How did you know it was time for an SSRI?

[Anonymous]

dc (10) has audhd. His main issues are RSD, extreme oversensitivity and poor emotional regulation and he has a rough time with rebound from adderall (helped with a booster but still rough). He seeks to create chaos and intentionally provokes, is accusatory, and often feels wronged. When frustrated or disappointed he bursts into tears and generally argues every point. In contrast he is a very good person and tries to be a good and thoughtful friend, take others perspective and likes to rise to the occasion when given positive feedback.
All of this is such a rollercoaster and I am at a loss as to what will help. Maturity? SSRI? guanfacine made him sad.
Any advice much appreciated!

[Anonymous]

My DD started Zoloft at 9 when she was not able to participate in so many things - either because of big meltdowns, constant stomachaches, or just generally too anxious to function. There were times when she was fine, but increasingly more that she was not.

[Anonymous]

We started our AuDHD kid on an SSRI at age 10 because many of his meltdowns/emotional dysregulation seemed anxiety- driven. We first tried guanfacine and clonidine. It was before our neuropsych, so ADHD and autism not diagnosed (but not at all a surprise- we waited too long).

He now also takes adderall but I think Zoloft does more of the heavy lifting in keeping him regulated. We noticed an improvement as he started the SSRI. At one point he wanted to stop (it was a pill swallowing thing, not a side effects thing) and his dysregulation got worse.

[Anonymous]

I’d probably dial back the stimulant before I tried an SSRI. That’s because I’ve taken an SSRI myself and consider them really heavy duty meds. After that if the symptoms did not improve I’d try an SSRI if the emotional reactivity was really interfering with life.

[Anonymous]

My child only has AdHD and anxiety so I may not fully understand but have you tried other non-stimulants? My child also did poorly in guanificine but was helped by clonidine. I know there’s at least one other option too but I’m blanking on it. It might help to get the stimulant dose down a little and clonidine helps with sleep which is huge for us.

I just commented this on a different thread but I hope you have a psychiatrist helping you- I know it’s really hard to find some one with availability but I have been so thankful for ours.

Have you done parent training? That has probably been the most helpful thing for me with my highly reactive child (although it’s hard to implement at times - I can definitely tell when we have been slipping)

[Anonymous]

When the parent therapist we were working with gently but multiple times started to suggest “I think the risks of not doing it are higher than the risks of doing it” and we really couldn’t disagree, as hesitant and concerned as we were about it. She was absolutely right. Meltdowns were daily, massive (requiring physical restraint for safety), and traumatizing the whole family. The child was having thoughts of jumping out a window (self harm) and it felt like they really might do it.

[Anonymous]

Trying an SSRI can really help. It won’t hurt to try for a few months. The possible benefits are really marked, and your child needs help.

[Anonymous]

We tried an SSRI when stimulant and Guanfacine combo wasn’t helping with my son’s significant emotional dysregulation and anxiety.

That said, I don’t think Zoloft really helped. We were on a low dose and switched doctors before titrating up. She advised us to discontinue the Zoloft and up the Guanfacine first.

My son seemed to get more upset on zoloft when triggered - when something went wrong, he would get really worked up and start smacking his head. This was on 12.5mg. His new doctor also said zoloft can be tricky for adhd kids and make them more impulsive, which we did struggle with. It helped with some things but created other issues. He may still need an SSRI but best to optimize other medications first.

[Anonymous]

If an SSRI made your adhd child more hyperactive, what did you do as an alternative? Our child benefits from one, but we also feel it exacerbates the adhd.

[Anonymous]

Have you done a re-evaluation recently? While symptoms of different disorders can overlap it sounds like Autism too.

[Anonymous]

Anonymous wrote:Have you done a re-evaluation recently? While symptoms of different disorders can overlap it sounds like Autism too.

OP's DC already has an Autism diagnosis (the OP says "AuDHD").

[Anonymous]

Anonymous wrote:If an SSRI made your adhd child more hyperactive, what did you do as an alternative? Our child benefits from one, but we also feel it exacerbates the adhd.

We took our adhd son off Zoloft and increased his Guanfacine dose. There are other apparently other SSRIs that don’t have the same effect on hyperactivity but we haven’t tried any yet

[Anonymous]

Anonymous wrote:Have you done a re-evaluation recently? While symptoms of different disorders can overlap it sounds like Autism too.

op says audhd but actually what part of the description of their child suggests autism?

[Anonymous]

Anonymous wrote:Have you done a re-evaluation recently? While symptoms of different disorders can overlap it sounds like Autism too.

op says audhd but actually what part of the description of their child suggests autism?

[Anonymous]

Anonymous wrote:Trying an SSRI can really help. It won’t hurt to try for a few months. The possible benefits are really marked, and your child needs help.

SSRIs can have serious side effects. In particular, activation syndrome can be fatal so it is a decision that can’t be made lightly.