My son has ocd and has been on lexapro since Late January, I think. Things were going quite well. It was a peaceful environment- such a huge relief. The past 2 nights he has been having the extreme meltdowns again. We have not skipped any doses and nothing unusual has happened to trigger anything. The Lexapro does tend to make him more hyper than usual, buy my husband and I thought that was a small price to pay to avoid the meltdowns...

can anyone offer any experience here???

I really need some advice fast- we are really into meltdowns the past few nights! Is it possible that a drug can suddenly stop working?

Yes, all SSRI medications can "poop out" (this is the actual term that is commonly used). It can happen rather suddenly too. The only option is to move to a different one, from what I've hear. Don't worry though, one medication pooping out does not necessarily mean the next one will; though it still can. talk to a your doctor soon, and he will probably proscribe something else.

Thank you! We actually have an emergency appointment tomorrow! It just seemed like such a short time for it to become ineffective...

Another option to look at is increasing the dose of lexapro if you are not already at the max (which is 20 mg). That will often fix a poop out b/c it is frequently caused by a too low a dose.

My son is only 7 years old, he takes 5 mg, I wouldnt want to increase without medical supevision. Like I said he has only been taking since late January, that seems rerally soon to lose effectiveness. This whole med thing is totally new to me, I honestly do not believe in taking meds but I DO see that it has helped him (all of us really!) It just stinks that I have to give my child meds just to be able to be able to cope with everyday life

I'd be very concerned about giving my child an SSRI too. I've read some pretty scary stuff in Prozac Backlash by Dr. Glenmullen (which talks about all the Prozac type anti depressants including Lexapro) and the possible brain damage they may cause with extended use. He also discusses that high rate of "poop out" someone already mentioned above and the reasons this may occur. I don't know the statistics on Lexapro but about a 1/3 of Prozac users experience this within the first year of use. The risk of problems is even higher with children than adults because of their rapidly developing brains. I developed Tardvie Dyskensia - involuntary movement after only three weeks on the combination of Concerta and Prozac -- I'm not saying this happens with everyone or most everyone, but it's good to know the potential risk factors when making important health decision for your child.

I'm currently reading a great little books by a research professor and therapist who uses a cognitive behavoral approach for treating OCD called "The Four Step Program" He has a book out that explains it in detail and says you don't even need a therapist to implement it. The book is called Brain Lock: Free Yourself from Obsessive-Compulsive Behaior by Jeffrey Schwartz. They have actual PET scans that show brain changes similar to those created using medication when people have used this program. I'm currently applying it and really think it is good (my OCD traits are quite mild but he has worked with many serious cases and had good results). The four basic steps are Relabel, Reattribute, Refocus, and Revalue. Since I'm ADD and that's too hard to remember under the pressure of the moment I've changed it to It's N.U.T.S.!
*Name it -- "This thought is an obsession or compulsion";
*Understand it -- "This isn't me this is my OCD";
*Trade it -- Trade the problem obsession or compulsion for a constructive enjoyable thought or activity. Refocusing the mind of something else -- things done to benefit others are especially useful (for a kids the idea of when you keep getting the same baseball card over and over you trade it for a better one you want) "Remember, it's not how you feel but what you do that counts!";
*Shrink it -- dimish it's importance. "This is just a worthless distraction to be ignored". Aim to do the refocusing step for at least 15 minutes (it might only be one or two minutes at first). Even these small steps start strengthening and healing the brain. The book explains this better, but here is the thumb nail sketch.

Take care and I hope things work out well for you!

Scattered

I have that book and think its an excellent theory- but how do you do that for a child? My biggest concern at this point is that school starts in 2 weeks! School is his biggest trigger for the meltdowns. I can not figure it out- he is an excellent student. But I have noticed the past 2 years when school started - his ocd was worse. Even if the med is changed tomorrow- I haev to wait for it to regulate in his system. I REALLY wish the doctors had discussed the possibility that a medication could suddenly fail, so at least I could have been prepared. Thank you for elaborating on it for me!

You might start by having him pick one thing -- the easiest to work on first at home. Teach him to recognize the thought/urge is OCD and not him. Help him pick another activity he enjoys to do for a while when the urge hits. Even resisting the urge for a couple of minutes can help in changing the brain's response and let him know he does have power over this. Does he have a hobby or special interest? Music, collecting, sports, etc -- something that would be a good refocusing tool.

It's not an easy course I know and stress frequently makes such thing worse. Have you tried relaxation breathing with him. Exercise is also a very useful anxiety reducing activity. Successes can build on each other, even if they are small at first -- be sure even small successes are taken note of. I hope things go well for your son in this new school year and with the medication adjustment.

Take care,
Scattered

He used to play a computer game to 'calm down' but the meltdowns come at bedtime so that isnt an option. We have actually stopped the bedtime rituals- that is a good thing. We'll see what the doctor says... crss your fingers

Fingers cross! Let us know how it goes!

Scattered

PS: My 8 year old daughter is ADHD with some anxiety rather than OCD but video games really deteriate her behavior. She never wants to quit them and throws major tantrums. Even after she is off her behavior is worse. We've severely limited her video games (once or twice a week at most) and pretty much all her electronic access includes TV/videos, since it erodes her behavior so much.

We just do a bedtime wind down with bath, stories and prayers. Bedtime is still a definate challenge but getting better.

The doctor increased his dosage by 1/2 a pill so now he will be at 7 1/2 mg, we'll see how that works out- He gave my son the 'lectures' on what not to do. For some reason when the doctor tells him NOT to do something - he listens but doesnt listen to us- (thought that didnt come until the teenage years ) We will see what happens-