Weaning child off SSRIs? Any advice or thoughts?

[mindinggaps]

Hi all, my daugther who recently turned 8 has OCD and GAD and has been taking Prozac to help manage things for roughly the past 18 months. After many trials and tribulations, we managed to find a dose that worked for her and overall the medication has had a tremendously positive impact on her quality of life. She has now been very stable and almost symptom free for roughly 6-8 months. Recently we've heard conflicting ideas on how to proceed with her treatment and I'm not really sure what to do.

• Her primary psychiatrist wants to keep her steady on medication with periodic dosage increases as needed to adjust for her growth.
• Another psychiatrist briefly looked at her file while she was getting care for a different issue and suggested that since she's been stable for ~8 months, we should try weaning off to see how it goes. This doctor mentioned that there's some research to indicate early exposure to SSRIs can increase the likelihood of needing them in adulthood so it's good to periodically check if they are still required.

Does anyone have experience weaning off SSRIs? Any thoughts on this topic? What would you do?

[prairiewindmomma]

I’d leave her on. I know you and your dh have been upset that she needs medication, but look back at your previous posts. She clearly benefits from being on meds. The changes you made in the past when she had med refusal caused a huge disruptance. You finally have her stable again—and it’s only been six months of stability. If it had been years and years and she was older and therapy had proved very beneficial…maybe I’d consider a wean down. But I certainly wouldnt consider one now.

Gently, I think you still havent accepted that your daughter needs medication to thrive. Every single post is about how you have issues with her needing medication even though you claim that you and dh have improved in your attitudes towards it.

[Lecka]

I would stay with the primary psychiatrist’s recommendations.

I think the “briefly looking” psychiatrist said something casual and generic, and you need to look at it that way.  Sometimes people comment in this fashion, and if you have a specific situation going on, you just have to take it in that fashion.  
 

Or change to them, let them do every thing and get to know your child — and then see if they still want to stick with their casual, generic comment — because it’s likely they won’t at that point.

[Lecka]

I used to get upset about comments like this, or read a lot into them, and now I recognize that they are more like chatting than anything else, they aren’t the same as — what would happen if they took a child on as a patient.  
 

It is a solid generic statement to make!

 

But does that mean it applies to you?  
 

Would the primary psychiatrist agree with this generic statement in general?  Yes, probably!!!!!!

[Lecka]

I would feel very free to bring this up with the primary psychiatrist if you want to after a little time passes (even a short amount of time can make a difference).  If it rings true to you — I think this is fair to bring up and see what the primary psychiatrist says.  
 

I would not say it in front of the child, maybe write a note and then see if you can talk about it vaguely, if your child will be in the appointment.  
 

But I think sometimes a little time passes and it becomes more clear that something was a vague, random comment, and not really some new insight or something to say “hey, should we be changing things?”

[mindinggaps]

4 minutes ago, prairiewindmomma said:

Gently, I think you still havent accepted that your daughter needs medication to thrive. Every single post is about how you have issues with her needing medication even though you claim that you and dh have improved in your attitudes towards it.

There's probably some element of truth that. Although, I do definitely accept and acknowledge that the medication is helping her tremendously. I appreciate the benefits of her being on it and have really come to terms with the reality that it's part of her life at least for now and potentially long term. Having said that, if there was an option for her to not need it, I cannot deny it's appealing. Therapy has helped her a lot and if she can in the future manage things without medication, I'd be lying if I said I didn't think of that as the preferable outcome.

 

4 minutes ago, Lecka said:

I would feel very free to bring this up with the primary psychiatrist if you want to after a little time passes (even a short amount of time can make a difference).  If it rings true to you — I think this is fair to bring up and see what the primary psychiatrist says. 

I actually immediately asked the response was - we can, but my personal recommendation is don't.

[prairiewindmomma]

Look at the other side of what she said—kids who had severe enough symptoms to warrant medication at an early age are more likely to need meds in adulthood….than children who had milder or later symptoms. All this tells you is that the kids who really needed meds…..really needed them. It’s a fact about severity of disease, not about length of exposure to the drug.

[mindinggaps]

1 minute ago, prairiewindmomma said:

Look at the other side of what she said—kids who had severe enough symptoms to warrant medication at an early age are more likely to need meds in adulthood….than children who had milder or later symptoms. All this tells you is that the kids who really needed meds…..really needed them. It’s a fact about severity of disease, not about length of exposure to the drug.

