To tell my son he can't take citalopram?

[PomBearArmy]

DS is 16 and has suffered with depression and anxiety since childhood. About five years ago I took him to CAMHS and spoke to a doctor who said that the only sensible option would be to put him on citalopram, that his anxiety was so deeply ingrained in his personality it would be the only thing to work. I chose to pursue diet changes, sport therapy, counselling, etc instead. There has been improvement, but he can and has gone right back to square one for any reason. It feels like the anxiety is just there inside him looking for things to fix onto. He can get as agitated about a small thing as he can about a genuine crisis!

He starts college in September and is very frightened, not really eating, not wanting to go out. He wants to go on medication now.

But I'm afraid of putting him on drugs at the age of 16. There is a history of mental illness in my family, and I feel like this is a 50/50 bet. Maybe medication would make him happier and prevent worse problems down the road, or maybe he would become reliant on medication for life, or react badly to it and end up on a slippery slope downwards like other members of my family. I have read about people becoming suicidal/psychotic on these pills.

Any opinions or personal experiences welcome, I just want to do the right thing by him, and I don't trust our local GP, he seems too 'scrip' happy.

HTH and hope it all goes well ....

bulletwithbutyerflywings - great name, smashing pumpkins ref?

And I have seen venlafaxine used in inpatient units but no, generally not used in CAMHS.

Not wanting to hijack but I went to the doctors this morning to say I'm depressed again and to see if I could get some ADs - not an easy decision for me, didn't want them previously but feel I need them now I have a young daughter who depends on me.

Doc was very nice but basically gave me some printed off info and told me to come back next week if I've decided that exercise, some time to myself or group therapy won't do the trick.

Well no it fucking won't, but thanks for the chat Doc. Now have a terrible headache and DD is being really, really grumpy today. Feel worse than when I went :(

So OP, back to the point, if your DS is asking to go on the ADs, I'm guessing he's ready. It's not an easy decision to come to.

My DH takes citalopram for a MH issue (borderline personality disorder) and its changed him for the better. He's soo much calmer and nicer on it and its helped him so much.

If your son does go on it he will have check ups to see how he's doing and coping with being on it so try not to worry too much and he will be put on a low doseage.

If your dr feels it will work with your son and he will benefit from it then I'd take his advice and let your son try it. My DHs doctor didn't take the decision to put him on it lightly and he was only given it after all other avenues failed and from your OP clearly everything else you've tried has failed to help your son too so prescription drugs are his only option now and I think you'll be amazed at the difference they will make to him if they work :)

I agree with the poster who said he will get much better prescription and monitoring now, at 16, than he will if he takes this option as an adult.

I'm sorry Maryz. I wish there was more information targeted at younger teens about Cannabis and depression/anxiety, not that they'd necessarily listen. For anyone with a family or personal history of depression/anxiety it is hugely risky.

Well done for being open-minded and taking the informed views on board. The prospect of taking any drugs long-term, possibly even for life, is scary and you're quite right to educate yourself about the risks and any side effects so you can be vigilant for your son and make sure he has the facts he needs to enable him to make decisions about and feel in control of his treatment. With your and your GP's support and ideally some cognitive therapy alongside the citalopram, this could be just the change that kick-starts a meaningful and long-term improvement for him. Let's hope so.

I have been on citalopram, and combined with CBT and other changes (search my username and you will find the thread I posted on it), it has made an enormous difference. The citalopram wasn't a magic bullet, but the rest wouldn't have worked as well without it. It is very easy to be afraid of meds - I know I was - but they can and do make an enormous difference, for lots of people.

I can understand that you are especially concerned given his age. I know that citalopram and lots of ADs are cautioned against for teenagers because they can act in unpredictable ways, so do speak to your doctor about that and maybe get a second opinion. There may be a more suitable medication for someone his age. If he does decide to take it - on doctors' advice - the best thing you can do is, in addition to supporting him generally (which I am sure you are), keeping a careful eye on him for the first month to mitigate against risks of self harming etc.

OP, you have already tried alternatives such as diet, exercise and counselling, and whilst they have made a small improvement, unfortunately it isn't going to be enough. You should definitely continue with these if they are helping, but it sounds like some form of medication may be necessary too.

