are close to some answers with a visit to Immunology yesterday. Her physical issues are very possibly rooted in low immune or autoimmune issues. As you might imagine her struggles have really taken a toll on her outlook and mood. She went from a very energetic, happy, bouncing kid to a subdued kid asking for a new body (she struggles with joint pain, extreme fatigue and recurrent infections). In many ways she has gone from Tigger to Eeyore and we all  really want the Tigger side back. The doctor yesterday suggested taking a med like Prozac for a short term might give her a boast to getting back to where she was while we deal with treating the physical issues. We are not at all opposed but we have no experience with this class/type of medication. We also really like to approach life from a more natural/homeopathic path wherever possible.

 

If you (or especially one of your children) have taken Prozac I'd love any insight or thoughts you would share. Do you love it? Has it been a help? Warnings we should know about?

 

If you have treated depression naturally I'd really love input and suggestions. This would be our first choice if it can be treated naturally. My little guy sees a homeopathic doctor for his special needs and she is an option but it will take a while to get a new patient appointment. 

 

I'm doing some research but BTDT experience is always the best. 

 

 

Thanks!

 

 

I've had Prozac - I had a good experience with Prozac.  (I had very messed up brain chemistry.  the Prozac stabilized it in the short term.  for long term, I had to treat the messed up chemistry.)

that said - I know many who had a nightmare with it.  I honestly think it *is* over prescribed. a recent study did determine at least half of those prescribed antidepressants aren't' actually depressed. which would explain a bad experience.

 

I know use very high quality of bioavailable b-vitamins (I don't convert them - or much of any other brain chemical - very well, so I just use bioavailable), 5-htp (start slow, build up.  I was told I could go up to 600mg.)  I also use MTHF from thorne.  go very very slowly.

 

re: the bolded, has she been checked for mthf? it could be the cause of her symptoms - and it won't respond very well to antidepressants. (they can help - but not enough.)

one thing, if she does have a mthf mutation, mthf (only use thorne) should help.  if it's not her problem, it will NOT hurt her as it's just a very specific form of folate.

[PuddleJumper1]

PuddleJumper - I am wondering if you ever decided to start your dd on the prozac? My 13 yo dd was prescribed it yesterday for post concussive syndrome and or PTSD following her horse related concussion back in early December. She complains of headaches and nausea and other things everyday. She has now been referred to a specialized TBI clinic but her appoitnment is not for another week and half.

 

Any information you can share? TIA ;) It hard to move forward with it when the parmacist upon giving me the medication says that I need to be careful because it can make them committ suiside. :confused:

 

How funny that this just popped back up today. I am just waiting for the appointment with the proper doctor to get her started on something. We still do not have answers for her physical symptoms. Having yet another doctor tell her, the other day, that he knows something is wrong but doesn't know what sent her into a bit of a tailspin. She asked me to go ahead and make the appointment. It should be in the next week or so.

 

I'll keep you posted :) 

[PuddleJumper1]

P.S. If it hasn't already been done, make sure they check her thyroid levels, and vitamin D levels. And there are a few other physical things like that that can sort of mimic depression. Prozac won't do the job if what she really needs is a thyroid boost. 

 

Her levels have been checked and as far as we know they are normal. We do see endocrine again on Tuesday so there may well be more labs. The new doctor she has been referred to  says in his bio that he loves medical puzzles. He's got one in dd. I'm hopeful that he will be able to help her. 

[PuddleJumper1]

Poppy - Thank you for this! Lots of good stuff in here. 

 

 

My only regret about putting my son on Prozac is that I didn't do it sooner. Seriously. Changed his life. The one side effect we've seen with him is that he sleeps more, which in his case is a very good thing. 

