Starting SSRI for teen
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Anonymous
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DD has had a host of health issues that has spiraled out of control, and her medical team feels that anxiety is a great contributor. If you asked me a year ago, I would say that mental health is very important but never would I think that anxiety could be this debilitating to one's every day life. She was never much of a social butterfly, but was a happy kid motivated to do lots of activities on her own. Now she is barely eating, lacks energy, and went from an A student to a C student. It all happened so quickly for us that we were caught off guard. In the meanwhile, we have tried to initiate various interventions, but was shocked at how long the waitlist is for good therapists. This includes talking therapy, OT and PT. Months of just waiting just to get an evaluation.
Our pediatrician and psychiatrist suggested that we initiate anxiety meds despite not zeroing in on a good therapist just yet, because they feel that sometimes kids are so deep in the hole that they might need some help so that they are at a point where they can access external help. My sister was on anxiety meds and had a horrible experience, so it brings me much fear to start DD on Zoloft (she is offered Sertraline, but I assume that's pretty much the same and is just a generic version). The psychiatrist is being conservative, starting her out at 12.5mg and going up to 25mg a week later as therapeautic dosage for now. Hoping to get some help: - Should we wait until the Saturday to start and observe over the weekend, or just initiate today? - What should we expect in the first week in terms of side-effect? The second week when we double the dosage? - When would she know if the meds are even effective? - If there is even a first thought of suicidal ideation or some other scary side-effect, do we call off the meds immediately if we notice the scary effect over a weekend? Or wait it out until we get a hold of our psychiatrist over the weekday? - Are there activities she should avoid as she is feeling out the meds? - Should we inform her teachers and ask if they see differences in behavior? She is still in middle school. Any other useful insights would greatly be appreciated. |
Anonymous
| Every kid is different. Some do well and others don’t. Sometimes an SSRI is not the way to go, especially if a kid has undiagnosed autism. Be aware that suicide attempts can be impulsive and spontaneous. No planning ahead. Having a therapist in place can help with this. I know it’s very hard to find one. Been there, done that. |
Anonymous
| Bumping this up for the OP for more perspectives. |
Anonymous
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Like PP said, every kid is different. Mine showed effects right away but what you saw was not always what you ended up with. As far as suicide concerns, ask your doctor. Sometimes they will have your kid work through it t and sometimes they stop meds immediately .
I wouldn’t tell teachers. That’s such personal information. And I would just start. There is nothing medical about waiting for a weekend to start a med that can take 6 weeks to show an effect. |
Anonymous
| Thank you for bumping it. We started meds tonight. Hoping for a smooth road ahead but nervous about what to expect in the next several weeks. |
Anonymous
| Going off is much worse than starting, taper off very slowly. |
Anonymous
What was your taper off timeline and dosage, and did you (or your child?) stop because the SSRI was not working well? |
Anonymous
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I started an SSRI at 15. I had some headaches, nausea, and jaw clenching at night when I started out, and it took about a month to see a real change. The side effects went away after a few weeks. I went from crying and having panic attacks all the time over pretty much nothing to being a normal moody teenager.
I’m still on an SSRI— we tried tapering off a few times to see what would happen, and the obsessive thoughts, anxiety, and depression came right back like a faucet had been turned on. I have an extensive family history of mental illness though. The side effect I get if I miss a few doses (usually two) is a weird dizzy “brain zap” feeling. It’s not painful, but it’s not comfortable and certainly reminds me to take my medication. My 16-year-old niece has started Zoloft recently (looks she inherited the family depression genes) and is doing amazingly on it. The suicidal ideation side effects are scary and should be taken seriously but are very rare. Untreated depression is much more likely to cause suicidal ideation. All the best to you! |
Anonymous
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If it’s anxiety, you should expect to see a reduction in symptoms really pretty quickly, in a few weeks. SSRIs tend to kick in more quickly for anxiety than depression.
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Anonymous
| Thank you to the previous two posters. So he has only said he felt dizzy and slept the best he has had in weeks. I am not sure if this is due to the meds. Seems unlikely it would have kicked in that fast. |
Anonymous
| While the meds usually take several weeks to truly kick in, sometimes there’s a bit of a placebo effect in the first couple of weeks. |
Anonymous
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You are making the right decision. Anxiety medicine was life changing for my teenage niece, who suffered from debilitating anxiety for years before ultimately medicating at 16/17.
She did a genesite test to determine which anti anxiety med would be a good starting point for trial and error, and is under the care of a pediatric psychiatrist. I’m not sure about her immediate side effects so I can’t be a help there. There is usually a titration period. But of course you want to watch her very carefully to observe her behavior. |
Anonymous
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OP here again. We are only on day 4 and DD is behaving very strangely. She is so anxious, seems paranoid about a lot of random things, and has barely wanted to eat or drink much. Trying to get her to eat just so that she can maintain energy.
Is this normal? How long does it last? She is only on 12.5mg and is supposed to go up to 25mg in a few days. If this is what we are seeing after 4 days on a low dose, I fear going up to 25mg. Help! |
Anonymous
NP here. When I first started Zoloft, I had a euphoric feeling for the first few days. Not sure it was placebo effect like PP mentioned, but I was definitely feeling euphoric. But the feeling went away after the first week. |
Anonymous
I would have her stay on the low dose and perhaps reach out to the prescribing doctor for further advice. |