You said that you have been to CAMHS and spoken to a doctor, was this doctor a psychiatrist? As he is only 16, a psychiatrist who specialises in child and adolescent mental health is the best person for him to be seeing, not your GP. I have had mental health problems and been prescribed ADs by a GP, but they are not the experts and I think when it comes to under 18s, you should see a specialist who can decide the correct medication for his symptoms and monitor him for any side effects e.g. suicidal thoughts during his treatment.

I hope your son gets the help and support he needs and that he starts to feel better soon.

OK, so your DS having ASD means you do need to take more responsibility for his treatment, but that means that you need to put your fears aside.

Paracetamol is thought to alleviate pain by affecting the production of certain chemicals in the brain and CNS. Does taking paracetamol for pain terrify you as much, PBA ?

And now I've read to the end of the thread, I'm glad you're prepared to take on board people's experiences.

Good luck to your DS for college, btw!

I second the advice to see a psychiatrist, especially for discussing and deciding on medication.

Google Rob Kelly's Thrive programme, it did wonders for my sister who had a diagnosis of bipolar and was on medication.

I agree with frogspoon ask to be refered to a spicalist that can monitor your ds and know the right durgs to use.

Good luck.

Citalopram saved my life, twice. It may not work for your son, but you at least have to let him try.

Don't let him struggle on, OP, when there is help out there for him.

At 16 he can do what he likes. We have the opposite problem, as in we have a son with ASD and other problems including OCD and anxiety. His CAMHS doctor thinks that medication would be best for him, after many years of trying other things, but my son won't take it. As he is over 16 there is nothing we can do about it.

I also am wary of meds - but your son has been anxious for years now. Citalopram may make the difference he needs to get him through the rest of his teenage years. Sinking further into mental health problems won't help him in the long run.

OP, I feel for you.

I have been through similar with my DS who is younger than yours and suffers from anxiety and depression. I am not a doctor, but I do work in a related field and have learnt a lot about his area.

As he has free floating anxiety, which 'fixes' on things happening around him, it is likely to be caused by a chemical imbalance in the neurotransmitters in the brain. Alternative treatments wont fix this.

Your DS needs to be seen by the psychiatrist in the CAMHS team, who will prescribe and monitor him. Medication, alongside CBT is likely to have the best outcome for him.

Medication has made a massive difference to my DS, who after a pretty scary year is back on form. I was also worried about putting him on ADs as he is only 12. But for us it was definately the right decision.

Good luck

pom thank you for listening. If my mother had listened better when I was 16, I wouldn't have had a breakdown at 25.

Now at 44 no one is allowed to remove my meds.

you said he has had counselling has he had psychotherapy?

even if your son starts to take ad's he should still be having some form of counselling to help him manage his anxiety

the chemical imbalance for depression and anxiety is not proven and there is a lot of debate over this though drug companies have vast amounts of money to uphold their research. having a pill to correct this imbalance certainly sounds like an easy option and serves them well and for the nhs is the cheap option. please read up on these drugs before he starts taking them he is very young, many people going through very anxious times in their life and learning to handle it, what triggers it off is very important this can be done without drugs or by taking a low dosage of medication. to understand yourself and your anxieties rather than taking a drug that numbs them

and agree with others your gp is not the person your son needs to see he needs to be referred to a child psychologist

Just another one to add to the already extensive list in favour of Citaloprom. I had depression after cancer and the Citaloprom kept me working and was a lifesaver. I also had counselling which helped enormously but the drugs really gave that some space to work. Several years on I feel great, but wouldn't hesitate to use them again. Another one who thinks that we wouldn't be having this type of conversation about asthma inhalers, which my DH still uses at the age of 42.

Personally, I'm bloody grateful that we've got these meds available. Having had cancer and depression, the depression was by far the worse.

her son is 16

no we would not be having this discussion about inhalers

but the chemical imbalance is not proven, royal college of psychiatry, mind and other organisations do support the chemical imbalance/depression research that is backed by drug companies

to understand the root of your depression and/or anxiety is very important he is of such a young age is it not more important for him to do so rather than than take drugs feel better and not get to the root of the cause

FreudianSlipper, it is possible to get so ill that therapy will not work, or not work fast enough to save the patient a very long period of intense suffering (that is damaging in itself). I was so ill I'd have topped myself (was very much on the cards) before therapy had achieved any breakthrough. Citalopram got me through the crisis, but the progress I made in therapy, individual and group, is what now helps me keep well.

yes i am aware of that

some people need ad's to help them start or go through therapy. long term therapy you will often feel worse before you feel better