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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by shana s on January 24, 2001, at 14:33:20
I need advise. I have a daughter age 9 diagnosed (quickly)
as bi-polar. I have a 6 yr old diagnosed ADHD. Both were put
on Concerta. I have watched my 6 yr old fall from happy
to sad and depressed in a matter of 2 wks since she started
the med. My 9 yr old is also on the road to an ulser and is living on
Mylanta. I contacted the p-doc, he prescribed 10mg of Paxil for each
child. Has anyone out there dealt with Concerta before? Also,
I have not filled the Paxil, as I see only info regarding it's
use in over 65. Any info, or input is extremely appreciated.
Posted by Dr. Bob on January 25, 2001, at 0:51:33
In reply to Concerta?? and Paxil for Kids, posted by shana s on January 24, 2001, at 14:33:20
> Any info, or input is extremely appreciated.
I'd be interested, too. I don't have any experience myself with children that young...
Bob
Posted by Sulpicia on January 28, 2001, at 15:35:33
In reply to Concerta?? and Paxil for Kids, posted by shana s on January 24, 2001, at 14:33:20
> I need advise. I have a daughter age 9 diagnosed (quickly)
> as bi-polar. I have a 6 yr old diagnosed ADHD. Both were put
> on Concerta. I have watched my 6 yr old fall from happy
> to sad and depressed in a matter of 2 wks since she started
> the med. My 9 yr old is also on the road to an ulser and is living on
> Mylanta. I contacted the p-doc, he prescribed 10mg of Paxil for each
> child. Has anyone out there dealt with Concerta before? Also,
> I have not filled the Paxil, as I see only info regarding it's
> use in over 65. Any info, or input is extremely appreciated.Hi Shana -- you've got your hands full! Sorry! I'm not a professional so this is personal experience only. I have ADD [inattentive type] and my 15 y/o daughter has bipolar II.
First the ADD: the meds are notoriously hard to get right. Changes in dosage are nearly always necessary and more often than not, you have to try more than one med. Ask the pdoc about lowering the dose? I have no idea why paxil would be prescribed for adhd, unless for co-morbid depression -- what reason did he give you for prescribing this med?
Now the bipolar: my daughter shows some signs of add/hd but is not stabilized on her meds right now. The pdoc said that the bp would have to be well under control and even then, there was a risk of setting off cycling or mania from stims like concerta.
Paxil set off my daughter's hypomania -- prior to this we thought she had depression. Paxil and other AD meds can trigger mania w/out concommittant use of a mood stabilizer. You didn't mention this, but is your 9 y/o on any other med?
By ulcers, I take it you mean stomach ache? If it's on going, check with the doc?Lastly, I don't like "quickly" as you term the bipolar diagnosis.
Can you get a second opinion? At the very least, I would persist and communicate to the pdoc that his plan is working for your children.
I hope things get a bit easier for you.
S.
Posted by Adele on January 29, 2001, at 9:36:19
In reply to Re: Concerta?? and Paxil for Kids, posted by Sulpicia on January 28, 2001, at 15:35:33
> > I need advise. I have a daughter age 9 diagnosed (quickly)
> > as bi-polar. I have a 6 yr old diagnosed ADHD. Both were put
> > on Concerta. I have watched my 6 yr old fall from happy
> > to sad and depressed in a matter of 2 wks since she started
> > the med. My 9 yr old is also on the road to an ulser and is living on
> > Mylanta. I contacted the p-doc, he prescribed 10mg of Paxil for each
> > child. Has anyone out there dealt with Concerta before? Also,
> > I have not filled the Paxil, as I see only info regarding it's
> > use in over 65. Any info, or input is extremely appreciated.
>
> Hi Shana -- you've got your hands full! Sorry! I'm not a professional so this is personal experience only. I have ADD [inattentive type] and my 15 y/o daughter has bipolar II.
>
> First the ADD: the meds are notoriously hard to get right. Changes in dosage are nearly always necessary and more often than not, you have to try more than one med. Ask the pdoc about lowering the dose? I have no idea why paxil would be prescribed for adhd, unless for co-morbid depression -- what reason did he give you for prescribing this med?
>
> Now the bipolar: my daughter shows some signs of add/hd but is not stabilized on her meds right now. The pdoc said that the bp would have to be well under control and even then, there was a risk of setting off cycling or mania from stims like concerta.