Yeah, I believe there is some unknown within the medical community on this. One explanation for kids who were put on medication young being more likely to need them as adults is exactly what you said. Another is that early exposure impacts the developing brain and changes how certain neurotransmitters are regulated over the longer term.

[Terabith]

My youngest, who was exposed to SSRIs during my pregnancy and through nursing and who desperately needed and started them at age 4.5 or 5 (I can't remember which side of her fifth birthday we started, but it was very close), has absolutely thrived on them.  When she was 11 and a year or so past her first period/ well into puberty, we weaned her off.  It wasn't her psychiatrist's idea, but her psychiatrist agreed it was worth trying to see if she still needed them.  

She did.  She absolutely did.  It was enough that at age 11, she asked to go back on them, and she has never ever wanted to stop.  She can tell if she's a few hours late with a dose.  

Gently, you DID try weaning her off awhile ago, and it didn't go well.  I would definitely stick with the primary psychiatrist's recommendation.  

Every time you take a child off of a medication and restart it, it is a gamble.  There is no guarantee that just restarting will lead to stability, because every crash in how well symptoms are managed can have real repercussions to their brain, as well as to their development in general.

Being anxious/ depressed/ OCD/ experiencing severe or distressing symptoms really, really sucks.  Trust me, I know from personal experience how much it sucks.  

Why put your child through unnecessary and possibly dangerous suffering for no real reason?  

I think it would make sense to try weaning off after puberty and several years of stability, but not six months.

[fairfarmhand]

Don’t.

shes still very young to try to “tough it out” with only therapy. She’s just eight. That’s very very young. My adult kids on ssri would struggle with that. 
 

it didn’t work a few  months ago. And not much has changed.

[Lecka]

4 minutes ago, mindinggaps said:

Another is that early exposure impacts the developing brain and changes how certain neurotransmitters are regulated over the longer term.

And what will be the impacts to her brain development if she goes through another period of severe challenge during her early development?  
 

I just say that to say — you can always look at the possible negatives of doing something, but it may not be a neutral choice.  There may be negatives to not doing it, too.  It’s just always a good thing to look at.  
 

On one hand, maybe everything goes great with reduced medicine, and she can get back on track, and it turns out she has grown out of her issues.  This is one hypothetical.

 

But there’s another hypothetical where it’s a big mess.  
 

What do you think her primary psychiatrist thinks is the most likely outcome?  Do you trust this person?  Do you think this person has a good sense of your child?

 

Just realistically, do you think the primary psychiatrist is a big drug pusher who loves putting kids into medication, or do you think this person sees a lot of patients and has patients where he/she does think “hey things are stable now, and it seemed like a less-serious issue in some way, maybe it seemed clearly related to something like the death of a parent or something, let’s try reducing the dosage and seeing if we can discontinue.”  You can ask this, too.  Like — you can ask, do you agree with this but don’t think it’s right for my child?  Or you can ask if he disagrees in principle in some way.  
 

You didn’t have the chance to ask the “quick glance” person if he/she has any patients where he/she would make the same recommendations as your primary psychiatrist.

 

Anyways…. Even if it is true that you are going to turn out to have changed your daughter’s sensitivity, even if this is true, does that change her need for this medication?  Does she need the medication even though there is this risk?  I think this is the real question.  I think it’s possible there are some negative sides to this treatment, and those can be acknowledged, and then compared to the positive sides of the treatment.  
 

I think it is up to the parents to look at the positives and negatives and decide on the best decision, and I think that is okay for you to do, and okay to consider negatives like this.  
 

But I think it is important to weight what a medical professional thinks.  Only the primary psychiatrist has done this.  The other one has not, he/she has only made a generic comment.  I think this is fair to hold a heavy weight in decision making, but it’s not the only thing to consider.  

[Katy]

I would leave her on it as long as she is stable. She’s very young. Chances are puberty will destabilize her a lot, and that will likely start in a matter of months. Don’t change what’s currently working. 

[Terabith]

Just now, Katy said:

I would leave her on it as long as she is stable. She’s very young. Chances are puberty will destabilize her a lot, and that will likely start in a matter of months. Don’t change what’s currently working. 

That is a good point.  Ages 8-9 were the most unstable for both of my kids.  I think that is very, very common for girls.

