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[quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous][quote=Anonymous]How often are the panic attacks? If often and the PTSD is pretty bad, I would recommend Lamictal.

A lot of doctors will go to SSRI’s but in my opinion unless they are extremely anxious or extremely depressed, the side effects and how long they take to titre up in your system don’t make them worth it for panics attacks/PTSD.

Lamictal is a mood stabilizer and is very mild. You have to start with a low dose and move up every week to a slightly increased dose to prevent the side effect of rash. But when I tell you that medication can do wonders with no side effects like weight gain, nausea, sweats, etc… My daughter took it for anxiety/PTSD and it was amazing. Once a day at bedtime. I could see changes within 7-10 days even with a low dose. [/quote]

This is really upside down. Lamictal is a much heavier duty drug than SSRIs. No competent doctor would prescribe it as a first step for panic or anxiety

Not sure what SSRI side effects OP fears but you can start at a very low dose and take an Ativan for the first few days.

As for therapy, treating panic attacks is the bread and butter of therapists specializing in anxiety. The main thing is to find a specialist. [/quote]

How old are you? This is old school advice. Kids should not be on Ativan. It is highly addicting and it just snows you. Doesn’t retrain the chemicals in the brain

SSRI’s take 4-6 weeks to even start working, have a ton of negative symptoms, and long terms issues with use. weight gain and sexual function issues are two of the top side effects. Neither will help a teens depression or anxiety and will make it worse. Some may stop abruptly. Also bad.

There are many new options.

Prazosin or Hydroxine for sleep

Buspar, Propolanol, Lamictal, and Clonidine are all good options too. A lot of meds are used off label and have less side effects than SSRI’s.

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It is very common to prescribe Ativan to get over some of the initial symptoms of starting an SSRI. like 4-5 days, not long term. Since OP claims to be worried about side effects, it is worth asking about.

Your other list of meds is pretty random and in no way superior to SSRIs in terms of side effects. SSRIs are very, very well studied and effective for anxiety, which is why doctors start with an SSRI. Also it does not take 4-6 weeks for anxiety to start being effective. You don’t have to be on the SSRI forever.

Maybe OP’s kid truly has a medical contraindication to SSRIs (not sure) but that is very rare and not the reason to make ridiculous claims about them.

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Not PP you replied to, but no, it's not common to prescribe Ativan to get over side effects of SSRIs. Also SSRIs are well-known to provoke serious mental side effects in a small subset of patients. And yes, sometimes it takes more than a month for an SSRI to "work" and for side-effects to diminish. This is why there is a moderate rate of medication abandonment for SSRIs, because some patients cannot tolerate the side effects while still waiting for the benefits to kick in.

SSRIs can be a Godsend to certain patients, so I agree they're wonderful in the right situation. But please don't claim that SSRIs are easy to manage in most cases. The reality is more nuanced.

I agree that OP cannot tell in advance whether or not an SSRI would work for her child. The only way to know is by trying a low dose, and it's important not to scare the patient into thinking it's going to be a terrible experience, because sometimes this ends up being self-fulfilling! It's a shame that OP's child absorbed a fear of SSRIs from their family; also, it can be true that they might suffer from side-effects. I know there's cognitive dissonance there, but that's just how it is.

Proceed with caution, OP.
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If the main side effect is insomnia from starting an SSRI, indeed prescribing a benzo for *short term* use is common.

Serious side effects are very rare and [b]SSRIs are very well tolerated by most patients[/b] - that doesn’t mean no side effects but tolerable.

For anxiety the effects are often felt much sooner than for depression. I take Lexapro and feel significantly better in just a few days. 
[/quote]

My husband is a doctor and he says the bolded is wrong. They work for some people, they don't for others. We'd need to dig up peer-reviewed articles and their statistics to further the discussion.

You're not talking to uneducated idiots here, PP. I'm not a doctor, but I'm a research scientist in biology, and I am aware that SSRIs as a group of meds are by no means innocuous.

OP already knows all this. What matters are the feelings of the child and the family. [b]At one point, they will need to decide whether the symptoms are so bad that they are ready to risk potential side effects.[/b] It's their decision. Good luck, OP. Severe anxiety and panic attacks are very difficult to live with.

[/quote]

This is the only way these things should be discussed. All the people who say ‘I wOuLD nEveR’ have simply not yet encountered a situation where their child’s symptoms were such that they need to consider these options. IYKYK, and if you don’t…well, I’m happy for you, honestly. I just wish you were a bit more curious, that’s all.

(But fwiw, in my experience the universe has a way of testing our “nevers.” I once had lots of opinions too.)

Best to all parents out there. [/quote]

There are medications out there that help anxiety and don't take weeks to start seeing relief while having weeks of terrible side effects and possible suicidal ideations. And then having to slowly wean off it and start another.  [/quote]

Once again. SSRIs are very very well studied and are the gold standard for anxiety. [/quote]

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