> Paxil set off my daughter's hypomania -- prior to this we thought she had depression. Paxil and other AD meds can trigger mania w/out concommittant use of a mood stabilizer. You didn't mention this, but is your 9 y/o on any other med?
> By ulcers, I take it you mean stomach ache? If it's on going, check with the doc?
>
> Lastly, I don't like "quickly" as you term the bipolar diagnosis.
>
> Can you get a second opinion? At the very least, I would persist and communicate to the pdoc that his plan is working for your children.
>
> I hope things get a bit easier for you.
> S.
Shana: my daughter tried concerta. For some people the Ritalin drug is like a depressant. My daughter responded much better to adderol. Concerta is tough because it goes on and on. It also seems to keep kids awake at night. Try a shorter acting stimulant first..just in the morning.ADELE
Posted by Noa on January 30, 2001, at 15:35:26
In reply to Re: Concerta?? and Paxil for Kids, posted by Adele on January 29, 2001, at 9:36:19
Just like with us adults, kids each respond uniquely to different meds. It may not be the right one for them.
Posted by kiddoc on March 7, 2001, at 2:12:52
In reply to Concerta?? and Paxil for Kids, posted by shana s on January 24, 2001, at 14:33:20
> I need advise. I have a daughter age 9 diagnosed (quickly)
> as bi-polar.If she was diagnosed quickly, I would recommend getting a second opinion. Such a diagnosis should be done by a qualified person, and carefully. Some people in the child psychiatric community overdiagnose bipolar disorder. This diagnosis is quite difficult to make in kids of this age.
I have a 6 yr old diagnosed ADHD. Both were put
> on Concerta. I have watched my 6 yr old fall from happy
> to sad and depressed in a matter of 2 wks since she started
> the med. My 9 yr old is also on the road to an ulser and is living on
> Mylanta.Depression is one of the possible side effects of stimulant medications. Because an individual gets this side effect from one drug in this class of medications doesn't necessarily mean that they will get the same side effect from another drug in the same class. Rather than prescribe paxil, consideration should be given to switching stimulants medications.
I contacted the p-doc, he prescribed 10mg of Paxil for each
> child.It sounds like he didn't see or speak to the children before prescribing the paxil. Is that correct. If so, that is a red flag. Furthermore, prescribing paxil (an anti-depressant) to a person with bipolar disorder may worsen a manic episode, ie make that individual worse off than before
Has anyone out there dealt with Concerta before? Also,
> I have not filled the Paxil, as I see only info regarding it's
> use in over 65. Any info, or input is extremely appreciated.Concerta is a good medication. Paxil is fine for children, if they need it. Please go back to the basics. That is, give a second look at the diagnosis. A second opinion is perhaps a good idea. kiddoc
Posted by Diane J. on March 23, 2001, at 13:12:46
In reply to Re: Concerta?? and Paxil for Kids, posted by Dr. Bob on January 25, 2001, at 0:51:33
> > Any info, or input is extremely appreciated.
>
> I'd be interested, too. I don't have any experience myself with children that young...
>
> BobDear Dr. Bob,
My daughter Kendra Is ten years old. She has taken Paxil since she was five and a half years old, although we think she has reached the point where she doesn't need the medication and we are beginning to taper it off.
I realize that there are individuals who would wonder why Kendra would be on Paxil at such a young age. It is a long story, be warned!
When Kendra was about three years old she began to experience some extreme fears. Just the sight of a dog would send her screaming and clinging to me. We did not have a dog, and she had never been harmed by one. She was so frightened by the possibility of wasps being outside that she would refuse to go to the ice cream man's truck. She had never been stung. Now maybe you think these are typical fears of children, but this was our second child, and we knew her fears were a little out of the ordinary. The biggest issue was her fear of the toilet. She was too afraid to use it. Nothing could convince her to even give it a try. We read to her while she sat on a little potty, her sister kindly demonstrated many times, we offered rewards and incentives, but nothing worked.
Kendra was four years old and in a year she would start kindergarten. I was concerned, and so we went to see a child psychologist. Unfortunately, this really did not help. A year later when kindergarten began, Kendra still did not use the toilet. There was nothing physically wrong with her, and she was completely capable of controlling her urges. She would simply ask for a pull-up when she needed it.
