Teenagers and prozac (or similar)

[MoodyBlueGreen]

Hi, I wonder if anyone can help me with their experience/advise on this.

My 15 year old DD has been referred to CAHMS with anxiety, depression, self harm and suicidal thoughts. She is being assessed at the moment for treatment. She has also been seeing a councillor at school which has been a help.

The psychiatrist at CAHMS has said that it is likely that he will be putting DD on prozac or similar to 'lift her mood'. I was very alarmed by this as resorting to medication seems very extreme especially at such a young age. He reassured me that the dose will be small and will be monitored closely.

Have any of your DCs been on such medication? If so, how did they get on with them? Were you happy with the benefits that your DC's got from the medication?

[Innismhor]

My DD suffers from depression has been on Prozac since March. Her experience at the start was entirely positive - she started to feel better within a couple of weeks with no side effects. Unfortunately she regressed in July and has been very ill over the summer. She's now on a higher dose and seems to be responding again.

Depression is a horrible disease and really crippling. This medication although pretty crude is helping her to live through it and start to enjoy things again.

[MoodyBlueGreen]

Hi Innismhor, thank you for your comments. It sounds as if Prozac is not a cure all and be taken with care.

I hope your DD will come through it soon, depression is indeed a really horrible illness. Wishing her and you best wishes.

[quirrelquarrel]

Sorry your daughter's going through this- it's shit, it really is!

I was 17 when I started on citalopram and just past 19 when I started prozac, and still 19 when I started taking the max dose. Am 20 in a couple of months now and no signs of going off it, but this dose and drug are right for me even though things have improved.

IME it's been worth it, but it's not a miracle fix. At the moment I'm feeling 10x better than I did 2 years ago. But I'm dependent on the drug. If I miss a couple of days, I'm a weepy mess. And when I weaned off one AD and started on the other, the week in between was horrible. Don't know if that's just me in my natural depressed state or the fact that I'm messing around with my brain chemistry or whatever.

To 'lift her mood'- well, I would resent him saying that. He shouldn't be starting her off with any expectations. It's almost a gamble in a way- not saying that if she doesn't gain, she'll necessarily lose- but you don't know what will happen. Sometimes a 15mg dose will work wonders for someone, and sometimes a 60mg dose of something else will do nothing for them, apart from making them feel awful through side effects. It really is an adjusting game, if you decide to go down that route. And if she's expecting an improvement and instead starts to feel very empty, flat and numb, she may not be able to cope with that. The first sign of my depression came at 15 when I began to feel incredibly numb (without drugs) and I couldn't cope with the idea and spiralled down quite quickly, I was very unhappy with the idea that I'd 'lost my emotions'. It was very scary and I imagine it would have been even worse if someone had promised me that things would get better and then they got worse in an unexpected way.

My parents were very against my taking them, even though they knew that I wasn't doing well, but they know a lot of people who are on these meds- depression and anxiety related disorders run way back in our family on both sides and now they recognise that it was a good step to take. The NHS has been a bit crap really- they'll shove pills at you as soon as you prove that you're not functioning well, but when it comes to really trying to get at the root of what's causing your problems, they have this completely insufficient network in place and it's so easy to fall through the gaps. So my parents were frustrated by that as well.

Good luck to your DD- and remember that you can always refuse the pills if the CAHMS people insist. You can go away and do research and if you feel uncomfortable, you can ask him a lot of questions. They are there to help your DD so if you have to make a pain of yourself so be it.
What does she think? Does she have anything against taking them, or would she want to take them?

I could go on, but don't want to write an essay!

[MoodyBlueGreen]

Quirrelquarrel and HarryStottle, thank you very much for your input. It is good to get some views from people who have gone through similar to DD.

We saw cahms today again. We discussed medication again - they were also talking about sleeping tablets (melatonin) - he thinks that the lack of sleep (DD has told him that she only goes to sleep at around 3am at night) is a main concern.

I am worried that if she takes all this medication she will become dependent and they only serve to mask her underlying anxieties and not help her to overcome the root cause of her problems.

[ToffeeWhirl]

My eldest son (now 13) started on Prozac when he was 11. He has OCD and generalised anxiety. He started on 20 mg. He suffered some side effects for a few days. The benefits kicked in after a couple of weeks and his troublesome symptoms eased significantly. He took himself off the pills five months later, without my knowledge initially, and it was fairly disastrous, with him unable to go to school or even leave the house because of his anxieties.

