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.

Before you go down the big drug company conspiracy route. The consultant psychiatrist and the CAMHS team my son saw do think that brain biochemistry is important - as does the child clinical psychologist that he is also seeing.

There is also a fair amount of evidence out there including a NICE review on the use of AD's in children. The evidence from NICE says CBT and pharmaceutical intervention has the best outcome, if as in this case other interventions dont help.

Perhaps reading the evidence might be the way to go?

Lots of people with chronic illness rely on medication their whole life.
If you don't "let" him try something that may help then you are adding o his anxiety.
Let him and his doctor decide.

many people have come on here and said well i took this and that i have a chemical imbalance and now i am so much better. op's son is 16 and also has other conditions

all i have said this is not proven

there is a lot more research out there (harder to find) that questions this

i also posted that he needs to see a child psychologist before any decision should be made if that decided that is best he should also be having some therapy and hopefully get to the what is happening to make his feel this way

He is asking for the medication, why will you not let him try and see how he progresses. there is nothing to lose and as you say the last 5 years of alternative therapy have been of no long term aid. What is this problem you have with him maybe taking medication all his life, if he had a heart condition, diabetes, etc he would be taking medication, so why is a chemical imbalance any different.
Let him and his Doctor decide and be there as and when you are needed.
Good Luck toyour Son

these drugs have different effects on different people. They might work for him, they might not. The chap with the years in medical school thinks it is worth a go.

why won't you let him try? (with close monitoring of course)

Better to see a psychiatrist with the right prescribing expertise than a psychologist, in my view.

The poor child has had years of psychological intervention and is asking for medication.

Ideally a specialist is the way to go,(GPs arent supposed to prescribe ADs for children and most won't), but a psychologist cant advise on the merits of drug treatment as they are not medically qualified. CAMHS will have a specialist child psychiatrist.

And NICE have systematically reviewed all the available evidence - thats what they do and they are very good at it. Interestingly, NICE do not reccomend just prescribing alone for adolescents, without appropriate psychological support.

It sounds like you've tried so many other things that I'd say now is the time to give ADs a go. I have generalised anxiety disorder and take ADs every day and have done since I was 25 (I'm now nearly 28). I know there are horror stories, and who wouldn't be concerned?

But really, they do make my life more liveable. They're not mind-altering drugs which change your personality. In my experience, they've just made it a bit easier to get back to the real me. You'll need to keep a close eye on him, obviously, as he's still under the 25 age bracket, but you sound like a loving mother who would do that anyway.

I've not read the whole thread yet (sorry ) but I would also suggest mindfulness meditation, in addition to ADs. CBT, counselling... they've never really helped me. But working through this book www.amazon.co.uk/Mindfulness-practical-guide-finding-frantic/dp/074995308X has been something which has helped, or at least made me start looking at things differently.

i have not said he should

i am saying be wary do your research and get mh professional appointment

and yes i do think there is a problem if someone is taking a drug for life when it is not understood why they suffer such anxiety, its it likely when they do feel anxious, and we all do at times, their dose will be upped again and they become dependant on their drugs when there might be no need too

and that he is so young. more and more teenagers along with adults are being given drugs simply because it is the cheaper option, sometimes it is needed other times it is not

FreudiansSlipper he has been under medical treatment for MH problems for 5 years. I'd say they are pretty last-resort at this point.

I am so sorry OP

but we are lucky enough to live in an age where the drugs DO work

This week alone I have 2 friends suffering, in pain, and they dont want to take XXXX and YYYY. take the bloody drugs they have been told, and rightly so

I have so much compassion, but if I were in your shoes I would let him have them, and I am sure you will see an improvement

Although we have similar names I think we are coming from very different places freudianslippers.

The evidence for abnormalities in brain biochemistry is well established and prescribing is not based on pharma company brainwashing (why people seem to think medics are so easily influenced is beyond me).

In some cases there is a clear psychosocial root for anxiety / depression but in others there is not. The skill of the psychiatrist is to separate the two and then treat accordingly.

yes i know a psychologist can not advise on drugs but they can on the op's conditions rather than a gp and will refer him

i know it is established in some area's of mental health but the causes for anxiety and depression are so complex to say well this is the reason here is a drug that sorts it out its not that simple and especially with a child

more and more children and adults are been given these wonder drugs, we know it is cheaper and has quick result but understanding the cause is so important and at such a young age if he does start taking drugs he still needs this too

i know it is established in some area's of mental health but the causes for anxiety and depression are so complex to say well this is the reason here is a drug that sorts it out its not that simple and especially with a child

more and more children and adults are been given these wonder drugs, we know it is cheaper and has quick result but understanding the cause is so important and at such a young age if he does start taking drugs he still needs this too

Freudian, you keep saying this. It's not exactly that anyone disagrees about it, more that this child has been receiving help and treatment from CAMHS for years and is still very unwell. OP has not said anything about just chucking drugs at him and closing her mind to anything else, has she?

no she has not

but that is often what happens not because she wants it, sadly it is to do with funding and often once people are feeling better the reasons why they suffered are not deemed that important. you can argue well are they if they are feeling better

i think she is right to have be concerned about her son going on ad's. how many have come on here saying they are great, changed their life blah blah corrected the imbalance. nothing wrong with that (though wil argue the imbalance part regarding depression) but a child of 16 with other conditions it needs careful consideration, needs to be researched by her which obviously she is doing and a professional that really has an understanding of his condition

FS, no one is advocating drug treatment alone.

But in refractory anxiety and depression, in conjunction with psychological therapy, they have a valuable place, and in some cases are a lifesaver.

Have you read the thread? The doctor first advised citalopram 5 years ago. She has tried lots of alternatives over this time.

Cognitive therapy is most effective when the patient is well enough to fully engage with it. Plenty of treatment plans involve using medication to get the patient to a level where cognitive treatment can work.

But you seem to feel that only a psychologist can or will try and 'understand' this boy's condition?

And I object to the idea that CAMHS simply give drugs because it's easier! I think you will find that drugs really are the last resort for young people.

Citalopram is indicated for both anxiety and depression by the way.

Yabu

Continue with everything else but docs take prescribing ADs for under 18s seriously and wouldn't be recommending it if it wasn't the best option

If your son wants to then he can get them without your permission anyway so you may as well support him

I am on citalopram - it works for me, however i am not entirely sure i would want my child to take it. I haven't read all the thread just yet but has anyone mentioned that there are concerns about giving teenagers SSRIs as there is an increased risk of suicidal thoughts in the first few weeks when you get the side effects but not the benefits. I became suicidal in the first few weeks of taking this, i KNEW it was a side effect, saw my doctor and kept myself safe but.

For me, I would want my child assessed by a pyschiatrist before i allowed them or at least, didnt discourage them from taking this sort of medication.

Don't be scared of medication per se even citalopram which is effective against both depression and anxiety and certainly doesn't have the suicide risks that seroxat had.

Actually if my DC were in a position that they needed ADs at that age i would insist on a psych assesment.

Again, apologies if he has been seen by psych team ive only read the OP and skim read that you have been given a bit of a rough ride.