Kindergarten began, and I had to tell the teacher, a dear woman who had been teaching kindergarten for over 25 years. She said she had never experienced this kind of problem before. Also, while at kindergarten Kendra cried a great deal because she was so anxious. For example, there was a boy in her class who would vomit if he was afraid and unhappy. When the class was supposed to use glue for a project Kendra started crying because she was afraid the boy would throw up because she knew he didn't like getting glue on his hands! Kendra cried so much she had to go to the principal's office because the class was disrupted.
The teacher went out of her way to help my child, and she also spoke to the psychologist on the phone for nearly an hour. Mrs. G told me that "these should be the happiest days of Kendra's life, and she is miserable." She said she thought I needed to get some intervention. I ended up taking Kendra to a psychiatrist, who prescribed a half of a 10 mg Paxil tablet per day.
Well...the ENTIRE Kindergarten team told me she was a completely different child. Of course she was still sweet yet stubborn, but now she was happy! She loved Mrs. G and kindergarten, and she went on to do well. As for the toilet, she did eventually begin to use it, but it took a few months. She was six years old by that time, and she was taking 10mg of Paxil.
Fast forward to last summer... Kendra went to a new therapist who taught her ways to deal with her occasional bouts with anxiety. It helped a great deal, and Kendra learned a lot, and she is doing so well in school. She is happy and she has many friends. That is why we are thinking that perhaps she doesn't need the drug anymore. But we have no regrets about using it. It was of tremendous help to my child.
I hope this information is of interest to you.
Sincerely,
Diane J.
Posted by Dr. Bob on March 23, 2001, at 23:17:49
In reply to Re: Dr. Bob-- Paxil: My child's experience, posted by Diane J. on March 23, 2001, at 13:12:46
> I hope this information is of interest to you.
To me and to others, too, thanks!
Bob
Posted by Sara T on March 29, 2001, at 23:10:57
In reply to Re: Paxil: My child's experience, posted by Dr. Bob on March 23, 2001, at 23:17:49
> > I hope this information is of interest to you.
>
> To me and to others, too, thanks!
>
> BobI have a 9 year old son with Asperger's Synndrome, a high functioning autism, and we have had him on Prozac, paxil, xanax and currently Zoloft. The SSRI's in particular (except the paxil) have worked well for his anxiety and OCD type behaviors. He has also used ritalin and currently Adderall for attentional problems. for a nine year old who stands 4'3" and weighs 52 lbs. he takes a pretty good dose, 150 mg Zoloft/day and 20 mg Adderall/2xday and I also give him 1/3mg of melatonin to help him settle down at night. Some folks forgo meds for their Asperger kids and ADHD too and use diet and/or vitamin regimens. Some people get results, many don't. There isn't alot of solid science backing up those approaches but if you get results and it doesn't hurt them, who can argue.
Prozac and Paxil are pretty commmonly prescribed for pediatric patients with anxiety and depression. With ADHD, mood disorders, depression and anxiety are ofter comorbid. It really isn't uncommon for kids with those diagnosis to be taking both a stimulant such as ritalin and an antidepressant. Calming the anxiety can help with attention problems too.
I myself have ADD and I take Concerta and Zoloft. The Concerta is basically ritalin in a new delivery form. It is much smoother working than the shorter acting forms. You don't experience the sharp ups and downs. And I take the Zoloft for depressiona and anxiety. The combo has worked well. I am going to give my son a trial on the Concerta because it is longer lasting than the Adderall and now that he is older he will have more homework and afterschool activities.
Meds can't do everything for a child. It takes alot of patience and consistency on the part of the parents, (maybe that's why I know so many who take antidepressants). But I wouldn't want my child to miss out on the opportunity to use is talents and experience success. If there's anything that has made it possible for my son to go from doing absolutely nothing in 1st grade to doing 3rd grade level work within a month's time (while in 1st grade) it was starting on meds. He is in 3rd grade now and is an Honor Roll Student and does 5th grade math and reads at 6th grade level. He actually has some friends, even though socializing is difficult for him, he enjoys being with his class and likes school. A far cry from when he was 6 in kindergarten and came home saying he wanted to burn himself up and was very negative toward school.
I am considering enrolling my daughter in a study that is going on for Effexor in pediatric patients. I'm not so sure about it, but my insurance (HMO) isn't taken by many private practice psychologists.
