Would you start a 16 yr old on Citalopram weeks before exams?

[Katisha]

DS has anxiety and occasional panic attacks but otherwise seems his usual self - does his revision, his weekend job, all the usual things he'd be doing.
He says it feels like a feeling in his chest, fight or flight.
He was prescribed beta blockers couple of weeks ago but says they are not having any effect
Dr today says to go on to Citalopram but I am concerned about doing this weeks before GCSEs start as I've read of the tiredness and nausea at first.
Any advice? My instinct would be to try upping the dose of the beta blockers in case the Citalopram knocks him off course in these crucial weeks, but I'm no expert.

Personally I would say no as some people find that they feel worse on ADs at first.

I'd wait. I started citalopram at 17. It ranged from climbing the walls to tiredness where I'd fall asleep anywhere. This lasted for about a month before they started having the desired effect.

I’ve found them really helpful in controlling both depression & anxiety. I did feel very tired for a couple of weeks but after that I felt... normal.

As others are saying, it can take a few weeks to work for some people, so if the exams are within 6 weeks, it might be best to wait

I’m a traInning nurse and in my opinion it’s catch 22. There’s always a risk with any medication that there is a chance of side effects. Eg drowsiness lack of concentration. But there’s also a chance untreated anxiety may have a detrimental effect on his ability to perform in exams.
It’s deciding which would be the better option. Medicated anxiety but risk of side effects or untreated anxiety but risk of this affecting exams

Hope that helps 💐

Also, just a thought but when I went on them I immediately felt better because I felt that something was being done. Sort of a placebo effect.

I would have thought that for SHORT TERM use a low dose of diazepam would be more predictable at helping your DS cope with anxiety and panic attacks.

I doubt that any GP would prescribe it though.

My daughter, at the time age 20, started on citalopram and said it was like a switch being flicked on....she felt better almost instantly and she is almost a different person now than the teenager she used to be.....but everyone is different!

Thanks for taking the time to answer everyone.
Still unsure - the GP basically put the decision in DSs hands with no real discussion as to possible side effects other than "some people feel worse before they feel better"
I wonder if the original dr would have tried upping the dose of the beta blockers first. It's hard to get the same dr. each time.

I'm on citalopram. For me it was absoulety fine from day one but I do know that lots of people have pretty bad side effects.

Have you thought about trying CBD oil ?

It can take a while for the brain to adjust to citalopram and similar esp in the first few weeks causing sleepless nights (very common) and hallucinations.

He could try it for a week and see how he gets on. If he has side effects then he can stop and retake after the exams.

Have you explored talking therapies? I had a period of depression as a teen (when my dad died) and it included panic attacks that resulted in me dropping out of 6th form college. Luckily, I got some counselling from a psychologist and it helped me turn things around and start to rebuild my life. I started off doing volunteer work but eventually I ended up doing a law degree on a part-time basis.

Yes he's had some counselling which has helped to an extent. It seems almost like a physical thing - a physical sensation - as I say he seems able to fully live his life other than hating this panicky feeling.
So would taking for two weeks as a trial period be ok?

I found the first couple of weeks hard. When do GCSE exams start?

I'd def get him some talking therapy, find someone who will teach him how to deal with panic attacks and anxiety. Drugs at that age would be a real missed opportunity, he could learn skills in managing his moods that will last him a lifetime.

And I'm not anti meds at all, far from it. I just wish I had been taught how to manage my emotions earlier in life.

It's totally natural for him to be experiencing anxiety and its physical sensations at exam time. It's just his body doing what bodies are designed to do when they feel threatened. Could you both learn about anxiety management together? Breathing techniques, relaxation techniques, exercise etc - it would be such a shame if he learns that his body's responses are something to be medicated instead of something he can work with.

Panic attacks are not totally natural Belonger.
Some people need medication. It can form part of a strategy to deal with disabling anxiety. It's not a case of being a bit worried about exams.

Honestly, I would be doing everything to could to NOT have my 16yo on anti depressants.

DS has anxiety and occasional panic attacks but otherwise seems his usual self - does his revision, his weekend job, all the usual things he'd be doing.

This ^ sounds like normal exam stress. Please think very carefully here. My GP many years ago prescribed me Prozac after a MC. I never took them. I was sad, which is normal, I was not depressed. I often think back and wonder if I would have been dependent on the pills every time things got a little bit tough.

Some awful attitudes to mental health issues here.
Would you leave asthma untreated? Or is it just mental health problems we should be able to solve by struggling though?

I’d question if this was normal practice/ in our area only consultant psychiatrists can initiate medications in under 18’s
The first few weeks of treatment can cause increased anxiety and in rare cases suicidal thoughts
No I wouldn’t give it to my child in the situation you described

I found citalopram very effective but the first 48 hours or so I was absolutely out of my skull, I remember saying if this is a prescription medicine what on Earth do illegal drugs do?! I was completely disorientated. The next couple of weeks I was very tired. I then found they made me care less about everything. It’s a fine line, they’d have helped with exams if I was absolutely into the point where I blind panic couldn’t revise but they definitely dull my performance at work because I just don’t care enough to go the extra mile anymore.
I’d suggest if he thinks he can get through without them, all the other stuff, taking breaks, trying to do some exercise, eating well and sleeping well - plus maybe talking therapy? Then see how he’s feeling a few weeks after if the enciety hasn’t abated post exams start them then, side effects all over by the time he’s back at school.

wolfie

I wasn't saying mental health shouldn't be treated. I was saying sometimes anti depressants are not the way to go. For a 16yo who is functioning in every way but feeling anxious and having some panic attack's there are options.

That's between the GP and the actual patient. Some patients can function on the outside but are crumbling on the inside. I was referring to the PP who described panic attacks as totally natural.
There are other options. But sometimes pills are necessary. It doesn't help to portray them as a last ditch treatment.

I've just started on escitalopram. My Dr made me wait until after my recent exams

I was in your shoes a year ago with my DD. I wouldn't hesitate to start, the tablets have changed her life, they've changed all of our lives. I am adamant that DD would not have had such success in her exams had it not been for the meds. She is on her next round of exams this year and still taking them, I think she always will be, but they have made such a difference I wouldn't change a thing.

His exams start in 2 weeks