How did you decide to start/not start your child on SSRIs for anxiety?

[Anonymous]

You need a new psychiatrist. Right or wrong, you don't trust him. You just can't get good medical advice from someone you don' trust.

[Anonymous]

NP here. I don't trust any psychiatrists, having had a lot of experience with them through a family member's mental illness history.

[Anonymous]

Switching to a different ADHD med to see if that alleviates the anxiety symptoms is a very reasonable step to take. ADHD meds can cause anxiety. If my psychiatrist didn't agree to try that first, I'd be dumping him and finding a new one.

[Anonymous]

Unless my child was non-functioning or suicidal, I would not place a child on an SSRI. They can be very helpful medications, but SSRI withdrawal is extremely difficult and can be almost as bad as the symptoms that the SSRI was prescribed to treat. SSRIs also have a black box warning that they can increase suicide in kids. It's not worth the risk and difficulty, IMHO, unless the problem is severe. I'd try other meds before SSRIs.

[Anonymous]

Anonymous wrote:Unless my child was non-functioning or suicidal, I would not place a child on an SSRI. They can be very helpful medications, but SSRI withdrawal is extremely difficult and can be almost as bad as the symptoms that the SSRI was prescribed to treat. SSRIs also have a black box warning that they can increase suicide in kids. It's not worth the risk and difficulty, IMHO, unless the problem is severe. I'd try other meds before SSRIs.

Wrong and wrong. Withdrawal under a doctor's supervision is rarely a problem. And the black box warning is, according to every expert I've spoken to, unwarranted. More kids have committed suicide since the warnings began because parents are afraid to use this tool. of course, no one should take an SSRI unless it is warranted, but if it is waiting can only make things worse. And its not always easy to tell with kids how bad the anxiety and depression is.

[Anonymous]

Anonymous wrote:

Wrong and wrong. Withdrawal under a doctor's supervision is rarely a problem. And the black box warning is, according to every expert I've spoken to, unwarranted. More kids have committed suicide since the warnings began because parents are afraid to use this tool. of course, no one should take an SSRI unless it is warranted, but if it is waiting can only make things worse. And its not always easy to tell with kids how bad the anxiety and depression is.

Don't agree that "waiting can only make things worse." Our child was extremely depressed to the point of being aggressive. We reduced some of the pressures he was under and he has improved vastly from being aggressive. He is still mildly depressed so we haven't ruled out SSRIs as a next step but had we started them at that point a) there is a chance he may have become even more agitated and aggressive and b) we wouldn't know that it was possible to improve without the medication.

[Anonymous]

And I agree -- I am a horrible reporter of symptoms and frequency. Unfortunately I am not with DS 24 hours each day (matter of fact I am only with him from 4 pm until 8 am the next morning on school days) and cannot fully account for each and every symptom and frequency. Since you are better than I am at such reporting, would you please recommend some tools and techniques that I might use to improve on such accounting? Thanks!

Your sarcasm is uncalled for. I believe many people, including myself, on this list spend less time with their kids than you because of work schedules yet are able to accurately describe symptoms, frequency and severity. Since you struggle with this, I suggest you use a checklist such as found here http://www2.massgeneral.org/schoolpsychiatry/screeningtools_table.asp. You should also not compare medication management of your two kids. People within the same family can react very differently to medications. I've got one kids who cannot tolerate the stimulants but does very well on non-stimulants. I have another who does wonderfully with stimulants. My DH isn't helped by either class.

[Anonymous]

Just another voice in the crowd to say that I wish I had given my DS anti anxiety medications when when he was nine and more compliant. He is 16 now and refuses to take meds of any kind. He suffers from sleeplessness, anxiety and perhaps depression, too (he sleeps all day during the weekends and awakens at night). We are at a loss to help him.

[Anonymous]

Anonymous wrote:

And I agree -- I am a horrible reporter of symptoms and frequency. Unfortunately I am not with DS 24 hours each day (matter of fact I am only with him from 4 pm until 8 am the next morning on school days) and cannot fully account for each and every symptom and frequency. Since you are better than I am at such reporting, would you please recommend some tools and techniques that I might use to improve on such accounting? Thanks!

Your sarcasm is uncalled for. I believe many people, including myself, on this list spend less time with their kids than you because of work schedules yet are able to accurately describe symptoms, frequency and severity. Since you struggle with this, I suggest you use a checklist such as found here http://www2.massgeneral.org/schoolpsychiatry/screeningtools_table.asp. You should also not compare medication management of your two kids. People within the same family can react very differently to medications. I've got one kids who cannot tolerate the stimulants but does very well on non-stimulants. I have another who does wonderfully with stimulants. My DH isn't helped by either class.

Thank you for the link. Which of the 12+ rating scales should I use to document symptoms? Should I print them all out and ask our therapist when we see her next on Tuesday? We have completed several of these in the past when we first had DS diagnosed. I clearly recall the SCARED form as well as the the ADHD-IV, the Vanderbilt form, and the SSRS. Should I be completing these forms monthly? Quarterly? Or should I request these be done and sent to our pediatrician?