He is now on 40mg per day, which is quite a high dose for his age group, and this seems to be working well so far. His psychiatrist told us that people with OCD usually need a high dose to feel the benefit, so she expected this. DS is also having CBT. It is very important, I think, that the medication is given alongside counselling or CBT. Have CAMHS offered this for your DD? The drugs should be given to enable the patient to access the therapy, not instead of therapy. I think CAMHS are sometimes quite happy just to dish out the meds, so you may have to ask/insist/fight for further therapy (I did).

I felt the same reluctance as you in allowing DS to go onto these meds, but he had no quality of life without them. In the end, I decided it would actually be more cruel not to let him have them. As for being dependent on them - well, maybe he is. But the alternative is too dreadful for him and, at the moment, he is actually able to go out a bit and enjoy life more. He is even hoping to go back to school (he is home educated because of his issues).

Your DD's lack of sleep is an indication of depression and will be having a very bad effect on her mood and general state of mind. Poor girl. Personally, I wouldn't hesitate in accepting medication for that too, although I would hope her psychiatrist wouldn't prescribe both at the same time. She needs to get used to the Prozac first and see if that helps her sleep issues.

Are you going back to see the psychiatrist soon? If you still don't have a prescription for the medication, what help is your DD getting with her issues at the moment? She needs to be seeing a therapist as soon as possible, whether or not she goes on the Prozac.

How are you in all this? I know how draining and upsetting this must be. DH and I feel like we are on a rollercoaster with DS1 most of the time.

[MoodyBlueGreen]

Thank you Toffeewhirl for your comments. It's really useful and comforting to talk about this to those who understand even if its through mumsnet.

You ask about me and DH. We are coping but our overwhelming feeling is guilt. It's blindingly obvious now that she has suffered from anxiety for a long time. It's never been too acute like your DS but there all the same. I feel full of regret and guilt that we did not seek help earlier.

As for treatment, CAHMS is putting together a package now. DD will take the meds in conjunction with counselling and treatment that is 'like CBT'. The former will be supplied by her school counsellor who my DD trusts. The latter will be given by the CAHMS counsellor who has been assessing DD. She doesn't like him much, calls him 'the old dude' (in reality he's about my age), not the ideal person perhaps for her to open up to. I think he is ok, we will see.

DH says we should just go with it. DD herself just wants to continue seeing her counsellor. DD is unsure about the meds. She knows that I'm worried but she is not anti either. We will have to make sure that she has the right info so she can help decide herself.

She is so up and down its hard to know how she is. She does go out and has several good friends who are supportive. But on the other hand I've found notes that describe how low she is feeling and how it might be easier to end it. Heartbreaking.

[MoodyBlueGreen]

PS, ToffeeApple, wishing and hoping that your son will come through this soon. Thank you for sharing your thoughts with us.

[MoodyBlueGreen]

Sorry I meant Toffeewhirl , time for bed I think.

[ToffeeWhirl]

Ooh, I used to love toffee apples . Might namechange to that sometime.

I'm sure you and DH have absolutely no need to feel guilty, but it's natural to feel like that. I hope you can soon come to terms with it and move on. I was shocked when I discovered how miserable DS1 was at school at the end of his first term of Year 6. I hadn't noticed any signs at all - and yes, I felt guilty too. DH and I still fall into agonising conversations about what we should have done differently, but the truth is that we did our best - just as you and your DH have done and are still doing now.

I'm glad CAMHS is sorting out a package of treatment for your DD. It sounds as if she is seeing the right people for each job, ie the counsellor she likes for the talking therapy and 'the old dude' for CBT. It matters less if she doesn't like him because he'll simply be going through a CBT programme with her. DS1 didn't like his first CBT counsellor much, but the CBT still worked well.

I understand your DD's reluctance to go on Prozac and your own reservations. I was particularly worried about the 'black box warning' I had heard about Prozac, ie. that there is evidence of an increased risk of suicidal thoughts and behaviour in young people who use it. I discussed all the risks and possible side effects with DS1's psychiatrist and, in the end, opted to try it because DS1 was so ill. I kept a close eye on DS1 and was reassured that he started on a low dose. Luckily, he has only experienced benefits from being on it.

Your DD could always start with the therapies first and see how they go. DS1 was too young to take Prozac when he first had CBT (he was nine) and it still worked well for him then.

It's really good that your DD can still go out and that she has supportive friends. That will be invaluable for her in her recovery.

Thanks for your good wishes for my DS1. He is still doing well at the moment, so I remain hopeful that he will get back to school.