[Lecka]

19 minutes ago, mindinggaps said:

Another is that early exposure impacts the developing brain and changes how certain neurotransmitters are regulated over the longer term.

I do just want to acknowledge, this is concerning, and nobody can say if it won’t turn out to be the case. 
 

I think it is very fair to find this hypothesis concerning and troubling.

 

Nobody said parenting was easy!!!!!!  This is not an easy situation.  
 

But I do think, as parents, sometimes we are faced with a situation where there are a lot of data points, and we really don’t like some of the data points, but we have to make our peace with them somehow, and we have to come to a decision that works for us somehow.  I don’t think it’s an easy process, especially with new information or comments that can seem to cast a doubt on what we are doing.  But that is also part of life.  I don’t like it, but it can just be part of it.  
 

I think it’s helpful to make a list of pros and cons, and possible outcomes.  
 

I also think it’s helpful to think it’s probably going to feel “questioning” or “up in the air” at times like this, and that’s okay.  It just means you care about your child and want the best for her.  But it’s most likely that if you have got a plan that is working, to stay with the plan.  That is just the most likely thing, just because if there is a plan, there is a plan for a reason, it didn’t just happen out of nowhere.  

[TheReader]

28 minutes ago, mindinggaps said:

There's probably some element of truth that. Although, I do definitely accept and acknowledge that the medication is helping her tremendously. I appreciate the benefits of her being on it and have really come to terms with the reality that it's part of her life at least for now and potentially long term. Having said that, if there was an option for her to not need it, I cannot deny it's appealing. Therapy has helped her a lot and if she can in the future manage things without medication, I'd be lying if I said I didn't think of that as the preferable outcome.

 

I actually immediately asked the response was - we can, but my personal recommendation is don't.

I think the bold is your answer, then. 

You already asked her primary doctor, who said no (at least for now).  If you trust this doctor otherwise, I would listen to that, full stop. 

I know society treats this as different than other things, but it's a medical issue, with a medicinal solution, and one that is keeping your dd stable & with a greatly improved quality of life. Stick with it. 

[Lecka]

I do also think:

Person A promises certainty.

Person B says “I’m sorry, but I can’t promise certainty.”

Listen to Person B every time.  This is reality.  

[mindinggaps]

6 minutes ago, fairfarmhand said:

it didn’t work a few  months ago. And not much has changed.

Yes, this is true. Our last attempt to lower the dosage did not go well.
 

7 minutes ago, Lecka said:

What do you think her primary psychiatrist thinks is the most likely outcome?  Do you trust this person?  Do you think this person has a good sense of your child?

 

Just realistically, do you think the primary psychiatrist is a big drug pusher who loves putting kids into medication, or do you think this person sees a lot of patients and has patients where he/she does think “hey things are stable now, and it seemed like a less-serious issue in some way, maybe it seemed clearly related to something like the death of a parent or something, let’s try reducing the dosage and seeing if we can discontinue.”  You can ask this, too.  Like — you can ask, do you agree with this but don’t think it’s right for my child?  Or you can ask if he disagrees in principle in some way.  
 

Fully agree with everything you are saying. The risks of another setback are substantial. I generally trust her psychiatrist although there are some aspects of her approach and treatment plan which mildly annoy me sometimes, which I am sure is true of any physician.  Her primary psychiatrist basically told us at diagnosis she would likely need medication for life and that quick judgement did not sit well for me. She's always doubled down on this and at times it's been at odds with other care providers who are a much more wait and see...too early to say what the longer term looks like. She's big into preventative increases which sometimes feel unnecessary.

 

9 minutes ago, Terabith said:

That is a good point.  Ages 8-9 were the most unstable for both of my kids.  I think that is very, very common for girls.

When we brought up weaning down, the psych said she would recommend a preventative increase if anything. We declined on that. We will only increase it if feels warranted and right now, it does not.

[Terabith]

I kinda suspect that the reason your primary psychiatrist is so adamant on staying on the medication is because of your and your dh's reluctance to use it.  

[Lecka]

7 minutes ago, Terabith said:

kinda suspect that the reason your primary psychiatrist is so adamant on staying on the medication is because of your and your dh's reluctance to use it.  

I would hope this person is just giving their honest medical opinion.  (Edit:  I see what you mean, and I think, maybe, but this would rub me the wrong way, I wouldn’t like it.)

