Experiences reducing SSRI for child doing well?

[Anonymous]

My 7 year old has been taking an SSRI since she was 4 for a severe panic disorder. She has anxiety, ASD, and ADHD. She is doing great these days. She’s still anxious but full functioning and happy and in general education at school. I plan to ask her psychiatrist whether it’s time to consider backing off on the SSRI a bit now that we’re out of crisis mode. Can anyone share your experiences decreasing an SSRI in a child? I realize this is a unique circumstance since she’s so young, so perhaps no one will have much experience.

[Anonymous]

You may need to reduce it very slowly. You should also read up on withdrawal syndrome. Most people who come off SSRIs (or any medication whose mechanism of action is neurotransmitters) tends to reexperience the symptoms they had initially as part of the withdrawal process. It can take weeks to a couple months to give the brain a chance to stabilize off meds to actually get a picture of how she is doing off meds.

Talk to the psychiatrist. I did work pediatric psych but we didn't put kids that young on SSRIs - the youngest ones were more in the 8-9 range. Has she done CBT? There are good pediatric therapists who do CBT. It is best to do it when she is on the meds as you learn best when not going through change or in an anxious state.

[Anonymous]

This is OP. To clarify, I’m not talking about taking her off the meds. Just reducing the dose.

[Anonymous]

What do you hope to achieve by reducing the does, especially if she is still anxious? I know I've decreased myself off of an SSRI and it's not fun. Allow 2-4 weeks to taper to a smaller dosage and expect similar side effects as when increasing the dosage.

[Anonymous]

Your child's doctor will have the most important perspective, but since you are asking for others, I'll mention the advice I was given was to stay at the effective dosage for long enough to fully establish it as a baseline. Unless the SSRI was always intended as short-term (depression in response to a major loss or catastrophe), it is not something to decrease as soon as progress is attained. I see it has been three years, so perhaps it is time to explore that option now. Make sure that DD has had the counseling and CBT training, etc. so that she has the skills to deal with her condition as it is less managed by meds. Good luck!

[Anonymous]

Anonymous wrote:What do you hope to achieve by reducing the does, especially if she is still anxious? I know I've decreased myself off of an SSRI and it's not fun. Allow 2-4 weeks to taper to a smaller dosage and expect similar side effects as when increasing the dosage.

She’s had zero side effects from increasing the dose each time we’ve needed to. What I hope to achieve is adequate anxiety management on as small of a dose of medication as possible. I’m hoping that perhaps she’s ready for a smaller dose.

[Anonymous]

She’s doing great because she’s adequately medicated. I would not reduce her dosage unless you are willing to manage the escalation in behaviors but if you decide to try it, do it when she is not in school and you are around to monitor her.

[Anonymous]

My DD needed a higher dosage as she aged, not less.

[Anonymous]

Anonymous wrote:She’s doing great because she’s adequately medicated. I would not reduce her dosage unless you are willing to manage the escalation in behaviors but if you decide to try it, do it when she is not in school and you are around to monitor her.

Disagree. These are strong medicines and reducing the dose is prudent. I’m an adult woman but I found I could reduce my SSRI dose down to 1/4 of the supposed therepeutic dose and get most of the benefits and fewer side effects. Because of the way SSRIs work, most of the withdrawal effects don’t happen until you stop completely. I was taking half a pill every 4 days before I started to feel withdrawals!

[Anonymous]

Anonymous wrote:

Anonymous wrote:She’s doing great because she’s adequately medicated. I would not reduce her dosage unless you are willing to manage the escalation in behaviors but if you decide to try it, do it when she is not in school and you are around to monitor her.

Disagree. These are strong medicines and reducing the dose is prudent. I’m an adult woman but I found I could reduce my SSRI dose down to 1/4 of the supposed therepeutic dose and get most of the benefits and fewer side effects. Because of the way SSRIs work, most of the withdrawal effects don’t happen until you stop completely. I was taking half a pill every 4 days before I started to feel withdrawals!

Disagree. Reducing the dosage may or may not be prudent, it's different for everyone. I'm also an adult woman and I certainly do feel it when I have reduced or forgotten my meds. For me personally, I don't want most of the benefits...I want all of them. Depression and anxiety suck and I'm not trying to be a hero and muscle through anything. But also, side effects for me are not bad and I may think differently if they were.

[Anonymous]

Anonymous wrote:She’s doing great because she’s adequately medicated. I would not reduce her dosage unless you are willing to manage the escalation in behaviors but if you decide to try it, do it when she is not in school and you are around to monitor her.

This is what I was thinking. OP sounds like my young adult child. I feel better so I don’t need medication but doesn’t understand that you feel better because of medication.

[Anonymous]

Anonymous wrote:

Anonymous wrote:She’s doing great because she’s adequately medicated. I would not reduce her dosage unless you are willing to manage the escalation in behaviors but if you decide to try it, do it when she is not in school and you are around to monitor her.

This is what I was thinking. OP sounds like my young adult child. I feel better so I don’t need medication but doesn’t understand that you feel better because of medication.

These aren’t actually like diabetes medications. SSRIs can be very effective to help someone get out of a crisis, then can be discontinued.