Sertraline for teenager with OCD

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Hi, my dd is 14 and has OCD, diagnosed at 12. Went for private CBT at the time for around 8 months and she did improve big time. However, it came back more aggressive and with general anxiety too. GP referred to CAMHs, attending there since Jan for CBT also with very little progress.
seen by psychiatrist who has recommended sertraline…. Just wondering if anyone has experience of this drug with teenager who have OCD.
thanks in advance

Not sertraline but DS & I have been taking 20 mg escitalopram long term (over 10 years) for anxiety & depression - we both have OCD too and find that it helps a fair bit to keep it under control.

Wishing your DD all the very best xxx

If it helps to PM me please do

Sertraline is likely to make a very positive impact. It is in the nice guidelines as a treatment. It is highly recommended as a medication to treat ocd …. I have seen it be beneficial to many with advanced / life impacting ocd

Not what you’re asking but I feel compelled to say that I wish when I was a child with severe OCD that someone - parents, psychiatrists, teachers etc. - would have taken more time to think about whether there there was an underlying neurodiveristy issue. It’s a story I’ve heard several times. That may well be something you’ve already looked at, and ruled out, but just in case.

@Germolenequeen thank you. I’m glad medication has such a positive impact you and your DS. It’s a bit daunting for her and us but we’ve had nearly a year of CBT and she seems stuck, if that makes sense. She’s not improving but not getting worse either. So I suppose the next logical step is to try the medication. Thank you

@Acreativeusername thank you. It’s reassuring to know these guidelines recommend sertraline as a first step.

@FloorWipes thank you. I have an older autistic dc so that was always at the back of my mind with dd too. From what I can see, she doesn’t meet the criteria for asd and I have mentioned it other professionals and teachers along the way. She would have traits but not many tbh. I know girls can present differently to boys, so I do keep this possiblity in mind. Thanks for your advice, I know sometimes people can be misdiagnosed. I hope you’re doing well now .

That’s good to know. It still might be relevant though. OCD is a condition with different causes. Treatment for your DD should look different based on that. For example, how does her OCD relate to issues like intolerance of uncertainty, need for routine, problems with executive functioning and so on? These sort of traits are common features in autism. This could be quite different from an NT child who has developed OCD in response to a traumatic event for example. Furthermore, CBT often assumes quite a linear and wordy NT thought process that might not exactly be shared by an ND person. So even “just” traits are really worth keeping in mind.

www.ocduk.org/overview-of-nice-recommended-treatment-for-ocd/

Thank you @FloorWipes , I will definitely keep this in mind. She started her medication today and was fine after it, I know it’s only day one but at least she had no immediate reaction/ side effects. I’ll be keeping a watchful eye on her.
thanks @Acreativeusername for the link!

I would also recommend googling inattentive adhd as it is more about a hyperactive mind than hyperactive behaviour and was life changing for my ocd when I realised it was being driven by executive function deficits. Commonly undiagnosed in people born as females.

@ittakes2 I will definitely look in to that thank you! She is on sertraline about 1 month now and she is starting to feel a bit calmer in herself. A good bit to go yet but I’m hopeful.

That’s really good news

Sorry, late to the thread but my 14 year old son began taking sertraline earlier in the year for OCD. He says it certainly helps. He also has ASC, anxiety, and likely ADHD.
How is your daughter now? My son was started at increments of 25mg until he reached 100mg. Psychiatrist said this is the preferred dose to effectively treat OCD.

@ittakes2 So interesting about inattentive adhd. This sounds like my son too. Thank you!

I'm resurrecting this to continue the discussion about setraline and OCD. My DD 14 is on the pathway for an ASD diagnosis (i think possible inattentive ADHD as well) and has associated anxiety and OCD to the point where I've deregistered her from school as it was making her suicidal. She has improved alot recently but has had a sudden spike in OCD compulsions which are dominating her life and extremely debilitating. I'm beginning to think medication needs to become part of the way she helps to keep functioning. I want to talk to someone about setraline, do i just make a GP appointment? She has had some involvement with CAMHS (very very long waiting lists and quite generic input given her neurodiversity) and is having counselling with an autism charity which has been really good. I want something to happen soon as she really really needs help. What do I do?

Yes GP is an appropriate starting point. Good luck.

@vikingwoman im just seeing your reply now. DD is doing very well. Since staring sertraline she is more confident, relaxed and coping much better with her intrusive thoughts. Still some compulsions so work in progress but so much improvement thank goodness.

@RobinGoch i agree, your gp would be a good starting point. I’m in Ireland and gp can’t prescribe sertraline to children, but maybe gp will refer to appropriate services. Hope you get some help soon.

Great to hear some improvement. Can I remind you to go back to the NICE guidance I sent you explaining meds and CBT benefits as treatments … Best wishes