What I thought was — maybe some other care providers like to leave it open, but privately they think the same thing.  But it might not be their role in the slightest.  It might not be appropriate for them to say.  They also might know you don’t like it and want to just focus on the present and not get distracted.  (Edit:  they also may not feel like they could make a prediction, or might think it’s possible it’s more of a stage.)
 

I do not know enough about it to say — but it could be considered appropriate for one professional to say “in my professional opinion…. Long-term prognosis.”  Then for other professionals it could be totally not in their lane to share an opinion, because it’s outside their profession.  
 

However — I also think if you’re not comfortable with *this psychiatrist* you could change!  
 

But if you don’t like the information, that is a little different.  
 

I think it would be worth thinking, if you think a different psychiatrist would say “your child’s really not that severe, your child really doesn’t fit into this presentation where it seems likely it will be long-term and need increases over time.”  Because if you do think that?  That is a reason to consider seeing someone else.

 

But somebody who makes a flip comment, just does not count, without more depth and context.  

Edited July 24 by Lecka

[prairiewindmomma]

Yes, as I recall from your last post the psych wanted to go up on the dose, and you did not think it was warranted. 

[prairiewindmomma]

I have gotten the impression over the series of posts you’ve made that the main psych has been respectful, listened to you, and as much as possible has tried to minimize medication because of your concerns and reluctance. She’s trying to balance your desires and your dd’s medical needs.

[Lecka]

Do you know what the rationale is for the preventative increases?  I’m just asking hypothetically.  It might be optional and fine if you don’t want that option.  Other parents might hear the same information and think “I do want that option.”  A lot of the time that is fine and to be expected, for different parents to have different opinions.  
 

Other times it’s like — oh, the bad outcome happens to the kid once, and then the parents get on board.  I think sometimes it’s tempting fate.  I have no idea if this is tempting fate, or a free choice that is equally acceptable on either side.  

[Terabith]

Even if she DOES need medication forever, so what?  So what if she still has to take it when she's 43?  

Like I get that we'd all prefer for ourselves or our kids not to need meds, but it's not any major failure to need them.

[Ottakee]

1 hour ago, prairiewindmomma said:

Look at the other side of what she said—kids who had severe enough symptoms to warrant medication at an early age are more likely to need meds in adulthood….than children who had milder or later symptoms. All this tells you is that the kids who really needed meds…..really needed them. It’s a fact about severity of disease, not about length of exposure to the drug.

And I don’t know about meds for OCD but I know that for mood stabilizers, if you have one that works well, client is stable, you remove the med, often client needs meds again and then the original med/dose either is not effective or then requires a higher dose.

[Terabith]

I'm not some person who is just all gung ho for meds.  I was really reluctant to medicate my preschooler, but once we decided to do so, it was absolutely the best decision we could have made for her.  

My other child needed meds for a year or so in high school during a time of crisis, and then weaned off of them and seems fine.  That child (now an adult) doesn't have the same level of inherent anxiety and depression that youngest does.  

They might need meds again at some other point in their life, and that is completely fine.  I think they are someone for whom going on and off on an as needed basis might make sense.  

But it really truly doesn't for my other kid.

[Clarita]

41 minutes ago, mindinggaps said:

Fully agree with everything you are saying. The risks of another setback are substantial. I generally trust her psychiatrist although there are some aspects of her approach and treatment plan which mildly annoy me sometimes, which I am sure is true of any physician.  Her primary psychiatrist basically told us at diagnosis she would likely need medication for life and that quick judgement did not sit well for me. She's always doubled down on this and at times it's been at odds with other care providers who are a much more wait and see...too early to say what the longer term looks like. She's big into preventative increases which sometimes feel unnecessary.

If you struggle with trusting this provider (I count second guessing and being annoyed at the approach and treatment plan), then maybe you should seek a second opinion and decide if you should go to different provider. I don't think it's normal to be annoyed at a provider's approach and treatment plan. 

[MercyA]

Oh hell no. Please don't try to take her off of her medical treatment. It didn't work before and it's not going to work now.  I've said it many times, but it's no different than a diabetic needing insulin. 

I think rather than your psych making a snap judgment about the likelihood of long-term treatment, she was responding to the severity and very clear nature of your daughter's symptoms. 