Spence Children's Anxiety Scale (SCAS)
Depression and Anxiety in Youth Scale (DAYS)
Beck Anxiety Inventory for Youth (BYI)
Self-Report for Childhood Anxiety Related Emotional Disorders (SCARED)
Liebowitz Social Anxiety Scale-Child Adolescent version (LSAS-CA)
Children's Depression Scale (CDS)-3rd Ed.
Child Depression Inventory (CDI)
Attention Deficit Disorders Evaluation Scale (ADDES-3)
ADHD Rating Scale-IV (ADHD-IV)
ADHD Rating Scale
Vanderbilt ADHD Diagnostic Parent Rating Scale
SNAP-IV Rating Scale - Revised (SNAP-IV-R)
ADD-H: Comprehensive Teacher's Rating Scale: Parent Form (ACTeRS)
Conduct Disorder Scale (CDS)
Adjustment Scales for Children and Adolescents (ASCA)
Social Skills Rating System (SSRS)

[Anonymous]

Anonymous wrote:Switching to a different ADHD med to see if that alleviates the anxiety symptoms is a very reasonable step to take. ADHD meds can cause anxiety. If my psychiatrist didn't agree to try that first, I'd be dumping him and finding a new one.

Thanks to you and 20:21 -- you are both absolutely correct. I do not trust the psychiatrist and agree with you both that it's time for me to find someone else. Thanks for helping me think through this and for the advice.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

And I agree -- I am a horrible reporter of symptoms and frequency. Unfortunately I am not with DS 24 hours each day (matter of fact I am only with him from 4 pm until 8 am the next morning on school days) and cannot fully account for each and every symptom and frequency. Since you are better than I am at such reporting, would you please recommend some tools and techniques that I might use to improve on such accounting? Thanks!

Your sarcasm is uncalled for. I believe many people, including myself, on this list spend less time with their kids than you because of work schedules yet are able to accurately describe symptoms, frequency and severity. Since you struggle with this, I suggest you use a checklist such as found here http://www2.massgeneral.org/schoolpsychiatry/screeningtools_table.asp. You should also not compare medication management of your two kids. People within the same family can react very differently to medications. I've got one kids who cannot tolerate the stimulants but does very well on non-stimulants. I have another who does wonderfully with stimulants. My DH isn't helped by either class.

Thank you for the link. Which of the 12+ rating scales should I use to document symptoms? Should I print them all out and ask our therapist when we see her next on Tuesday? We have completed several of these in the past when we first had DS diagnosed. I clearly recall the SCARED form as well as the the ADHD-IV, the Vanderbilt form, and the SSRS. Should I be completing these forms monthly? Quarterly? Or should I request these be done and sent to our pediatrician?

If you’re unable to determine which scale might help you document and track your DC’s symptoms, I suggest you set aside time each Sunday evening to complete each one. Over time, perhaps you’ll learn how to better observe and report.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

And I agree -- I am a horrible reporter of symptoms and frequency. Unfortunately I am not with DS 24 hours each day (matter of fact I am only with him from 4 pm until 8 am the next morning on school days) and cannot fully account for each and every symptom and frequency. Since you are better than I am at such reporting, would you please recommend some tools and techniques that I might use to improve on such accounting? Thanks!

Your sarcasm is uncalled for. I believe many people, including myself, on this list spend less time with their kids than you because of work schedules yet are able to accurately describe symptoms, frequency and severity. Since you struggle with this, I suggest you use a checklist such as found here http://www2.massgeneral.org/schoolpsychiatry/screeningtools_table.asp. You should also not compare medication management of your two kids. People within the same family can react very differently to medications. I've got one kids who cannot tolerate the stimulants but does very well on non-stimulants. I have another who does wonderfully with stimulants. My DH isn't helped by either class.

Thank you for the link. Which of the 12+ rating scales should I use to document symptoms? Should I print them all out and ask our therapist when we see her next on Tuesday? We have completed several of these in the past when we first had DS diagnosed. I clearly recall the SCARED form as well as the the ADHD-IV, the Vanderbilt form, and the SSRS. Should I be completing these forms monthly? Quarterly? Or should I request these be done and sent to our pediatrician?

If you’re unable to determine which scale might help you document and track your DC’s symptoms, I suggest you set aside time each Sunday evening to complete each one. Over time, perhaps you’ll learn how to better observe and report.

Thanks! I will plan to complete all 12 each Sunday evening and share them with DS' therapist, psychiatrist, and pediatrician each week. Many thanks again!

[Anonymous]

Anonymous wrote:

Anonymous wrote:Unless my child was non-functioning or suicidal, I would not place a child on an SSRI. They can be very helpful medications, but SSRI withdrawal is extremely difficult and can be almost as bad as the symptoms that the SSRI was prescribed to treat. SSRIs also have a black box warning that they can increase suicide in kids. It's not worth the risk and difficulty, IMHO, unless the problem is severe. I'd try other meds before SSRIs.

Wrong and wrong. Withdrawal under a doctor's supervision is rarely a problem. And the black box warning is, according to every expert I've spoken to, unwarranted. More kids have committed suicide since the warnings began because parents are afraid to use this tool. of course, no one should take an SSRI unless it is warranted, but if it is waiting can only make things worse. And its not always easy to tell with kids how bad the anxiety and depression is.

Have you withdrawn from an SSRI under a doctor's supervision? I have. It was miserable.

[Anonymous]

French kids don't have autism either:

http://mobile.bbc.co.uk/news/magazine-17583123

[Anonymous]

And when French kids do have autism, a cure they use it to wrap them in frozen bedsheets. Yes. I heard this.