Goodness, this has been a bit of a long post. I am sitting up with a poorly DS2, but he's gone back to sleep at last, so I'll sign off now. Best of luck with everything.

[MoodyBlueGreen]

Thanks again ToffeeWhirl. I was worried that 'the old dude' may prove a problem but if it doesn't matter so much for CBT then I'm relieved.

The 'black box' was my real concern with me too. I remember reading something about it in the papers a while ago and have googled it since. As DD has had suicidal thoughts I am particularly worried that she might be vulnerable. Obviously I haven't mentioned it to her but it's something that I mean to discuss further when she is not around.

I have a younger child too. I think all this is hard for them - it's hard to know what to share with them.

I hope your DS continue to make progress and he is back at school soon. Best wishes to all of you.

[Alonglongway]

Just wanted to wish you and your DD well. We went through something similar but CAMHS didn't prescribe medication and that proved to be the right thing. DD had 10 weeks' CBT and a few follow up appointments and found it incredibly helpful.

[coffeeandcream]

Hello OP,

I thought you might like another perspective. As a teenager I was prescribed Prozac for depression, 40mg iirc, and I took it for about 18 months, also whilst under the care of CAMHS.

My mum was really unsure about me going on to the tablets, convinced I'd overdose. It really pissed me off that she couldn't trust me and at the time it made me feel like she was preventing me getting help. She also tried to convince me to start cutting down the dose over time which terrified me. I know she did all this out of concern for me, but she was not the professional and should have trusted them to do what was best for me.

The medication and therapy were a real help, but they took time. Be patient and just be there for your DC.

Really hope things get better for you

[AmericasTorturedBrow]

So sorry for you and your daughter

I was similar to quirrelquarrel and was on citalopram at 15, Prozac at 17. Initially it worked at the low dosage then I kept hearing people go on about "drug dependency" and got worried I'd be hooked on Prozac forever so I stopped then restarted and basically thought I could self medicate. It was disastrous and I attempted suicide at 18 so I would really urge to keep expectations low and to never let her know you're worried she might become "hooked".

I went back onto Prozac and into a mental health unit for a month with 3x day counselling. Over the next few years did various bouts of therapy which were always more beneficial when I was on a medium dose of medication, it steadied me enough to talk stuff through without freaking out. I've been off medication (still seeking the right form of therapy though) and unclassified as depressed since I was 21 (aside from bout of PND and antenatal depression)...I'm now 30.

Take the advice and start in a low dosage, it might work wines, it might do nothing, but it needs to be taken as proscribed and given I think at least 2-3weeks to kick in.

Good luck, you sound wonderful and supportive. Wishing you both well

[MoodyBlueGreen]

coffeeandcream and americastorturedbrow, thank you for reminding me of my DD's perspective.

You are absolutely right that if anything helps her to feel better then its got to be tried. I think its important that we parents keep our anxieties to ourselves if we can.

I am hoping for a cure but really should be more realistic that it will be something that she will have to live with for a while to come. Perhaps trusting the professionals and going with it all is the thing to do.

I just want to say to all of you that suffered from similar that I really admire your frankness, thoughtfulness and strength that you show in your posts. If my DD could come through this and be able to take such a view of the whole thing in a few years time then i would be very proud.

[elastamum]

My DS (12) suffered a severe depressive illness earlier this year and was prescribed 20mg fluoxitine and melatonin for his insomnia along with CBT. He was very ill and couldnt get out of bed to face the world for about a month

For him it has been pretty miraculous, 6 months on he is happy, back at school and doing well. It took about a month to fully take effect and after 8 weeks we took him off the melatonin as his sleep had re established itself. Take prozac at breakfast though - not later in the day as it is a stimulant.

The CBT is very important, and he says this made all the difference, but the fluoxitine lifted his mood sufficiently for him to be able to engage in the therapy. He also had a good book on CBT called Think good - feel good that we worked through together.

IMO, if the doctors recommend this approach, it is really worth a try.

[MrsBodger]

My oldest daughter was diagnosed with depression at 14. During yr 10 she dropped out of school. She was very very low, not sleeping at night, not getting out of bed, with suicidal thoughts.

Camhs were very good with counselling from a psychologist who she really liked, but with limited effect. I think this was partly because some of the techniques the psychologist wanted her to try, my daughter wasn't really prepared to commit to - mindfulness, meditation, etc. Her depression did improve, but it became clear she was also suffering from panic attacks. One of the main triggers for this was being with large groups of people her own age - so much for going back to school.