You need to reach a place of acceptance about this. It's okay that your DD has a medical condition. Be happy that she is doing so much better. 🙂 

[sweet2ndchance]

So someone who briefly looked at her file and saw her when she was stable and not when she was having issues that needed medication said that you should wean her down? Is this person's opinion worth possibly falling from where you and your dd are in terms of mental stability? Personally, I would take what they said with a grain of salt. And like @Terabith said, if she needs medication through adulthood, then she needs medication. It's not going to do her any good that I can see to yo-yo her medication throughout childhood just to see if she might not need them. A stable childhood would be much more important to me than trying to prevent her from needing medication lifelong. She may need medication lifelong no matter what I do so I would rather control what I can control right now which is giving her a stable as possible childhood.

I resisted going mental health medication and fought to get off them as hard as I could. I finally had to accept that I really am better when I am on medication. It's not a bad thing to need medication. I probably should have started them as a child but the world was different then. I will probably be on some kind of mental health medication for the rest of my life because I'm not using them to just get through a rough patch of life. My brain chemistry requires medication to be able to function normally. It's not a failure, it's just a part of me that I can easily keep in check by taking medication.

[Terabith]

In February you posted this:  

Hi all, it's been a few months since I've posted here but for those who have followed and provided advice, I wanted to share a quick update on my daughter who has been struggling with OCD. Last I posted she was really struggling and her psychiatrist was considering the option of adding on an atypical anti-psychotic to her Prozac. Ultimately, after careful consideration we really did not feel comfortable with this and followed the advice of a few posters here to seek a second opinion. She was evaluated by another psychiatrist who confirmed her diagnosis of OCD and also suggested this was co-morbid with GAD. She was again thoroughly tested for ASD which was again confidently ruled out.

Interestingly the psychiatrist we saw suggested lowering her SSRI dose, which was quite high at the time since he wondered if some of her aggression could have been a side effect. We did a brief trial at 20 rather than her normal 40mg dose of Prozac and unfortunately things deteriorated very rapidly. Her OCD symptoms intensified and she began exhibiting new compulsions alongside obsessions of germs and dirt. In the past she had health related anxieties which made her afraid of her medication and these materialized in new ways - she was hesitant to follow the direction of the doctor since she thought he was trying to hurt her. The doctor wanted to trial a different SSRI, Zoloft and after much convincing we gave it a try. Again, this was a failure.

Feeling lost and frustrated we ended up back where we started with her at 40mg of Prozac which did bring some stability back to things. The new psychiatrist added a note to her file recommending that she maintain on at least this dose of Prozac moving forward as a baseline. Any new care providers should not mess with this. So after a couple months of ups and downs and tinkering, all we really learned was she needs to be on Prozac. We returned back to her original pych who overall we strongly preferred and are monitoring now. No new meds, focus on ERP and therapy. 

So...I don't know what to make of it all.

----------------------------------------------------------------------------------------------------------------------------------------------

I'm not sure you're remembering how bad things were not even six months ago.  

[Clarita]

From what @Terabith's quote it seems you already got several other psychiatrist's opinions. Have you and your husband considered seeing a therapist for yourselves concerning your daughter's diagnosis. I know some friends of mine whose children have medical issues who have gone to therapy to handle their children's diagnosis. 

[TechWife]

Follow the advice of the physician who knows her case, not the one that briefly looked at her chart. 

[prairiewindmomma]

5 minutes ago, Clarita said:

From what @Terabith's quote it seems you already got several other psychiatrist's opinions. Have you and your husband considered seeing a therapist for yourselves concerning your daughter's diagnosis. I know some friends of mine whose children have medical issues who have gone to therapy to handle their children's diagnosis. 

Didnt both parents already seek therapy on this point? I think last fall? It’s in previous threads, I just havent had time to look back.

[TechWife]

1 hour ago, mindinggaps said:

…I actually immediately asked the response was - we can, but my personal recommendation is don't.

Six months is not a long time. I don’t know how long she’s been struggling, but she deserves to have every opportunity to live a full life. Doing  better and making progress in therapy do not equate to being able to stop medication. 

I agree with a previous poster who suggested you & your husband seek therapy for help in dealing with yourselves as you parent someone with a chronic illness and come to terms with the nature of the illness and available treatment. 

[ScoutTN]

Ain’t broke, don’t fix it. 
I would leave her on the medication. 

[EKS]

I had a friend who had schizoaffective disorder that was reasonably well controlled with medication.  The problem was that after being on meds for a time, he would feel better and then decide he didn't need them anymore, stop taking them, and invariably end up in jail.

