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TiredDaddy
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28 Jul 2011, 2:18 pm

Our seven yr son has Aspergers and part of it is anxiety. He has started talking less and less and replacing speech with just noises and sounds. In therapy today, the therapist said she thought it could have something to do with the anxiety side of his Aspergers and that we may need to start looking at putting him on some kind of anxiety meds. She said the part of him that has to have everything perfect and done right might be causing more anxiety with the therapy and OT therapy going on which in turn is causing him the ratchet up his ticks, noises and meltdowns. Plus, school is getting ready to start which in turn will cause even more anxiety because of the chaos of the first few weeks. We have an appointment to meet with another doctor to talk about putting him on meds, but his mother and I are concerned about side-effects, his age to be going on this kind of med, and that we might lose more of what makes him him - if that makes sense. Does anyone have experience with this and a kid this young?



Janissy
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28 Jul 2011, 3:07 pm

Here is my daughter's experience with anxiety meds. It was very mixed results.

At age 7, like your son, her anxiety levels started to increase. I don't think it's a coincidence it was at the same age. That's the age when social expectations really increase, especially from other kids. Awareness of the world and how socially complex it is increases and anxiety increases along with that distressing new awareness.

My daughter's therapist also recommended anxiety meds. Luvox was her doctor's choice. It's primary pharmaceutical use is supposed to be for OCD (which has an anxiety component) and she was getting obsessive about things so it seemed a good choice. All the SSRIs are roughly similar but there are some chemical variations.

The first many months were fine. As the drug took effect, she slowly became less anxious. I was vigilant about watching for side effects and there didn't seem to be any. If you do go this route, I strongly advise you buy the book Pervasive Developmental Disorders, Diagnosis, Options and Answers by Mitzi Waltz, available at Amazon. It has a gigantic section on most any drug a child with a PDD might be prescribed and it describes side effects very well. That was the guide I went by, as well as the package insert. I also asked teachers to look for side effects- anything "different". For the first many months, the only thing different was less anxiety.

Her doctor thought everything was going so well, maybe it would go awesomely if he upped the dose. So he did. There were immediate side effects. She suddenly grew frighteningly impulsive, hair-trigger angry, and developed outbursts of fury that alternated with screaming. Holy Crap!! ! So we went back to the original dose.

That all worked out for about a year but then the impulsivity, hair-trigger anger and screaming and outbursts came back. But they came back slowly. And they didn't seem accompanied by anxiety. So her doctor cut her dose down to 1/2 what she started with. That went well for another few months. But then what I called the "overdose symptoms" (the scary things that happened when her dose was increased) came back. And the anxiety came back too.

So her doctor took her down to 1/4 of the original dose. That worked for several more months. Then the "overdose" symptoms came back along with the anxiety. And this time they were far, far worse.

So her doctor put her on a liquid form of the drug so that it could be decreased to 1/8 original strength. That worked for about 2 months. Then the 'overdose" symptoms came back with such ferocity that I feared I would have to have her spend some time in a psych hospital. She became violent and downright scary. Scary to herself too. In a lucid moment she asked what was happening to her and why she felt so angry all the time. I frantically googled and discovered that sometimes people react this way to SSRIs as it slowly, slowly alters brain chemistry.

So off she went entirely. The anger went away. The violence went away. The anxiety stayed. But after the whole family- not least her poor self- had endured that, anxiety seemed rather like a small problem in comparison.

Her doctor said "we could try a different SSRI, she might react differently". But never again! It's just not worth it. There was that long honeymoon as age 7 gave way to age 8 and everything seemed hunky-dory. But it didn't last. And what replaced (or rather, augmented) the anxiety was far worse. It is entirely possible that a different SSRI would have done no such thing. But it was a risk we didn't want to take again. She now looks back on that as a dark time in her life.

That probably wasn't the story you wanted to hear. And if you'd asked for experience stories 4 months after starting Luvox, I would have been it's #1 salesman, telling you it's the greatest thing ever. But there is that potentiality.

Just because it happened to her doesn't mean it will happen to your son. There are many SSRIs and many different brain reactions, since everybody has different brain chemistry. So I'm not saying "don't ever do this". What I am saying is that this particular side effect is one you need to be vigilant for.



AardvarkGoodSwimmer
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28 Jul 2011, 3:12 pm

Is he trying to perfectionize therapy rather than loosey-goosey? Or maybe he's not connecting with his particular therapist?

For depression, medication is very hit and miss.
"Treating depression can be hit or miss", Los Angeles Times, Devon Schuyler, Aug. 3, 2009.
http://articles.latimes.com/2009/aug/03 ... ug-choice3

And I suspect the same is largely true with anxiety. And the key is to find a doctor who can light-touch it.

Please note: I AM NOT A PARENT. but I am a pretty good guy :D and I have lived the life of a person on the Asperger's / Autism Spectrum. For me, it's been extremely helpful to play to strength and then just be matter-of-fact about any deficiencies. For example, I have patchy social skills, okay, so be it, I have patchy social skills.