Try to find a good psychopharmacologist that deals with pediatric patients. It may take some time to get it right, but the results can be dramatic.
Hope this helps.
Sara T.
Posted by bluegreydawn on May 21, 2001, at 2:32:27
In reply to Re: Dr. Bob-- Paxil: My child's experience, posted by Diane J. on March 23, 2001, at 13:12:46
> > > Any info, or input is extremely appreciated.
> >
> > I'd be interested, too. I don't have any experience myself with children that young...
> >
> > Bob
>
> Dear Dr. Bob,
>
> My daughter Kendra Is ten years old. She has taken Paxil since she was five and a half years old, although we think she has reached the point where she doesn't need the medication and we are beginning to taper it off.
>HI- I'm wondering how the tapering off is going?
My son was recently prescribed paxil for anxiety at school, but after reading on the web about the "withdrawal syndrome" I am not sure about him using it. (Some people are actually sueing the drug company for failing to provide information about withdrawal) I wonder if I would be just setting him up for a miserable experience?
I am also concerned because everything I read about Paxil states that there have been NO studies done with children(This was also on the 'official web site'). One site even specifically said that it should not be administered to people under 18. Psycho-Babble is the only site where I have seen it stated (more than once) that it is frequently prescribed and safe for children.
I've read that some of the potential side effects are asthenia, weight gain, and loss of ejaculation or libido. I also read that in toxicity studies done on mice, giving them 8 times the normal dose resulted in atrophy and tumors in the genital tracts.
What does this mean for an 11 year-old, overweight boy? I am quite certain that he is about to experience the change of life called puberty. Not that I am really concerned about his libido at this point, but I am concerned about his hormonal balance at such a important milestone of developement.
Is there a safer subsitute for Paxil?
My son has been diagnosed with ADD, and OC tendencies. He also has a behavior broblem that looks like defiance to authority figures at school, but the behavior arises when he is really afraid (of looking bad and/or not being in control of his situation) and he either runs away or lashes out. At all other times he is a soft-spoken piece of cake, and everybody loves him, but he is very shy. Since I have been home-schooling him his behavior problems have practically dissappeared. I am amazed at the academic progress he has made. But he has to go back to school because I'm a single parent and I can't "do it all". That is why we're seeing the psych doctor, because he has to go back to public school.
We tried Ritalin so far. It helps academics slightly, but seems to increase stress.
I am really worried about using Paxil even though it has been approved for use in Social Anxiety Disorder in adults.
??????????????????????????????????????????????????
Posted by Diane J. on May 23, 2001, at 22:05:28
In reply to Re: Dr. Bob-- Paxil and My Child, posted by bluegreydawn on May 21, 2001, at 2:32:27
Hi--Just wanted to let you know that we decided Kendra needed the Paxil. We did get down to 0 for a short time, but her anxiety was increasing, so she started taking it again.
This is really a tough situation to be in. It's difficult to know what to do. I have read similar articles about Paxil, and it does concern me. It IS helping her. Withdrawal was hard because I was worried she might suffer because of it. In the end we decided it was best that she take it. She has had no panic episodes this entire school year. But I still worry about what could possibly happen down the line, if there's a possibility that Paxil could be harmful. But we have never seen a side effect since she began taking Paxil five years ago. She didn't gain a pound because of Paxil, either. (She's 10 and weighs about 60 lbs.) By the way, the only antidepressant I know of that is approved for pediatric use is Imipramine.
I feel for you! Something that really helped us was involving Kendra's teachers. I simply told them she had an anxiety disorder that was under control, but if they ever saw excessive anxiety or lots of tears to please let me know. That hasn't happened at all this year. Kendra is a self-assured, cheerful, sweet, independent individual, a real character.
I hope you can make your decision and feel good about it. I hope your son will be okay, too.
Diane J.
> > > > Any info, or input is extremely appreciated.
> > >
> > > I'd be interested, too. I don't have any experience myself with children that young...
> > >
> > > Bob
> >
> > Dear Dr. Bob,
> >
> > My daughter Kendra Is ten years old. She has taken Paxil since she was five and a half years old, although we think she has reached the point where she doesn't need the medication and we are beginning to taper it off.
> >
>
> HI- I'm wondering how the tapering off is going?
