OCD Medication Question

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I have so many things to say but being that it's my first post I will just go with my current issue we are dealing with. My son, 14, has been on his OCD medication (Zoloft) for about 6-8 months now. He is not the same child I knew last year, however, puberty has hit hard and he started a new school with all new kids and new rules. He has been in a tailspin since September. The only thing I can control is this medicine right now. His doctor believes that I will be adding to his issues if I remove him from this medication.

He has become uncaring about his grades, fearless in the respect that he's stealing, less than respectful to his teachers, taking chances he wouldn't normally take. Has anyone had this kind of experience themself or with their child with this medication. One of the side effect I read was impulsiveness. The sad part is it hasn't even completely controlled his OCD!

I can't offer advise about zolof itself, but if you wish to try and switch to alternatives many people see positive results from Melatonin and / or Gaba.

There will be plenty of people here who can offer advise on the medicine itself though.

SSRI's are notorious for causing mood swings, rage, and suicidal impulses in children and teenagers, or amplifying those tendencies, which is why the FDA cautions their use in children and teenagers. It should also be kept in mind that these medications, more often than not, have more side effects than positive effects with respect to OCD. They were not actually designed to treat OCD, and their long term success rate with OCD is generally no better than cognitive behavioral therapy. If they do help OCD, it's usually only for a short period of time, after which the dosage will need to be adjusted, or new medications will have to be thrown into the mix...in other words, the medication, especially in children, tends to be a constant balancing act.

If he were my kid, based on my own experiences with being medicated for OCD throughout my childhood, I would take him off of the medication and get him into a cognitive behavioral therapy program specifically for teenagers for OCD. UCLA's Semel Institute has a good one and there is also one in Mass. at McLean. If you are not in that area, they might be able to refer you to a more local one.

Some people need medication to get to the point where they can do CBT, but in the long term the CBT has been the better choice for me because it eliminates the question of what crap in my life and aspects of my emotions is a side effect from the medication, is the medication even working, if it was working has it stopped working? And the CBT has also taught me how to cope much better with my OCD, and has given me some sense of control over it so when new symptoms arise I can usually stop them from becoming permanent or life impacting.

My daughter was on Zoloft for Anxiety and she started having OCD symptoms after taking the Zoloft for about 3 months. When they starting adjusting the doage my daughter became violent and attacked another girl. The only other time she was violent (to that degree) was when she was on Paxil, also a SSRI. Since I made the connection between SSRI's and violent rages with my dd, we weaned off all meds. I changed her diet (with positive results) and I would only consider meds again if it were the last resort. BTW, she still has the OCD symptoms and we have been weaned off the Zoloft for 10 months.

I feel like an idiot allowing it to continue this long to be honest but his doctor was so insistant that I will make matters worse that she has me petrified that I'm making the wrong decision. I keep coming back to the fact that he was not lime this just six months ago, what has changed. The problem is several other things have changed in his life but this is really the only one I can control. Is dosing down difficult. Were there proems with withdrawal such as worse behaviors? I need to know what we are in for.

http://crazymeds.us/ This guy probably knows.

As a guy who has been on many different drugs one thing my mom did correctly was to use her own judgement/instincts about medications (not adding but removing) if you don't think its working for him insist that the doctor begin to lower the dose and begin to attempt something else. If the doctor refuses to budge find a new one. I've been through enough half-wits to know that if a doctor sticks to his/her guns over something that is having an obvious adverse they aren't worth the insurance copay. If you live in the boston area I can recommend a psychiatrist I've had excellent luck with (I've been seeing him since I was 12)

Weaning is very difficult. It must be done very slowly. My daughter was on a very low dose luckily so it only took about 2 months to step completely down. If your dr is not on board you can step him down yourself. Make sure you have enough to do this so you don't run out if you discontinue with that dr. Stepping down takes a lot longer than going up, you have to go slowly to avoid the negative withdrawal. I would say that even after we were completely off of it, I don't think it was out of her system for at least another month.