TiredDaddy
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28 Jul 2011, 3:15 pm

No that is exactly what I wanted to hear. I am trying to find out as much info good and bad as I can before the doctor's appointment. He already has big meltdowns whenever something "bad" happens - such as just a few minutes ago he spilt a drink in his room, went running down the hall yelling at the top of his lungs, grabbed every towel in the kitchen towel drawer and went yelling back do the hall. I don't know I would call it violent, there is some hitting sometimes, but he keeps that aspect under control, but he will flip a switch at the drop of a hat and just start yelling or melting down. The therapist is saying it is all anxiety, but I just don't see it when he is home, playing and not in a stressful situation. Then she was blaming it on his OT therapy putting pressure on him, but he has only gone to that twice. My wife and I think it is too soon to be talking meds since he was just diagnosed with Asp in March and we have yet to really get into the therapy aspect or even school modifications.



TiredDaddy
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28 Jul 2011, 3:17 pm

Te perfectionist thing was the therapist word. To us, he doesn't connect with the therapist at all. He sits there reading his book or drawing his sharks while we talk to the therapist. Our therapist has said she sees her role as more of helping us have the tools to help him. We have only been doing it since March, and my wife and I have never done any kind of therapy before so we don't know what to expect.



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28 Jul 2011, 3:17 pm

I wouldn't trust a newspaper article to tell you reviews about medical research/intervention. Use websites like our governments one: http://www.ncbi.nlm.nih.gov/pubmed/


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Avengilante
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28 Jul 2011, 3:51 pm

Psyche Meds Drove My Son Crazy < article


Chamomile tea brewed very strong has the same calming effect as Xanax, without side effects. You might have to flavor it with something sweet for a kid, to mask the grassy herbal tea taste, but its very effective. Its available online in gelcap form, if he can take it that way.


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Last edited by Avengilante on 28 Jul 2011, 3:54 pm, edited 1 time in total.

Ai_Ling
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28 Jul 2011, 3:52 pm

I dont know very much but I do think putting a 7 yr old on meds might be a bit too young and probably should be done only if its absolutely necessary. But you do have to watch out for the anxiety component. Maybe for now, try your best to keep any changes within his environmental to a minimum. When I was his age, I switched to a new school and I went mute. You dont want your kid going mute, its so hard to break. Being mute practically falls into a comfortable routine for an aspie.



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28 Jul 2011, 5:18 pm

There are other types of therapies you might want to consider before meds. AS kids have difficulty expressing their emotions which I think contributes to the anxiety and related behaviors. Teaching a child to recognize how they are feeling inside and giving them methods to calm themselves when they notice that they are anxious or angry or frustrated... can be very successful for many kids. We use a social story with a point scale but others here have talked about a program called "How is your engine running" which also sounds great. Keep in mind it will take time and a lot of repetition for your child to learn these techniques. Identifying emotions does not come naturally to most aspies.

I guess I just want to say that there are other avenues to try. However, some people find that all the "talk" type therapies in the world just aren't enough because the child's anxiety is just too debilitating. Then medication is an alternative that you probably have to consider.



TiredDaddy
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28 Jul 2011, 5:26 pm

Thanks for all the info. We are gathering more and more info, but I think we really want to wait. We will still listen to what the doctor says, but to us it is just too soon and we haven't explored enough other avenues.



squirrelflight-77
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29 Jul 2011, 6:45 am

Hello! I dont have much in the way of experience or knowledge with children and medications but I do have anxiety and OCD and have since childhood so that is where my opinion is coming from. :)

If your child is relaxed and fine other than therapy than I would look into other therapy options. Therapy should be helpful not adding a stressful problem into your childs life, IMO. School will be a stressor and you will want to keep an eye on that and see if they anxiety is there.

I would not rule out medication for anxiety if your child truly has that issue. But first I would try teas, and more natural lighter alternatives. You can even make an iced tea out of tension tamer tea and send that to school with lunch, etc. Be sure that he is well rested. Look for changes at home that may tell you that anxiety and stress are too high at school.

If he is fine at home and stressed anxious at school I would look for something he can have 'as needed' I would not want to put him on a med if the anxiety is not pervasive.

Now having said all that, I had anxiety and OCD problems as a child and still do. It would have made a huge difference for me to have had that treated as most of my childhood was spent in a state of anxiety. I dropped out of groups I loved bc of a new haircut or new shoes, wearing a new shirt was horrible as was someone talking to me, having to walk somewhere by myself, I was unable to use public restrooms unless empty and the worried I would not be able to go, getting lost on my way to class, not having the right stuff for class, etc etc etc etc...

I also am unable to talk about things that upset me bc my anxiety gets so high so if you asked anyone in my family, teachers, etc I was considered to be very easy going and just fine. On the inside I was a disaster and it came out in OCD symptoms same as now. A lot of my OCD is around food and I was diagnosed with malnutrition 6 times as a child for refusing to eat or only eating saltine crackers for months on end. I did not realize I had OCD or the role it played in my life until I had a full nervous breakdown in my mid twenties with severe anxiety, severe OCD, and agoraphobia and had not been able to leave my home in 9 mos. Luvox and xanax literally saved me as I was suicidal at the time.

So I guess I'm just saying keep an eye on it for now but please understand that anxiety is a torturous condition whether for children or adults. I have had panic attacks since I was 7 and anxiety really made my childhood difficult and no one even knew how much I was struggling bc I didnt 'act out'. I just dissapeared and tried to not be noticed and it worked.


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