<p>Logging in under my alternate ID to get the sage advice of CC parents. DS is 21 and has had great difficulty dealing with the everyday stress of life. He manages to accomplish what needs to be done but is so stressed and unhappy about how he handles his life; also is quite lonely and in great need of a social life. Social anxiety, a brush perhaps of OCD, maybe some mild depression. Picture a young Woody Allen…</p>
<p>He’s had counseling at college off and on; we recently discussed the possiblity of medication and his counselor referred him to a psychiatrist. The doctor gave DS literature on three different SSRI’s: Zoloft, Paxil, and Celexa. From what I’ve read they’re quite similar and much depends on the individual’s own chemistry in terms of success.</p>
<p>We’re not all that comfortable with such medication and I wondered what experiences CC parents have had with their college children and SSRI’s - has it worked successfully? Have side effects been an issue? Is there a withdrawal problem?</p>
<p>We just want DS to be able to accomplish what he wants in life without so much anguish just not something he’s managed to control on his own.</p>
<p>Paxil tends to be better in patients with comorbid depression and anxiety, but the older SSRI’s (Zoloft and Paxil in this case) may have more sexual side effects than the newer ones (in this case, Celexa). He shoud discuss these issues with his doc when they make a meds decision. Good luck.</p>
<p>I do not have a kid in college on an SSRI, but I DID stay at a Holiday Inn Express so…All things being equal ( meaning a good evalaution with a specific diagnosis and a good discussion of evidence based risk and benefits of all treatments), Paxil gets a bad rap for it’s short life and discontinuation syndrome. I’d be especially concerned about this with the under 21 set who are likely to miss doses. The other too are pretty similar, but the celexa can be a little sedating, and is the newest, with the fewest studies to support it’s having any unique indication. A “me-too” drug, as far as I’m concerned. It may be the only one not available generic of the three; a generic means no free pens for me, but perhaps a savings with certain pharmacy plans.</p>
<p>Strattera is not an SSRI. It’s more like an old fashioned “TCA” or tricyclic antidepressant. Not approved for mood or anxiety disorders in the US, though it is elswhere. In the US it is only apporved for ADHD.</p>
<p>"Isn’t citalopram (sp?) generic for Celexa? "</p>
<p>Yes, but as far as I know, it’s still under patent, and only available in the original (name) brand. I could be wrong about that though. Patent might be expired. That’s why there’s Lexapro!</p>
<p>Just checked and celexa is avaialble generic.</p>
<p>I’m bumping this up. My teenaged son recently started therapy for depression and it’s been recommended he try an anti-depressant. He came away from his pediatrician with a prescription for Zoloft. I have experience with this (surprise surprise) and remember mostly one night of very weird sleep, but few side effects otherwise. I’ve read what I can on it but am wondering if anyone out there has suggestions about how to start out. I told him if he’s going to start it, maybe best to do it on a weekend. I know it’s once a day but does morning/evening matter? With/without food? Please advise.</p>
<p>Thanks for the response. I have had one conversation with the pediatrician but didn’t think of all the piddly questions while he was on the phone. I have done quite a bit of on-line exploring, and was looking not so much for medical advice but anecdotal stories about what people have actually experienced with their kids. As you know, CC parents rock at that.</p>
<p>I fond that I had a weird, vertiginous feeling when I started SSRIs. I was on the couch for 3 days. I should have started with a half dose and then worked up. Ask the pharmacist about time of day and food. Some SSRIs have drowsiness as a possible side effect, so bed time is a good time for those pills.</p>
<p>When the time comes for your son to discontinue his SSRI’s, please make sure he weans himself off the meds VERY slowly so that his system adjusts. Google “withdrawal symptoms” for whatever med his doctor prescribes.</p>
<p>I am aware of the necessity to taper off. I just really don’t remember much in the way of side effects when first going on it, although I know many are possible.</p>
<p>Starting it was no problem, but in his case the doctor did it gradually.</p>
<p>Any guy who takes an SSRI should be aware of the sexual side effects. For a young guy, they could actually be advantageous. (When your son looks up this subject on the Internet, he will know what I’m talking about.) And I have been told that this side effect wears off after some months.</p>
<p>You’re also not supposed to drink alcohol when taking an SSRI, which could disrupt the lifestyle of some young people.</p>
<p>Discontinuing Paxil can be very difficult. Even with gradual tapering, the discontinuation side effects can be very weird. They’re not dangerous, like benzodiazepine or barbiturate discontinuation symptoms, but they’re often bizarre and disruptive. My relative attempted to discontinue Paxil after about 5 years but gave up the idea because a difficult period was coming up in his life, and he didn’t want to have to cope with the discontinuation side effects at the same time as other issues. Later, the medical need for Paxil returned anyway. My relative has now been taking the drug for 7 years, so if he ever does discontinue it, it will be challenging. </p>
<p>On the other hand, if a male patient does have difficulty with discontinuation, it’s not really a big deal. A guy can take an SSRI forever (although if the medical need is no longer there, it’s a bit frustrating to be contributing to the profits of the drug company with no therapeutic benefit). It’s young women who have to worry about the difficulty of discontinuation because a woman shouldn’t be taking an SSRI when she becomes pregnant.</p>
<p>He should follow the advice of his physicians, but I cannot impress enough the importance of developing a good exercise routine. I don’t know his athletic background, but given that young men can be very competitive, the focus should merely be on getting steady exercise and not necessarily on intense activity.</p>
<p>Just wanted to add that S has been on an SSRI since he was a freshman in college. (I actually don’t know which he is on now, because he’s older and it’s not my business anymore.) It pulled him out of depression and social anxiety and made a huge difference in his life. He was not thrilled with the idea of taking medication and stopped a few times; he had no bad side effects, just a recurrence of his mental miseries, so he realized the medication was as essential to his well being as insulin would be to a diabetic and accepted that it is a lifetime thing.</p>
<p>Helpful responses all. In terms of exercise, DS is currently in soccer season, then will move to basketball, then lacrosse in the spring. I really am (for now) just fretting a bit over what to expect the first few days. How closely do I need to monitor him? I think it’s likely he’d take his first dose this Friday evening, and has a quiet weekend except possibly reffing a few soccer games. Somebody tell me he’ll be okay to go to school on Monday?</p>
<p>For teenagers, only one SSRI has been showed to be effective and that is Prozac (fluoxetine).<br>
The side effects are more severe when you first start the medication. They will go away within a month. His personal response to the pills are unknown until he takes them.
It takes 2-4 weeks for anti-depressants to work. The greatest risk in terms of suicide, is right after they start working. If at the 3 month mark, no benefit is seen, return to your physician.
I would recommend he take it in the evening right before he goes to sleep. It can be taken with or without food.</p>