Anti-depressants for kids on the spectrum?

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The general question here is what do you think of anti-depressants for kids on the spectrum, and I'd like to ask parents as well as adults on the spectrum their opinions.

Of course, one cannot really discuss this situation 100% generally, however. Each case is unique. I'll share my own individual experience.

Severe depression and anxiety runs in my family. I take Prozac, and it's like a miracle for me. One of my nephew's had violent outbursts, and after trying to manage his behavior, my brother and his wife put the kid on Prozac at age 5. It has helped him considerably. They have three kids, so they had a real perspective on their son, and they knew his behavior was really extreme. So they didn't put him on drugs lightly at all. It was a very big decision. But since our own mother was so anxious and later suicidal, my brother just really wanted this kid to avoid a lot of the pain she had experienced.

I only have one child, so sometimes it is difficult for me to see if my son's anxiety is typical or more intense than other kids', but it just reminds me so much of myself. Yesterday, he went to karate for the first time. He did awesome. (A whole other thread--karate seems great for him.) Then, when he came home, his ABA therapist was there. He wasn't happy. He was tired from a long day, he wasn't excited to play with her, and he had just done an hour of intense focus in a class. So he had a little outburst. He karate chopped at her (didn't make contact), said she was boring, and then hid under the sofa cushions for a bit. Then, he was so ashamed and embarrassed about his own behavior. It was all really painful to watch.

It all feels so familiar to me, and all of this pattern of behavior improved for me on Prozac. It changed my life and allowed me to keep jobs, have relationships, and just get through a day without that crippling anxiety.

Reading that Temple Grandin takes Prozac, and hearing that anxiety is often co-morbid with autism, I'm pretty convinced that I'd like to look into this. It just feels like my kid is young for it. He's six. But I look at my family history, and actually, that's not young for us.

Would love to know your thoughts on this or hear your experience with anti-depressants for yourself or your spectrum kids.

Being overwhelmed by too much activity in one day is not the same as being depressed IMO. Even with the family history you mentioned, I would want to be sure that the thing I was looking into prescribing was the right tool for the situation.

Absolutely, I agree.

Might not have been the best example of his anxiety, which is kind of always lurking below the surface.

Yes.

Your son's behaviour sounds completely normal to me. He's only 6 years old, and he'd had an exciting day, was probably on a bit of a high, then there's the ABA therapist waiting for me. If anything, his behaviour was pretty restrained!

You don't say how old your son is.

You do say that he came home from focusing for an hour intensely on something and that he behaved in a manner that later he expressed shame and embarrassment about. Since he is able to express or display these behaviors... is he necessarily too young to discuss this option with?

Another thing to consider: he just started karate, you may want to give it some time to see if that could actually benefit him in easing his anxiety to some degree. Physical exercise plus how it can help one focus and if he enjoys it and excels won't "cure" the anxiety he experiences but may help him find ways to cope with it so it is not interfering with his life day-to-day. If he finds it is manageable for him, maybe it is unnecessary to pursue pharmacological options.

You might be able to find a way to have this discussion with him though, if you haven't already. [I couldn't figure out from your post if you had specifically discussed medications]

Actually, I did mention that he is six. It's at the bottom of the post, though.

I don't think he's old enough to really discuss it. And that brings up the ethical dilemma of making a decision about pharmaceutical intervention for an individual who cannot accurately report his feelings. Behavior and feelings aren't the same thing. He acts anxious. I don't know if he experiences anxiety, since he doesn't discuss his feelings too much, and his lexicon isn't really developed enough to describe his own emotions a lot of the time.

SCIENTIFICAMERICAN.COM: "Antidepressants: Do They "Work" or Don't They?" (March 2, 2010)
http://www.scientificamerican.com/artic ... -dont-they

OK, sorry I missed it.

But if you don't know that he experiences anxiety I'm not sure why you are even considering pharmacological intervention at all.

Beyond ABA, exploring some kind of counseling could be an option. I may have possibly missed that you are already doing that... but as someone who was put on meds at nine, with no CBT, DBT or ACT [the second two of which were not widely used at the time]? I would have preferred the therapy/counseling have been fully explored first. This would also help him develop ways to express what he is feeling.

Those trials were for depression, specifically. Not for any other application, yes?

The Wikipedia.org article about "Selective serotonin reuptake inhibitor" states that "[t]he main indication for SSRIs is major depressive disorder (also called 'major depression', 'clinical depression' and often simply 'depression'). SSRIs are frequently prescribed for anxiety disorders, such as social anxiety disorder, panic disorders, obsessive-compulsive disorder (OCD), eating disorders, chronic pain and occasionally, for posttraumatic stress disorder (PTSD). They are also frequently used to treat depersonalization disorder, although generally with poor results." The depersonalization disorder claim cites the study http://apt.rcpsych.org/content/11/2/92.full "Understanding and treating depersonalization disorder" by Nick Medford in Advances in Psychiatric Treatment (2005). Another study in dicta http://www.ncbi.nlm.nih.gov/pubmed/10471245 states that "SSRIs are the treatment of choice for many indications, including major depression, dysthymia, panic disorder, obsessive-compulsive disorder, eating disorders, and premenstrual dysphoric disorder, because of their efficacy, good side-effect profile, tolerability, and safety in overdose, as well as patient compliance."

Side effects (regardless of indication) http://www.health.harvard.edu/press_rel ... de_effects were described in the May 2005 edition of the Harvard Mental Health Letter.

SSRI or SNRI for children? HELL NO!! !! !! !! !! !! !! From what I've read, most children, NT or otherwise, are still physically, mentally and developmentally growing at that age. Most are still growing developmentally into their mid 20's. Why screw with their chemistry before they mature? For that matter, why screw with one's chemistry at all, unless it's physical ailment, like diabetes?

I agree.

:/
I feel like you didn't actually read what I wrote. It's possible I just missed something in one of your posts as sometimes I can't get everything?

I asked if the trials, which you were referring to, were specifically regarding the use of anti-depressants ONLY for depression.
So, turns out that yes, they were.

The OP is also speaking of ADs being used for anxiety.
I actually take fluvoxamine for moderate-severe OCD with pretty decent results. Point is: what you referred to is relevent to only depression, because medications have different efficacy rates for different issues.

You are correct. A study http://www.ncbi.nlm.nih.gov/pubmed/11110015 which surveyed "all available studies on the use of selective serotonin reuptake inhibitors (SSRIs) for the pharmacotherapy of social anxiety disorder[,]" was reported by the U.S. National Institutes of Health in 2000 and found that "[t]he number of patients who responded to drug was approximately twice the number who responded to placebo." While I still have doubts about SSRIs and their side effects, it appears http://www.mentalfloss.com/article/2984 ... thing-else that they are in the same category of inventions (from Play-Doh to Viagra) which were more effective in ways other than those for which they were intended.

My 10 year old has asd and dysthymia. He is on Prozac and it helps him considerably. His depression started at age 7 and he was suicidal by 8. I was giving him 5HTP until he got his diagnoses at age 10 and he was switched to Prozac because the 5HTP wasn't as reliable. He is still his quirky self and he's no longer hating his life. He's a childhood cancer survivor so we didn't put two and two together until our youngest child was showing signs of asd as well.

I never had any luck with anti-depressants, just make things worse.