When do you determine that an SSRI is not working?

[bisous]

DS1 is going through some major issues right now that I don't want to get into. He has got some major anxiety symptoms and he is working with both a therapist and a psychiatrist. The therapy we paid OOP but the psychiatrist is through our medical insurance and is sort of difficult to get in touch with. We have an appointment in a couple of weeks but I thought I'd ask a few questions to see if I could get some real life experience?

It is evident that a huge piece of this will be continued therapy. That said, I don't see a huge improvement that I thought I might see with meds. I'm wondering if it is possible that the meds just aren't a good fit? He's been on Prozac since late November. He has already had a meds increase. He's still just got so much nervous energy that he can literally never relax. How do you know if the meds need more time? Or if they aren't working? Or if meds won't work at all for him? How long did you give different meds a try for? How soon could you "tell"? For those who have found success on meds, was the road a little rocky? Did you have some success with some meds and no success with others?

Would love to hear any and all input!

[MSWR0319]

DS1 is going through some major issues right now that I don't want to get into. He has got some major anxiety symptoms and he is working with both a therapist and a psychiatrist. The therapy we paid OOP but the psychiatrist is through our medical insurance and is sort of difficult to get in touch with. We have an appointment in a couple of weeks but I thought I'd ask a few questions to see if I could get some real life experience?

It is evident that a huge piece of this will be continued therapy. That said, I don't see a huge improvement that I thought I might see with meds. I'm wondering if it is possible that the meds just aren't a good fit? He's been on Prozac since late November. He has already had a meds increase. He's still just got so much nervous energy that he can literally never relax. How do you know if the meds need more time? Or if they aren't working? Or if meds won't work at all for him? How long did you give different meds a try for? How soon could you "tell"? For those who have found success on meds, was the road a little rocky? Did you have some success with some meds and no success with others?

Would love to hear any and all input!

I'm not a great resource but thought I'd share my story. I was put on Paxil in college. I don't think it did a thing. I stopped taking it because I never felt "better". About four years ago the dr suggested I try something again. She told me that she'd had the most success with anxiety using Celexa and then Prozac as her second choice. When I first started taking the Celexa I felt "drunk" so she reduced my dose by half. Within a few weeks I felt better (anxiety wise). It was very obvious that it was doing something. Now it wasn't a "bam" everything is all better, but I felt better. I went off of it for awhile last year and just felt off again, so I started taking it again right around the time the pandemic hit. Once again it was a slow feeling better. Now, I will also say that I think mine is definitely a hormone issue so that may change the way I reacted. I don't necessarily think or worry about things constantly, my body just feels anxious and I'm irritable off of it. For me Celexa was a great choice. So maybe trying a different med if this one doesn't seem to be helping at all would be a good option.

[georgiegirl]

With DS1 we noticed a small difference at 3 weeks, and he was definitely better by 2 months. He’s on Zoloft and he was only about 55 lbs when he started (age 10), so the smallest dose was adequate

How long has he been in the higher dose? I’d give it at least a month at a dose that’s substantial. Or try a different med. we love Zoloft for DS1

[bisous]

I'm not a great resource but thought I'd share my story. I was put on Paxil in college. I don't think it did a thing. I stopped taking it because I never felt "better". About four years ago the dr suggested I try something again. She told me that she'd had the most success with anxiety using Celexa and then Prozac as her second choice. When I first started taking the Celexa I felt "drunk" so she reduced my dose by half. Within a few weeks I felt better (anxiety wise). It was very obvious that it was doing something. Now it wasn't a "bam" everything is all better, but I felt better. I went off of it for awhile last year and just felt off again, so I started taking it again right around the time the pandemic hit. Once again it was a slow feeling better. Now, I will also say that I think mine is definitely a hormone issue so that may change the way I reacted. I don't necessarily think or worry about things constantly, my body just feels anxious and I'm irritable off of it. For me Celexa was a great choice. So maybe trying a different med if this one doesn't seem to be helping at all would be a good option.

I haven't heard of Paxil for a long time. I wonder if it has fallen out of favor? I have heard Celexa bandied about quite a bit. I feel like I know my ADHD meds and I need to bone up on my SSRIs so I can be better prepared for a conversation with the psychiatrist. Thanks for sharing your story. DS1 isn't great about sharing how he feels. I actually think he's struggled with anxiety for several YEARS now but he's never said anything about it. It is a core part of his personality but it sure doesn't make this whole process any easier!

[gatorsmom]

I’m sorry you are dealing with all this bisous. I feel such a connection to you because we both loved France but mainly because of our boys with issues. I sometimes wonder if our boys will ever find peace.

