Hi - My 6 year old son (almost 7) has severe anxiety and separation issues to the point where we pulled him from Kindergarten last year and home-schooled him. This year, after a lot of play therapy, social skills groups, diet changes etc. we got him an IEP and he started first grade since he made so much progress.
Now, 2 weeks into school, his anxiety is getting worse and he has tics again.
It seems our only solution is medication. We were previously prescribed Zoloft but after a family member took it and had a very bad experience we were hesitant to try it and he was being home-schooled so there was no need at that point.
So, I just want to hear about anyone else's experience with anxiety meds for their child. What do they take? Dosage? Pros? Cons?
He is almost 7, 65 lbs - very tall, prone to tics, and also ADD but the overwhelming issue is the anxiety.
We just started our 8 y.o. DS on Zoloft after several years of trying other (non-medication) options, including play therapy, counseling, cognitive behavioral treatment, etc. His anxiety is always present, but it waxes and wanes a lot, so it has been easy for us to convince ourselves during the good periods that he is maturing and better able to use the strategies, etc. but unfortunately the issues have eventually come back worse than ever each time. His anxiety is not as much separation related, he has fairly generalized anxiety, but the anxiety related to social situations has had a big impact for him (and he also has a lot of difficulty reading others' intent accurately and understanding non-literal language, which also contributes to the social-related anxiety). He also goes through periods where he becomes very explosive when his anxiety is high. We had already decided we needed to go ahead with the medication when his explosiveness increased again, and honestly I wish we had agreed to try the medication sooner, but we really weren't comfortable making that decision when he was going through a relatively good period.
Our DS (8 y.o. and about 62 lbs) was started on 25 mg once per day, and it has just been increased to 50 mg once per day. He has been on it just under a week, so it is hard to say whether it is really helping yet or not, as it can take a while before you can tell whether it is effective or not. Just within the past day or two we have noticed some improvement, but of course that may or may not be related to the medication. He was also put on a very tiny dose of seroquel (12.5 mg 2x/day); this medication is in the atypical antipsychotic class (but is prescribed in doses of over 400 mg for that purpose); at lower doses it apparently has some anxiolytic properties. We will hopefully remove this medication in the future, once the zoloft is working well. As far as side effects, he is complaining of some stomach aches and occasionally headaches, but I know I had debilitating headaches and nausea when I first started on an SSRI and it went away within 1-2 weeks, and his side effects do not seem severe so I am willing to stick it out and hopefully once his body adjusts he won't have these side effects anymore.
On the other hand, we are not currently considering medication at this point for my younger son (6 y.o.) who also has a lot of anxiety (including separation-related). However, he has made more steady progress over the past couple of years with only minor setbacks, unlike our older DS who has the huge set-backs. I know there is a possibility we may have to consider medication for our younger DS in the future as well, but for now he is managing with some very supportive school staff and lots of preparation for things that are anxiety-inducing.
Since we are so early in the medication process, I can't really speak to pros/cons etc. with any certainty, but I did want to reply since I know how difficult a decision this is. Are you comfortable talking to your Dr. about your concerns and the pros/cons? There are a couple of different SSRI's that can be prescribed to kids, so you might also want to discuss the pros/cons of each of the meds. The psychiatrist who prescribed the meds for our DS felt that zoloft was the best option, but it can only be prescribed in pill form so prozac was the back-up plan if DS could not take the pills. He REALLY struggled with the first couple of pills, but by the 3rd dose he knew exactly how to get it down quickly and he is absolutely fine with it and prefers it to liquid medicines (which he almost always thinks taste bad).
It sounds exactly what we are going through with our son. His anxiety is very high now because of school again which is why we think that if he stands a chance of success he may need the medication. We were not impressed with the psychiatrist we saw last year although I do believe she was conservative with her dosing as her recommendation was to start very low with 10mg of Zoloft I think once or twice a day. Her bedside manner and limited time she took didn't not make us feel warm and fuzzy at all. Anyway, if we go this route we will go to someone else and ask a lot of questions.
Swallowing the pills will be an issue since he went through a phase where he was so scared of choking he started limiting his diet and refusing to eat all but limited "safe" items. He has now overcome that but he still worries if his brother or sister coughs at the table he thinks they will die from choking. And there is nothing at all that he witnessed or anything we can think we did to make him afraid of choking. His fears come and go for the most part.
Thanks for sharing. It is really helpful to hear from others going through the same thing. Good luck to you also!
I can really identify with what you are going through. DS#1 also has fears that come and go for no reason, and he has severely restricted what he will eat in part based on previous gagging reactions, but also general sensitivities to taste and texture. I really was not sure the pills would be a possibility for him, but he has managed it. However, he doesn't have fear of choking per se. Our Psychiatrist's bedside manner is also far from ideal, which has made things more challenging. Eventually we have received the information to help us feel comfortable with the medications, but honestly I hope that once we know that the meds are working, we will be able to have ongoing care and medication monitoring provided by our Pediatrician, who we (both parents and DS) have a much better rapport with.
Our son had a similar background (including that we also pulled him out of kindergarten to home school due to anxiety as well). He also has tics like your son, and a previous diagnoses of ADHD, although he now has an Asperger's diagnoses and it's felt the attentional symptoms were more related to the anxiety than the ADHD in his case (he has no current symptoms of ADHD with anxiety treatment only, previous ADHD meds still left him with attentional symptoms). Anyhow, he started with CBT group therapy from age 8, it was called "Cool Kids" and he did gain coping skills, but it still wasn't enough on it's own and we also had continued severe problems with tics. He went on anxiety meds (Zoloft) a year ago at age 11 and at the time 82 lbs, starting at 25mg and moving up to 50 mg in a few months. He is now on 75 mg, but he's a full 95lbs (big growth spurt) and 12 years old, so of course you would expect different for your younger and smaller son.
Honestly, I wish he had started medication sooner. He's been able to relax with others and I think part of why this is the first year he's made real friends is that he isn't having to constantly cope both with social anxiety and anxiety about making mistakes or upcoming changes. He was in a pretty constant state of dealing with this and it was taking all his energy. He's generally been able to enjoy life more and he's come ahead all round. The only side effect we've had is mild heartburn if he forgets to take a snack or a glass of milk with it.
Busy keeping up with three children and an awful lot of chickens!
I'm glad my family doctor can monitor him if we decide on medicating as we do have a very good rapport with her.
Everyone who has found the right medicine seems to be on common ground wishing they had done it or found it sooner and how life changing it can be. It would be wonderful if he could actually enjoy school! I have two extremely different sons as I also have a DS who just started Kindergarten and absolutely loves it. He didn't shed one tear and just hopped on the bus happily waving bye to me. Now, I never really expect that from DS2 but if he could attend, not cry or worry and learn that would be enough. Fingers crossed, we find the right meds. without too much trial and error.