My point here is that you know that the last time you took your daughter off of her meds that she did not do well.  She is doing well now.  I'd leave well enough alone and reevaluate in 6-12 months.

[Bambam]

Your daughter is stable on her current dosage? 
Leave it alone. 

IMHO, in a year or two, then I might consider maybe tapering off, BUT, I would do it with the primary doctor, and I would go slowly - as in go down 10 mg every 3-4-6 months, keeping an eye on everything. If she starts having issues, then there is your answer - not the one you wanted, but an answer about how to keep your dd stable. 

Never taper off SSRIs without the doctor's advice and direction. 

[Kidlit]

I haven't been around in a while, but reading this I felt compelled to log in and respond.  OP, I know you know some of our story, but let me just say that weaning our child at child's own instigation after several years of relative stability (child also diagnosed with severe OCD and treated in partial hospitalization with ERP therapy for 12 weeks, also continuing the therapy once home, and then attending an anxiety "boot camp" sort of week at Mayo a few years later) did not work.  I think the child, now a successful college student who works and has a SO, has recognized the necessity of the meds for her and made peace with it.  We parents have, too.  

[mindinggaps]

Firstly, thanks to all for chiming in. I do appreciate it. @Clarita@TechWife@prairiewindmomma On the topic of therapy, I can confirm that both me and my husband are engaged with therapists to help manage our feelings around this situation. In full transparency, and somewhat ironically, the topic of me trying an SSRI to help manage the stress and anxiety I feel around my daughter's condition also came up at some point and I declined.

I have learned a lot and become a better parent but I fully acknowledge that my own anti medication bias is still there on some level. Usually it doesn't impact me. But somehow this professional caught my attention and got me thinking again. I hear what everyone is saying here and I take that seriously. It's also sobering to really look back at where things were not that long ago.

Truthfully, I don't know if I'll ever fully let go of the hope that we can at some point try lowering her dosage, but now is likely not the time. I also suspect some of my annoyance with her care provider is transference of other frustrations.

One of my main concerns is that when she becomes an adult she will resent me for the decision I made to medicate her with psychotropic drugs. I've read a lot of stories of adults who are angered over the fact that they were given medication when it was outside of their control. These are not medications I would want to take for myself unless absolutely necessary and therefore, I feel a bit hypocritical giving them to a young child.

Edited July 25 by mindinggaps
Extra information and clarity.

[Terabith]

21 minutes ago, mindinggaps said:

Firstly, thanks to all for chiming in. I do appreciate it. @Clarita@TechWife@prairiewindmomma On the topic of therapy, I can confirm that both me and my husband are engaged with therapists to help manage our feelings around this situation. In full transparency, and somewhat ironically, the topic of me trying an SSRI to help manage the stress and anxiety I feel around my daughter's condition also came up at some point and I declined.

I have learned a lot and become a better parent but I fully acknowledge that my own anti medication bias is still there on some level. Usually it doesn't impact me. But somehow this professional caught my attention and got me thinking again. I hear what everyone is saying here and I take that seriously. It's also sobering to really look back at where things were not that long ago.

Truthfully, I don't know if I'll ever fully let go of the hope that we can at some point try lowering her dosage, but now is likely not the time. I also suspect some of my annoyance with her care provider is transference of other frustrations.

One of my main concerns is that when she becomes an adult she will resent me for the decision I made to medicate her with psychotropic drugs. I've read a lot of stories of adults who are angered over the fact that they were given medication when it was outside of their control. These are not medications I would want to take for myself unless absolutely necessary and therefore, I feel a bit hypocritical giving them to a young child.

For what it's worth, I know a lot of adults who are also angry that their parents DIDN'T medicate them when they were children and that they suffered needlessly.  

My kid is incredibly glad we medicated her.  She would not be a functional, relatively happy and healthy adult if we had not begun medicating her at age 5 and maintained meds.  

Like....if we had not done meds, I think the odds that she would be able as an adult to hold a job, attend college, or live independently are approximately zero, because the severity of her anxiety did not allow her to grow and learn.  She could not socialize.  She was not a functional person.  She could not participate in any of the necessary tasks of childhood until she was on medication.  

But yeah, I think it's always smart to save for a "therapy for adulthood" fund, in the assumption that we are going to do something that screws up our kids, even while doing the absolute best that we can.