I live in South Jersey, Philadelphia area. His doctor is associated with CHOP and is Highly regarded in her field but you're absolutely right. My gut has been telling me for awhile and she keeps dismissing us. Today I did put my foot down and insist upon instructions to step down. He is on the maximum dose and my sister in law who is a pharmacist was alarmed when I told her his dosage. I'm beside myself with his bizarre behavior lately and I'm so scared about the weaning process. I'm going to check out the link you posted. Any other advise is appreciated. Thanks so much, what a Godsend this forum is for me.

I think you would be very hard pressed to find a psychiatrist who is receptive to the idea of discontinuing medication in general, not because they think it's always bound to have detrimental effects, but because medication has become the primary tool of their profession, while non-medicative approaches have drifted entirely over to the field of psychology.

Here is an anology for you. My friend has high blood pressure and high cholesterol. In his case I strongly believe this is due to his lifestyle. But rather than put him on a diet and excersize routine, the doctor sends him home with medication, which happens to be very expensive, and can cause some nasty side effects. Why didn't the doctor put him on a diet and excersize schedule? Simple. The doctor isn't a dietitian or personal trainer. If a patient comes to him with high blood pressure and cholestorel, he sends them home without medication, and the patient has a heart attack, the doctor is liable for malpractice because the doctor did not utilize the tools which were within the scope of the care he provided.

If I walk into a psychiatrists office and tell them I have OCD and want treatment, they will give me pills. If I don't want to take the pills, they will tell me they can't help me then, and to see a psychologist.

We started there with the doctor who referred us to his therapist. We worked with her for about a year and then one day I asked her "isn't there something we can give him to help him with these anxieties, it must be exhausting for him" and that's when we ended up back with the doctor. We still see the counselor though. I've been telling them about his erratic behavior and I've convinced the counselor but the doctor is annoyed with us. I just want to know how to take my own child off this medicine! I really hope they get back to me today.

If he is on 50mg (or whatever dosage) pills then it is hard to step down. It is impossible to split the pill appropriately to be able to step down 25% or so. You could try stepping down 50% every other day by splitting the pill, I don't know if this would work? We were on liquid, so it was much easier to step down. Do you have a pharmacist who would be willing to give you liquid dosage instead of the pills? That way you can step down very, very slowly. We stepped down 10% every week. So she was on 20mg, we stepped down to 18mg for a week, then we stepped it down to 16mg, etc, etc until we were off. It took a few months to do it this way but I believe it was the best way because my daughter is so sensitive to meds. Even with this slow step down, she did have reactions to the step down with periods of feeling itchy all over her body. So, if you can get the liquid dosage, you step down to 45mg, then 40mg, etc. It would take 10 weeks to do it that way but it is a gradual step down that alleviates the withdrawal side effects.

He is actually on 200 mg. a day (100 mg. pills) which is the maximum dose. And here it is the end of another week and still no response from the doctor on how to step him down. Do you think the pharmacist will help me if I call them?

I am not a doctor, but if SSRIs are a problem for your child (as they are for many, apparently), perhaps your doctor would be able to comment on the pros and cons of using clomipramine. It is a tricyclic antidepressant (not an SSRI) that is approved for the treatment of OCD...

Not sure but I will look into it. Do you have experience with this medication? Side effects?

Heard from the counselor today who says the doctor wants to meet with us AGAIN to discuss this so she's putting us off again. I called his pediatrician who is just referring me back to the psyhiatrist, guess he wants no part of it. Another trip into Philly, another school day missed, another co-pay, another week or two on the medicine all to discuss what we've already made very we want for our son. I feel so frustrated I want to cry.

First I have to say, I really only think any medication he's on is for a specific problem like, and not just a vague "he's difficult to deal with" issue. In other words, don't use medication to try to control personality, normal teenage behavior, even the bad aspects of it, and so on. They are not designed to be "mind control" drugs, are almost never successful to that end, and often degrade the patient's quality of life in the process of trying to find the "right" dosage.

OCD aside, what seems to be causing all of this strife? And what does he want of life at the moment? What are his perspectives? Often times, to teenagers, small issues seem pressing. Life for them frequently seems insurmountably difficult and unfair. They tend to get in bad moods and they don't know why because there really isn't a reason other than hormones and changes going on in the brain, and they don't have the ability to see past "rough waters".