>
> My son was recently prescribed paxil for anxiety at school, but after reading on the web about the "withdrawal syndrome" I am not sure about him using it. (Some people are actually sueing the drug company for failing to provide information about withdrawal) I wonder if I would be just setting him up for a miserable experience?
>
> I am also concerned because everything I read about Paxil states that there have been NO studies done with children(This was also on the 'official web site'). One site even specifically said that it should not be administered to people under 18. Psycho-Babble is the only site where I have seen it stated (more than once) that it is frequently prescribed and safe for children.
>
> I've read that some of the potential side effects are asthenia, weight gain, and loss of ejaculation or libido. I also read that in toxicity studies done on mice, giving them 8 times the normal dose resulted in atrophy and tumors in the genital tracts.
>
> What does this mean for an 11 year-old, overweight boy? I am quite certain that he is about to experience the change of life called puberty. Not that I am really concerned about his libido at this point, but I am concerned about his hormonal balance at such a important milestone of developement.
>
> Is there a safer subsitute for Paxil?
>
> My son has been diagnosed with ADD, and OC tendencies. He also has a behavior broblem that looks like defiance to authority figures at school, but the behavior arises when he is really afraid (of looking bad and/or not being in control of his situation) and he either runs away or lashes out. At all other times he is a soft-spoken piece of cake, and everybody loves him, but he is very shy. Since I have been home-schooling him his behavior problems have practically dissappeared. I am amazed at the academic progress he has made. But he has to go back to school because I'm a single parent and I can't "do it all". That is why we're seeing the psych doctor, because he has to go back to public school.
>
> We tried Ritalin so far. It helps academics slightly, but seems to increase stress.
>
> I am really worried about using Paxil even though it has been approved for use in Social Anxiety Disorder in adults.
> ??????????????????????????????????????????????????
Posted by robinibor on June 13, 2001, at 16:19:37
In reply to Re: Paxil: My child's experience, posted by Sara T on March 29, 2001, at 23:10:57
Hi Sara
I'm writing for a friend, Tammy, who has a seven-year-old son who has just been prescribed 10 mg a day of paxil. She is very concerned about using paxil because of the limited info on the med's effects on children.
Some of the message about your son was similar, for example his wanting to burn himself. That struck a cord because we thought it was such an extreme feeling. A.J.'s diagnosis has been given as depression--very likely aggravated by a father who does not live with them and is not responsive, always disappointing him.
So, what does Tammy do? A.J. has been tested high verbal IQ, but low-average performance IQ. He has visual motorization problems; he fidgets in class, angers easily, and HATES school. He has very low self-esteem...calls himself stupid when he does something wrong.
The poor kid. What advice do you have? My friend is agonizing over whether to fill the prescription. I think she plans to wait until school starts up again in September.
Do you--or anyone else on PB--have any advice?
Thank you.
Robin> Meds can't do everything for a child. It takes alot of patience and consistency on the part of the parents, (maybe that's why I know so many who take antidepressants). But I wouldn't want my child to miss out on the opportunity to use is talents and experience success. If there's anything that has made it possible for my son to go from doing absolutely nothing in 1st grade to doing 3rd grade level work within a month's time (while in 1st grade) it was starting on meds. He is in 3rd grade now and is an Honor Roll Student and does 5th grade math and reads at 6th grade level. He actually has some friends, even though socializing is difficult for him, he enjoys being with his class and likes school. A far cry from when he was 6 in kindergarten and came home saying he wanted to burn himself up and was very negative toward school.
>
> I am considering enrolling my daughter in a study that is going on for Effexor in pediatric patients. I'm not so sure about it, but my insurance (HMO) isn't taken by many private practice psychologists.
>
> Try to find a good psychopharmacologist that deals with pediatric patients. It may take some time to get it right, but the results can be dramatic.
>
> Hope this helps.
> Sara T.
Posted by stjames on June 18, 2001, at 18:26:38
In reply to Paxil: Please help us decide on starting 7-yr-old, posted by robinibor on June 13, 2001, at 16:19:37
I think she plans to wait until school starts up again in September.
> Do you--or anyone else on PB--have any advice?
> Thank you.
> RobinJames here.....
I would think starting a med while starting school
would be the worst time. Use the summer to get used to this new med and get it adjusted.james
This is the end of the thread.
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