[Lecka]

28 minutes ago, mindinggaps said:

One of my main concerns is that when she becomes an adult she will resent me for the decision I made to medicate her with psychotropic drugs. I've read a lot of stories of adults who are angered over the fact that they were given medication when it was outside of their control. These are not medications I would want to take for myself unless absolutely necessary and therefore, I feel a bit hypocritical giving them to a young child.

I think it is such a grave responsibility to make decisions on behalf of a child, and really not know how they will feel about it later.  
 

I think the most important thing is she has two loving parents, and even if there is some sense of blame later, I think having a caring and strong relationship and that foundation, will be the real most important thing in the long-term.  
 

And with all the impossibility of knowing what the future will hold…. There are people upset their parents declined to treat them with medication, too.  
 

I think this makes it really come down to being able to say “it was a hard decision and we knew there might be drawbacks, but we did what we thought was best at the time,” and I think that is the best we can do.

 

It definitely comes across like you’re taking this seriously and not being flippant or blowing things off — and I think that goes a long way.  
 

 

Edited July 25 by Lecka

[fairfarmhand]

I’m not trying to be flippant, but as a mom of three adult kids, she’ll probably find something to be upset with you about when she’s a young adult. It’s just the nature of the beast. However, you can say, I agonized over this decision and spent years second guessing myself, so I just did the best I could with the information I had. 

[Lecka]

I think it’s also a raw deal that she has some struggles, and that she is in a situation to take medication.

That is a raw deal, and it’s definitely not your choice for her to be in this situation.  
 

I think it’s okay to not like that it’s the situation.  
 

I think with parenting, there are times we didn’t get to pick our cards, but we can make the best of the hand we are dealt.  I think that is parenting with integrity and I think it can be a personal value in parenting.  
 

I think that can allow for both feeling like a hypocrite, and with not liking a situation.  I think both those feelings can be present, and still there can be parenting with integrity.  
 

I think it is just a hard situation, and maybe not realistic to not feel these conflicted feelings, when things happen to bring them up.  
 

[sweet2ndchance]

1 hour ago, mindinggaps said:

One of my main concerns is that when she becomes an adult she will resent me for the decision I made to medicate her with psychotropic drugs. I've read a lot of stories of adults who are angered over the fact that they were given medication when it was outside of their control. These are not medications I would want to take for myself unless absolutely necessary and therefore, I feel a bit hypocritical giving them to a young child.

You can't control your dd's future feelings toward how she was raised. You can only do the best you can with the cards you're dealt and the knowledge you have right now. The knowledge you have right now is that she needs medication to function normally. So you are doing the best you can by providing that for her.

Teenagers and young adults can almost always find something to be resentful toward their parents for. It's just part of the stage of life they are in. They often come back around when their hormones calm down and their brains are finished growing and realize that their parents were only human and made the best decisions they could for them. You cannot spend her childhood worrying about her feelings toward you when she is an adult. It's is a self-defeating behavior.

[MercyA]

20 hours ago, mindinggaps said:

 In full transparency, and somewhat ironically, the topic of me trying an SSRI to help manage the stress and anxiety I feel around my daughter's condition also came up at some point and I declined.

Gently, I would seriously consider the possibility that you yourself have OCD. I've had severe OCD my whole life, and your ruminations, your need for perfection, your continual reevaluations, your worry--that was exactly me before I went on meds. 

SSRI's are very safe overall. I really think you would benefit, and I think your daughter would as well.

Edited July 25 by MercyA

[QueenCat]

I would go with the primary psych's rec to keep her on the meds. Why take her off when it's working? That would be like taking insulin away from a diabetic.

[ScoutTN]

9 hours ago, fairfarmhand said:

I’m not trying to be flippant, but as a mom of three adult kids, she’ll probably find something to be upset with you about when she’s a young adult. It’s just the nature of the beast. However, you can say, I agonized over this decision and spent years second guessing myself, so I just did the best I could with the information I had. 

This.

Grown kids always critique their parents for something. 

[Spryte]

Please keep her on her meds. If you look back at your post history, she really hasn’t been stable long. I’m thrilled to hear that she’s been stable for a few months now, and relieved for all of you. She deserves more stability than she’s had yet. This endless tinkering with her dose isn’t giving it to her. 

