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Kids and SSRI's


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Hi all...

My daughter is 13 and is suffering severe anxiety, now that school has started she's got separation anxiety and is freaking out and is getting depressed--feeling very sad, crying for no reason, not wanting to do what she likes to do, etc.

I am taking her to see a psychologist who specializes in helping adolescents with these problems...but there's talk of maybe putting her on an SSRI.

I am nervous about this because I am BP I and I went severely manic on both Paxil and Lexapro. My father is also BP I and has gone manic on SSRI's. I don't know if this history is meaningful in terms of my daughter taking one of these drugs.

I am also nervous because of the news stories about studies showing that kids/adolescents shouldn't take SSRI's due to dangers of severe depression and suicidal thoughts and actual suicide.

Does anyone have information or experiences or know of anything I should consider? I am especially interested in this issue of a teenager possibly turning manic on an SSRI or the issue of family history/genetics in turning manic on SSRI's. Can turning manic on an SSRI cause kindling or get my baby off to some kind of bipolar mess early in life?

I am obviously scared. But am I paranoid? I want her to get help. I don't want to hurt her.

Thanks in advance...

~Cat

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From what I understand (and I may be mistaken), most of the increased risk of suicide associated with antidepressants in general is caused by the fact that they're working; they can give people more energy before they lift the mood, so people are more able to actually take action when suicidal thoughts arise.

I really don't know about the other part of your question, but I'd say be really sure to tell the doc your concerns, and about your family history. They usually ask, so I'm pretty sure it's something they'll take into account before starting her off on anything.

Best of luck.

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Last time I researched it, Prozac was the only SSRI in the US and Canada approved for adolescents. IIRC, it had to do with the fact that Prozac has a much longer half-life than all the other SSRIs, like by several days. That helps keep the blood levels even and is more forgiving if a dose is missed.

If it were my kid, I'd want a consult with a psychiatrist first, someone who deals with psych meds day in and day out. And keep the therapist.

You sound like a good mom who is really trying to find the best path to help your daughter. Bless you.

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Just wanted to second what Greeny said about seeing a psychiatrist for any treatment that involves meds - especially given your family history. It's very common for a psychologist to make a diagnosis and do therapy, but make sure you work with a good pdoc and not your family practioner if and when it comes to putting her on meds.

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Last time I researched it, Prozac was the only SSRI in the US and Canada approved for adolescents. IIRC, it had to do with the fact that Prozac has a much longer half-life than all the other SSRIs, like by several days. That helps keep the blood levels even and is more forgiving if a dose is missed.

If it were my kid, I'd want a consult with a psychiatrist first, someone who deals with psych meds day in and day out. And keep the therapist.

You sound like a good mom who is really trying to find the best path to help your daughter. Bless you.

To be fair, the reason prozac is the only one approved for pediatric use is because of the lack of data involving the use of other other SSRIs. The reason for this is because it's become increasingly difficult to get approval, let alone funding, for any kind of medicals trials involving children. In some cases I think political concerns have overshadowed actual public health concerns. If the FDA was worth a dime to begin with half the topics on crazyboards wouldn't be here.

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