Setraline - dose for 17 year old

[Pandabrain]

My 17 year old DD has been diagnosed with a social anxiety disorder. She has always had a bit of underlying anxiety but this escalated significantly during Year 12 and she found it increasingly hard to attend school. In the last term she only managed to attend two whole days. Most days she either didn't go in at all, or tried but could only do a morning. She also gets severe IBS symptoms which are really debilitating.

She's tried counselling, hypnotherapy and CBT but without much success. We finally managed to get an appointment with a psychiatrist who diagnosed her as having an anxiety disorder and agreed that it was time to try medication. My DD was keen to try medication so was really pleased about this.

She's been on 25mg of sertraline for about six weeks now but it doesn't seem to be making much of a difference. We had a follow up appointment with the psychiatrist a couple of days ago and although I asked if the dose could be increased she was reluctant to do this, as she wanted to wait a bit longer (partly because she has just started CBT with a new therapist). I'm now wishing that I had pushed a bit harder as my DD has started to become very distressed at the thought of starting school again in a couple of weeks and it seems that 25mg is quite a low dose. She hasn't had any side effects.

If anyone could share their experiences of doses of sertraline for anxiety that would be really helpful. I am going to go back to the psychiatrist and ask if she can reconsider but I was just wondering how other people got on with it for similar conditions. I think that we were maybe a bit optimistic in thinking that it would be a miracle cure but I was really hoping that Year 13 would be an improvement on Year 12.

I am not too sure about 17 year old but my daughter is 20 and on 50mg of Sertraline and finds it really really helps.

I can't advise much on the meds but I was older when I started on them.

I just wanted to offer some hope as I was your daughter. Anxiety, depression and anorexia meant I really struggled with my a levels. I could only manage half a lesson and often went to the start of a lesson and then went elsewhere to do the work. There was a health liaison officer who used to take me out for coffee to have a break from school or let me work in her office.
I was asked to leave 2 exams due to panic attacks. One after just 15 minutes so I had to be watched until the end of the exam in case I passed on the details. I did some of my exams in an office with just me and an invigilator after that.

I did well enough to get into the uni I wanted albeit with slightly lower grades than offered. The first term of uni was tough as I relapsed with anorexia and couldn't do practical aspects of my course because of fainting risks. Slowly I settled into life. I had a bit of support from sympathetic staff members. I continued to have bouts of depression and anxiety but greatly improved. In my final year I had a manic episode whilst on my year in industry. I got through it ok and got a first. I had a year off to focus on my mental health and did bits of work before starting my PhD. Depression returned and the treatments trigger mania. Finally started treatment for bipolar and life started to clock into place. I finally after 10 years I had an answer for why I was depressed or anxious and that was it just the way my brain is. My bipolar means I can do everything "right" and still be depressed. Mood stabilisers have made a huge difference. I got my PhD. I work in specialist role in a biotech company. I'm married and have a 4 year old. Mental illness is always there but I am a completely different person to the teenaged me that couldn't cope with a maths lesson. There is something so unique to the teenaged years and the only experience I have that came close to that was when I had post partum depression. I think it is that toxic mix of mental illness and hormones. I did better in maths than I did chemistry but I chemistry held my focus more than maths and I could often manage full lessons if I had a few 3 minute breaks to take some deep breaths in private. This strategy of going for things that hold my interest has seen me through the dark days. When it's grey and miserable and you are grey and miserable it has to be something special to get you out of bed. It took a long time to see the pattern but my moods are linked to the weather. August is when they start to dip as soon as the days start to get remotely shorter I feel the gloom. I used to always think it was due to going back to school or uni and it was only when it continued in employment that I realised the connection. I have a lumie alarm clock which mimic sunrise which helps me so much to regulate my wake ups.

It is quite a low dose of sertraline but they tend to take a slow and cautious approach to antidepressants after a number of them had to have black box warnings added for causing suicidal ideation in teenagers. It might be something to raise with the therapist? When's your next review with the psychiatrist? It can take 6 weeks to see an effect with the start of CBT it might be that they want to push that to 6-10weeks. When I have started meds as an adult they have been hesitant to increase doses earlier than 6 weeks on the first line of treatment. After having my daughter and having treatment resistant depression for the second and third line of treatments they put a plan in place to increase the dose automatically every 4 weeks. When that didn't help I went into hospital as there they could go quicker and I had my meds reviewed twice a week and changed once a week. So she's currently on the slow end of normal for the community and I can see why they would want to wait a little longer but I think I would want another medication review in the next 3-4 weeks.

My now 17 year old has been on Sertraline for about 2 years, for severe OCD and social anxiety. She started on 100mg (building up), and is currently on the maximum dose of 200mg. It helped her a lot to begin with, these days it’s not as effective. We are currently have her medication reassessed. Good luck

My son is 14 and on 50mg. He is very tall so around the size of a grown up. He is on it for mild depression. It seems to be working

Thank you very much for all of these replies, especially to @Superscientist for being so generous in sharing your story. It is hard for her teachers to understand why she can't go to school and it is so helpful to hear from people who have traveled a similar path. Your story is really inspirational, and I'm so glad to hear that you've made it through and found a diagnosis and treatment. She is also hoping to pursue a career in science.

We're due to have another appointment in about six weeks but I'll see if I can push for that to be a bit sooner.

My daughter has been on 50mg of sertraline since she was 14 and is now 17.
it’s been highly effective. I thought she might require a dose increase as she’s grown (was a teeny 6 stone when starting and now about 9 stone and taller), but it seems to have remained effective. She is on it for anxiety and intrusive thoughts. She feels it’s reduced her symptoms 90%. I will add that she also has ADHD and ASD.

DD1 is on 50 mg, which recently increased and it's definitely helping.

We had been back and forth to the GP for her anxiety for about a year, which hit crisis point before A levels. Personally think there is an undiagnosed ADHD, but not sure what another diagnosis would achieve?

About 4 weeks before the start of A levels, the GP who up until this stage had been reluctant to prescribe medication, finally agreed that it was in fact necessary.

DD1 was able to get out of bed, focus and seemed way more motivated. She went to every single exam, which believe me, was not a forgone conclusion before the medication, and I had concerns whether there was enough time for it to properly kick in.

She didn't do as well as she wanted, but has a place to do a Foundation Year in Engineering which is what she wants to do.