08-08-04, 07:04 PM
Hi my son who is on 10 has been on Strattera for about 2 months for ADHD. He was just taken off Lexapro b/c we weren't seeing that good results and it was very expensive interms of insurance. I think he probably needs one. Does any one have suggestion of one with maximum benefit but minimum side effects. He is also dealing with a bone condition where he is in pain and will eventually need multiple surgeries for. Any thoughts would be appreciated then I could take the info. to the dr. and kinda of know what I am talking about. He is on Strattera for impulsiveness, rudeness etc. which seems to be helping somewhat although we are not in school so don't know how he will fair then. thanks
Among antidepressants, only Prozac (fluoxetine) is approved for the treatment of pediatric major depressive disorder. Prozac (fluoxetine), Zoloft (sertraline), and Luvox (fluvoxamine) are approved for pediatric obsessive compulsive disorder. None of these drugs is approved as monotherapy for use in treating bipolar depression, either in adults or children.
SSRIs (Selective Serotonin Reuptake Inhibitors -- Prozac, Zoloft, Lexapro, etc.) have brightened the outlook for the medication treatment of child and adolescent depression. The side effects are not as annoying as those of the older medications. These medications are somewhat less toxic in overdosage. Some studies have shown that the SSRIs are better than placebo for depression. As compared to adults, adolescents are a bit more likely to become agitated or to develop a mania while they are taking an SSRI. These medications can decrease libido in both adolescents and adult. The doctor should warn parents about the symptoms of mania, especially if there is a family history of Bipolar Disorder. If the child has had a manic episode in the past, some doctors suggest adding a mood stabilizer such as Lithium or Depakote.
Most studies suggest that the older, tricyclic antidepressant medications (Amitryptiline, Imipramine Desipramine) are no better than placebo in the treatment of depression. Still, some doctors have seen individual children and adolescents who have responded well. Tricyclic antidepressants can be an effective treatment for ADHD. Since there is a small risk of heart rhythm changes in children on these medications, doctors usually follow EKGs. The usefulness of blood tricyclic levels is being debated.
Important Note: Bipolar disorder must be ruled out before a child is prescribed antidepressants for depression or stimulants, as these can trigger mania.
Just to share our family's experience My 11-year old son takes a small dose of Paxil daily which was prescribed for him by his pediatric psychiatrist. This helps with general anxiety and to a lesser extent with his depression. He has been on this for over 3 years with generally good results.