I have 2 boys on Prozac right now. Ds3 has been diagnosed with extreme ADHD and ds1 is suspected to have mild adhd. Both of them have anxiety but for Ds3 it’s the worst. The Prozac helps both of them to different degrees and in different ways but it doesn’t calm either of them down. It just makes them feel “better.” Ds3 takes both Prozac and Concerta. Without the Concerta he’s climbing the walls. All this to say, if your ds has nervous energy, I think that’s separate from the anxiety. The Prozac could be working and making them feel better (maybe not happy but better than depressed) but it won’t affect his activity level. To get him to calm down, he either needs regular physical activity or he needs a stimulant medication for ADHD. At least that is my guess based on how my boys react to their medication changes. I’m definitely no expert.

We were lucky in that Family members have divulged that they felt better on Prozac and we found it also works for my boys so we didn’t have to try out different anxiety meds. For now. In the last 8 months ds1 went from 10mg slowly up to 40mg. But he says he feels better at this point. I’m dreading but expecting the day that it or the Concerta stops working and we have to go through the process of finding a different medication. That maybe what you’ll have to do if increasing the Prozac doesn’t work.

[bisous]

With DS1 we noticed a small difference at 3 weeks, and he was definitely better by 2 months. He’s on Zoloft and he was only about 55 lbs when he started (age 10), so the smallest dose was adequate

How long has he been in the higher dose? I’d give it at least a month at a dose that’s substantial. Or try a different med. we love Zoloft for DS1

He's been at the high dose for about 3 weeks. It will be about 5 at our appointment so I suppose we should know if it is working by then? I've heard Zoloft quite a bit as well and will do some research on it.

[bisous]

I’m sorry you are dealing with all this bisous. I feel such a connection to you because we both loved France but mainly because of our boys with issues. I sometimes wonder if our boys will ever find peace.

I have 2 boys on Prozac right now. Ds3 has been diagnosed with extreme ADHD and ds1 is suspected to have mild adhd. Both of them have anxiety but for Ds3 it’s the worst. The Prozac helps both of them to different degrees and in different ways but it doesn’t calm either of them down. It just makes them feel “better.” Ds3 takes both Prozac and Concerta. Without the Concerta he’s climbing the walls. All this to say, if your ds has nervous energy, I think that’s separate from the anxiety. The Prozac could be working and making them feel better (maybe not happy but better than depressed) but it won’t affect his activity level. To get him to calm down, he either needs regular physical activity or he needs a stimulant medication for ADHD. At least that is my guess based on how my boys react to their medication changes. I’m definitely no expert.

We were lucky in that Family members have divulged that they felt better on Prozac and we found it also works for my boys so we didn’t have to try out different anxiety meds. For now. In the last 8 months ds1 went from 10mg slowly up to 40mg. But he says he feels better at this point. I’m dreading but expecting the day that it or the Concerta stops working and we have to go through the process of finding a different medication. That maybe what you’ll have to do if increasing the Prozac doesn’t work.

Thank you for writing all this out! DS1 is on ADHD meds too. He's on 40mg of Metadate CD and honestly I think he could use a higher dose but this psychiatrist seems to worry about dependence and is actually trying to see if he can handle going without meds which DS1 is very loathe to do.

The kind of restlessness I'm seeing is more emotional agony than it is busy-ness though. He can sit still for hours but he can't engage in his usual favorite ways to relax. He can't watch shows, read books, or the like because he's just so conflicted and stressed. It is so hard to see. Thankfully he is pulling off all the things he "HAS" to do--especially high level high school courses with good grades. It takes about all of him right now. He's 17 and not driving yet (COVID hasn't made that process easier!) but a part of this is that he has nothing left over. I honestly think he needs to get out of the crisis phase of anxiety before I lean too far into driving and jobs and other things that I really want to see him doing. I love the immediacy of ADHD meds. By contrast the waiting with the SSRIs is challenging.

I think I'll ask my sister what meds were successful for her. My DH could honestly REALLY use some anti-anxiety meds but he refuses to take them. He was on prozac as a child.

[MSWR0319]

I haven't heard of Paxil for a long time. I wonder if it has fallen out of favor? I have heard Celexa bandied about quite a bit. I feel like I know my ADHD meds and I need to bone up on my SSRIs so I can be better prepared for a conversation with the psychiatrist. Thanks for sharing your story. DS1 isn't great about sharing how he feels. I actually think he's struggled with anxiety for several YEARS now but he's never said anything about it. It is a core part of his personality but it sure doesn't make this whole process any easier!

I haven't heard of Paxil for a long time either. I'm thinking it didn't work or something. It was about 20 years ago that I tried it and I didn't like it then either.

[bisous]

So apparently my sister has had great success on Zoloft--except for the weight gain effect which she did not like. I don't think that will be a problem for DS1 who is very slim.

[KpbS]

I will send you a PM when i can get a min on my laptop.