It reminds me of the reason meds fail for so many patients — they go on meds at a crisis point, find their dose, get stable, decide they don’t need them, go off the meds, hit crisis point. Rinse and repeat. I see it with my loved one who needs meds all. the. time. (And by the way, he’s an adult who blames his parents for not getting him on meds and getting him help. At 33, he’s livid that his mom was anti-meds, and didn’t trust the docs he saw over and over. He’s livid that his non-custodial dad didn’t fight harder to keep him medicated, even though it was impossible to mandate med-compliance at the mom’s house.)

Also — there’s no guarantee that her meds will work again if you go off the Prozac now. What is your plan if the  Prozac is no longer effective? I would want a plan for that before messing around with her dose.

[Ottakee]

1 hour ago, Spryte said:

Please keep her on her meds. If you look back at your post history, she really hasn’t been stable long. I’m thrilled to hear that she’s been stable for a few months now, and relieved for all of you. She deserves more stability than she’s had yet. This endless tinkering with her dose isn’t giving it to her. 

It reminds me of the reason meds fail for so many patients — they go on meds at a crisis point, find their dose, get stable, decide they don’t need them, go off the meds, hit crisis point. Rinse and repeat. I see it with my loved one who needs meds all. the. time. (And by the way, he’s an adult who blames his parents for not getting him on meds and getting him help. At 33, he’s livid that his mom was anti-meds, and didn’t trust the docs he saw over and over. He’s livid that his non-custodial dad didn’t fight harder to keep him medicated, even though it was impossible to mandate med-compliance at the mom’s house.)

Also — there’s no guarantee that her meds will work again if you go off the Prozac now. What is your plan if the  Prozac is no longer effective? I would want a plan for that before messing around with her dose.

All of this

[Bambam]

Re your kid getting angry later because meds - don't borrow trouble from tomorrow. 

One option - if child is interested as a teen, you can work slowly with doctor and child lowering the dosage by a small amount (for Prozac, the smallest pill is 10 mg, so it makes sense to go down by 10 mg unless you want to cut pills in half and go down by 5 mg - which is also a valid option).  Have some sort of regular review of status with teen. If things seem to be spiraling again, talk with teen. Often they might want to try ABC (aka - more exercise, B - some natural thing they've heard of somewhere random, C - whatever), so in our position, we agreed BUT we set a time limit on doing that and seeing if it impacted anything (because otherwise, they would always want to try ABC - just need more time), and if teen is still struggling, then usually they will agree they do not want to be/feel this way, and so are more reconciled to taking the med.  At least that was our experience.  I felt this approach/attempt to get off med was the best idea as teen did not want to be on med, but it is better to try to get off while at home, supported (aka a minor too so parents have some control), etc - so they can figure out if they can do it, or not. 

I'm just going to throw out something to think about. If you are already worrying about her hating you later because you put her on meds, I would suggest thinking about whether you have anxiety. I don't think that is normal - outside of a brief thought - but certainly nothing to keep thinking on, so these meds help your brain chemistry work better. It isn't a failing to have to take meds. It can help one have a better more abundant life.  One of my relatives has rampant anxiety. It affects her badly. As a direct result, we often treat her differently (aka don't tell her stuff) because she will worry, and worry, and worry, and quite frankly, keep bothering/hassling me for updates (pretty much constantly).  It is really a juggling act to try to keep her somewhat informed, etc.  She is getting some help, but a large part of the issue is she isn't willing to be honest with provider in order to get what she needs. She says "she is fine" and she most certainly is not. 

[gardenmom5]

She's currently stable.  is she experiencing side-effects from the rx?  (familiarize yourself with them, especially the side-effects in children/teens.  talk to her about them.)

I was on prozac many years ago - and at that time the information I read was the need to stay on the meds for at least two years so there wasn't a return of symptoms when getting off.   I started experiencing side-effects after 18 months, and reduced the dose, the side-effect went away for several months, and I reduced the dose again . . .I had zero difficulty getting off of it.
A friend's young-adult daughter who ended up breaking open the capsules and counting the granules and reducing by a few granules at a time.  

After my experience with a psychiatrist with dudeling wanting to increase the dose of his antidepressant (we were trying to stabilize his severe anxiety) despite the suicidal ideation he started showing when the dose was increased (which were entirely due to the antidepressant he was on),  . . . I take what they say with a grain of salt.   (I took him off that rx, and his ideation went away after about a week.)  2dd (pharmD) had called me to express her concerns about the rx as soon as she heard he was on it, and that they can lead to that, especially in teens.)