At sixteen, she saw a psychiatrist, who suggested anti depressants. Both I and my husband were very very unwilling, but the psych made an extremely good case - that the small possibility of side effects and of needing to be on them long term was less of an issue than the already severe side effects of her illness, ie dropping out of school, cutting herself off from friends, restricting her activities.

She went on to Citalopram last year, and it's been very effective. Her depression is very infrequent now, and the panic attacks are happening less and less. We're not out of the woods yet, but I'm cautiously optimistic.

Best of luck.

[ToffeeWhirl]

OP, just wanted to say that my DS has just decided to go back to school after two years out. This is all down to the right dose of Prozac combined with effective CBT. The therapist said he needs to stay on the meds for six months after recovery to avoid relapse.

I would have no hesitation in accepting the Prozac if we had to go through this all over again. The advantages far outweigh any possible drawbacks, in my opinion.

[Rosesarebeautiful]

Thanks, this thread has been very helpful
My DS had Tourettes and is on Risperidone. He suffers with anxiety & obsessions too. Prozac was suggested today & I was unsure. This has helped allay my fears.

[MoodyBlueGreen]

The whole process has slowed down for us as CAHMS has repeatedly failed to make contact with the school to arrange the joint treatment. The whole situation has drifted for over a month. I am not very impressed with CAHMS at the moment.

On the other hand, as my DD is in year 11, pressure on her study-wise is mounting. She has English and Maths GCSE exams in early November.

I am about the chase CAHMS now to see what progress has been made and when she can start treatment. I am worried that if we go for the medication option then it may well clash with her exam demands as it sounds from your stories that it often takes a while for the medication to start working and the child can often feel worse before feeling better.

My DD is very diligent and conscientious student so the thought that she may well jepardise doing her best in the GCSEs because of starting medication now may upset her. Her condition at the moment seems not so acute, she attends and takes part in school, does her homework and revision and appears not to be self harming. Having said that she is not that happy either and seems stressed most of the time.

Thank you all for you input and good luck to everyone.

[MoodyBlueGreen]

Toffeewhirl - so pleased to hear of your DS's progress!

[ToffeeWhirl]

Thanks, Moody.

Oh, that's difficult for you. I can see why you don't want to mess with DD's head just before she's going to take exams. If it helps at all, my son only experienced side effects for a few days when he went on Prozac or increased the dose. If your DD is coping ok at the moment, maybe you should leave well alone? Perhaps the school counsellor is enough to help her negotiate her way through this time? What does your DD think?

CAMHS often need chasing, in my experience. Over the years, I have grown used to asking for what DS1 needs over and over again until we get it. Polite, but insistent, that's me.

[MoodyBlueGreen]

Things look as if they are moving at last! CAHMS and the school have had a meeting and agreed to give joint treatment (unprecedented I am told, but granted as we requested for her trusted school counsellor to be involved )

DD will have her first session next week of CBT-like treatment to help her to develop coping strategies to take her mind off negative thoughts and focus on more positive things with CAHMS. In the meantime she will restart her visits to the school counsellor.

As for medication, we have agreed that she will not start on them straight away (unless CAHMS think that she should) and wait to see how she gets on without them until after the GCSEs in November.

[ToffeeWhirl]

Brilliant news, Moody. I really hope the CBT helps DD. She may never need the Prozac after all.

And best of luck to her in her GCSEs.

[Beetlemania]

Reading these posts had been really helpful and I empathise with all of you. My 15 yo daughter has just been to GP who is referring her to CAMHS and mentioned the possibility of antidepressants which terrified me! She has been seeing a councillor at school for the last 12 months and although this helps her when she is having a troublesome time it is not helping her to be able to deal with these situations to stop them happening.

My dd has always been very, confident and popular. She is kind, honest and loyal and has always strived to do her best and please everyone. Things started to change for her when she started at secondary school when for the first time ever in her life she was scared to go to school. She is now in year 10 and still says she hates school. She seems unable to deal with "banter" from other pupils. She has panic attacks which result in vomiting and has had suicidal thoughts.

As a parent who has spent all my daughters life trying to ensure she is well equipped for life this is devastating, I feel guilt and shock that my happy, confident little girl can be feeling this way.

She has a secure family home with her Mum, Dad and brother and a vey close relationship with her grandparents. Apart from usual family pressures of work/school and out of school activities she really has no other pressures. I find it difficult to understand why she would feel so low as some of her peers have far more issues to deal with but I coming to terms with the fact that she really does feel depressed and it's not just normal teenage behaviour.

Thanks for listening, it helps