As a person with chronic depression issues myself, I want to point out that different depression medications have different effects for different people. For me, Prozac sort of greys everything out so it doesn't matter as much--the dark scary stuff doesn't matter as much, but neither does the happy stuff, or the stuff that really SHOULD bother you. But it's not like that for my son, apparently.  Celexa made me faint the one time we tried that, but for my son it just didn't work as well as the Prozac. Wellbutrin seems to be my Goldilocks drug for when I need chemical assistance. For general upkeep once I've crawled out of "the pit" again, exercise, good nutrition, plenty of sunshine, a clean home, a little socialization, etc. generally do the job if I keep on top of them. My husband is good about helping me monitor and giving me a more objective perspective on whether I really am just not feeling social today, or if my avoidance of social time is a warning signal (because in the early stages, it's genuinely hard for me to tell). So yes, all of those things might help, but if it's as big a problem as it sounds like, medication can be a real blessing. And most people really do only need it temporarily to get them over the hump so they can start doing those other things that will help them feel better. But as someone else pointed out, when the depression has set firmly in, it's not realistic to expect the person to be able to do all those things. You would not believe the force of will it can take to pry your own body out of bed and make yourself go sit outside on the porch cursing the sunshine for five minutes because you know it will be good for you. And actually getting dressed and finding something to eat can seem as insurmountable as climbing mount Everest. Like your body actually weighs more than you can lift, and you don't even remember what hunger feels like, so why bother with food. 

I also want to say that joint pain and fatigue can be part of the depression, and depression meds can actually help lessen those things. 

But yes, when you start a new depression medication, or ANY new medication, you want to keep a close eye out for side effects. Usually with Prozac the doctor will start at a very low dose and work up from there until they find the right dose for that person. It takes a couple of weeks for Prozac to build up in the system and reach its full effect, so generally you don't raise the dose for at least two weeks, but if you start seeing undesirable side effects before that, you can reduce the dose or stop the medication (under a doctor's supervision, of course). Also with Prozac, both the side effects (if there are any) and the desired medicinal effects come on gradually as the medication builds up, and they generally go away completely once the medication is stopped, so it's pretty easy to nip problems in the bud. 

One other thing I might suggest, as far as non-drug treatment would be to think about grief counselling. Grief isn't quite the same thing as depression, but can manifest in similar ways. And grief and depression can both occur at the same time. If the physical problems your daughter is dealing with are looking like they'll be a long-term, or permanent thing, she may be experiencing some real grief over what "could have been." Chronic illness or disability can feel very much like a death, even if you don't necessarily make the connection. It's a loss of yourself, who you always meant to be, the life you were "supposed" to have. And since there's no tangible, visible loss, it's sometimes hard to even figure out what that awful feeling you're experiencing is. Somehow, knowing that you're grieving a loss can make it easier to work through the process (and there is an actual, definable process, though we each go through it in our own unique ways). And when you don't know that's what's happening, it can be really scary, and you can get stuck, and a little guidance from a counselor can be very helpful. Just something else to consider. 

Hugs to you and your daughter. I hope you find a good solution that works for your family. 
 

 

[foxbridgeacademy]

IME (family/friends) meds like Prozac and Zoloft make depression worse for teens.  What has helped DD 11 and DS 13 is a combination of Dopa Mucuna and echinacea  during the day and 5HTP and True Calm at night.  She also takes Fish oil and probiotics daily.  

[Guest]

I have had such better response to a good St John's Wort supplement than Prozac, Wellbutrin, Topomax, Depakote, et al. Less side effects and it didn't make me manic. Treatment, whatever route you go, can be so helpful. But do watch for side effects!

[foxbridgeacademy]

We had some issues with jitters and rapid pulse on St johns wort.  My mom who used to take it daily said that those side effects wore off after a few days.  If you try any herbals I start with a very low dose and only 1 new thing at a time, increase until recommended dosage (or whatever you decide is the goal) then after stabilizing add in the next thing.  I have found with herbal remedies there's no 1 pill=cure.  As you see from my prev. post we use several things regularly and add in others occasionally (like Valerian when we've had a stressful day).