Anonymous wrote:There are genetic tests that give some indications of which classes of medication are more or less likely to work with certain kids.

You might want to consider them for these more complex situations.

These genotype tests only offer info about how you likely metabolize different meds. It's a place to start, but when we did the test, the meds on the recommended list did not work or made things worse. We finally tried kind of "non-recommended" more common meds because we knew others who did well on it. It was listed as not likely to work with my DS's genotype, but has been the first med to actually help his anxiety. So, it's definitely a place to start, but metabolism is only one factor in why a med works or doesn't. Psychiatrists go both ways as do the efficacy of genotyping.

There are genetic tests that give some indications of which classes of medication are more or less likely to work with certain kids.

You might want to consider them for these more complex situations.

I have a 10 year old ASD son (HFA) with severe anxiety and significant OCD and repetitive behaviors. Tried three antidepressants (including SNRI's) and all were activating as you describe. Both our psychiatrist and pediatrician say that Prozac is the most activating, disinhibiting, and worsens anxiety, especially in ASD kids. We now are trying a mini dose of lexapro and after only two weeks it is making a big difference in phobias and social anxiety in general. When it works, lexapro is considered one of the "cleanest" ssri's with respect to side effects (but again, everyone can have a different reaction to any of these.

I completely understand your frustration with meds, though. My DS had severe comorbid anxiety his whole life (and it was at it's worst at 6) and we just this year started trying meds as a last resort. Once you go through three or four that don't work and/or make it worse, it's difficult to remain optimistic about med therapy. We almost gave up. But, it really is about finding the right match and to be fairly certain that you are dealing with the correct diagnosis. For instance, adhd meds can be terribly activating if the child does not have ADHD (and both ASD and severe anxiety can mimic certain ADHD symptoms). For us, lexapro seems to be the med that agrees with my DS (at least for now) so that he can be more amenable to therapy. Unfortunately, there's a lot of trial and error before you hit on the right one. Best of luck.

What Prozac dose did you start with? 2mg of Lexapro made my child into a raging, impulsive beast, but 1.75 has been great. So before you give up on the ssri, try a smaller dose.

Strattera may be worth a try! One month in with our 8 yo son and still managing some nausea but seeing some success (ADHD/Anxiety/LD's). Good luck!

My ASD 6 year old DS who suffers from lack of focus/ hyperactivity and anxiety is currently taking Guanfacine(Tenex) and we just started Zoloft. He has had the following issues:

1- Focalin increases his anxiety and some OCD repetitive movements.

2- The SSRI's like Prozac ( which we had tried in the past) make his behavior worse. His Psychiatrist explained that in causes disinhibition in some kids. ( oN both Prozac and Zoloft, he has tried to take his clothes off in public. Never happened before.)

3- Guanfacine has really helped with hyperactivity.

He really needs help with focus and anxiety, as well as OCD ( it's affecting him socially)

Has anyone experienced this? Which meds were finally helpful? Would you recommend a Psychiatrist?

Thank you.