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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by MarieMurph on May 5, 2001, at 18:01:36
Hey, my brother is 11 years old and has been on Paxil for almost 2 years. He has recently just increased his dosage to 30mg. However, he can't take it anymore, because it just isnt for him. it is making him not act like himself, and just isnt working anymore. Therefore, the doctors are weening him off of it. This is his 3rd day taking 20 mg instead of 30. They prescribed ativan to help him(2mg). My momm gave him 1 mg the other day, and she felt that that was even too much for him. He got very dizzy, and acted almost like he was drunk. He is 11, and only weighs about 80 lbs. However, he is like crying and acting very angry and emotional. He doesnt feel good, and feels extra anxious. He wants more than 2 mg, but we dont know if we should give it to him. Can someone give me some advice as to how much ativan is ok in one day, and also, is this normal for him to be acting like this.. please help, I think my mom is going to have a nervous breakdown over this :(--- Marie
Posted by kazoo on May 5, 2001, at 23:25:14
In reply to can someone give me some advice??, posted by MarieMurph on May 5, 2001, at 18:01:36
> Hey, my brother is 11 years old and has been on Paxil for almost 2 years. He has recently just increased his dosage to 30mg. However, he can't take it anymore, because it just isnt for him. it is making him not act like himself, and just isnt working anymore. Therefore, the doctors are weening him off of it. This is his 3rd day taking 20 mg instead of 30. They prescribed ativan to help him(2mg). My momm gave him 1 mg the other day, and she felt that that was even too much for him. He got very dizzy, and acted almost like he was drunk. He is 11, and only weighs about 80 lbs. However, he is like crying and acting very angry and emotional. He doesnt feel good, and feels extra anxious. He wants more than 2 mg, but we dont know if we should give it to him. Can someone give me some advice as to how much ativan is ok in one day, and also, is this normal for him to be acting like this.. please help, I think my mom is going to have a nervous breakdown over this :(--- Marie
^^^^^^^^^^^^
Free advice is what someone who lives in a glass house shouldn't do, but I'll do it anyway.
There are problems with your post: you don't say why your brother is on the drug to begin with. You *do* say that when he is on the drug "it is making him not act like himself ...," which, I presume, is the pre-PAXIL stage, something the drug is suppose to reverse. So, I guess my question is: "Just how do you want this kid to act?"
I'm sorry, but I just don't get it, nor can I justify giving two strong mind drugs in such inordinately large doses to someone so young.
Furthermore, your mother's first priority is to take him BACK to the doctor and let them handle this. After all, they're the professional. If she feels the remedy is worse than the malady, get another doctor's opinion. They vary like the wind.
Lastly, there's no such thing as a "nervous breakdown." That's a hollywood-coined expression, so she'll have to have something else.
kazoo
Posted by JohnL on May 6, 2001, at 5:44:05
In reply to can someone give me some advice??, posted by MarieMurph on May 5, 2001, at 18:01:36
> Hey, my brother is 11 years old and has been on Paxil for almost 2 years. He has recently just increased his dosage to 30mg. However, he can't take it anymore, because it just isnt for him. it is making him not act like himself, and just isnt working anymore. Therefore, the doctors are weening him off of it. This is his 3rd day taking 20 mg instead of 30. They prescribed ativan to help him(2mg). My momm gave him 1 mg the other day, and she felt that that was even too much for him. He got very dizzy, and acted almost like he was drunk. He is 11, and only weighs about 80 lbs. However, he is like crying and acting very angry and emotional. He doesnt feel good, and feels extra anxious. He wants more than 2 mg, but we dont know if we should give it to him. Can someone give me some advice as to how much ativan is ok in one day, and also, is this normal for him to be acting like this.. please help, I think my mom is going to have a nervous breakdown over this :(--- Marie
What I don't understand is why the doctor is discontinuing Paxil and prescribing Ativan instead simultaneously. I also don't understand why they are weening him off Paxil.
Actually, I do understand Paxil isn't working and needs to be stopped, but there really is no need to do a weening thing. He could go straight from Paxil to something else like Prozac without any weening and without a washout. The transition from one drug to another is always a little weird, but it can be smoothed out a little bit if the weening part of it is skipped. I stopped and started many drugs using both techniques--weening, and no weening--and I by far favor the no weening approach. Just stop one med and start the other. Start the new one at half the minimum dose for the first few days while the old one fades away.
I have no idea why they prescribed Ativan, but I wouldn't even mess with that one at all. Something like good ole dependable Prozac makes more sense to me. If a second drug is needed for whatever reason (side effects, efficacy, whatever), Zyprexa (in my opinion) is the gold standard ingredient to mix with Prozac. Benzos like Ativan do not make my list of gold standards, in most cases. Of course, these are just my opinions. Hopefully your doctor knows what's best. Often they don't. Sometimes they do.
John
Posted by MarieMurph on May 6, 2001, at 9:25:40
In reply to Re: can someone give me some advice??, posted by JohnL on May 6, 2001, at 5:44:05
> My brother is on paxil because about 3 years ago he had a stomach virus, and the doctors kept misdiagnosing and mistreating him. He eventually, due to mistreatment, had to hospitilized for over a week in 2nd grade, and get every type of internal/gastrointestinal test done to him. A colonoscopy at age 7 isnt very fun. Anyway, with a history of anxiety in my family anyway, and then the experience, my brother suffered panic attacks/anxiety/post traumatic stress. He wouldn't go anywhere withought my mother. He wouldn't even go to school without her She had to eventually find a job at the school so he would go. so anyway, he just turned 11 , and has been on Paxil for 2 years. When i said that he doesnt feel like himself i meant that now he is almost too bold in school. He used to be a shy and almost timid kid. Im not saying that him being bold is bad, becuase it's great that he can do things now without my mother. However, it's more than just that. He feels like he's crawling out of his skin, he cannot concentrate, he's getting into trouble and fights at school almost everyday, and that's not my brother, he's not like that. And my mom has taken him to MANY MANY doctors, and is seeing a few right now. They all say that those are all side effects of the drug. When my mother first went to them, they initailly tried to get him off of it, but the withdrawal was unbearable, so then they thought that they would increase his dose, that sisnt really work either. So now my mom, my brother, and the doctors, think that it is a good idea to get him off of the medicine and see how he is. If he needs more, then they will switch him to something else. Now they gave him ativan because his withdrawal symptoms are awful, making him 100 times more anxious. The ativan will calm him down for the time being until the withdrawal is over, He is not permanantely on it. Why do you act like that is a bad thing?? Anyway, and about my mother, you don't even know how upset she is over this, and I sorta just used the nervous breakdown thing as an expression... thanks
Posted by JahL on May 6, 2001, at 11:44:17
In reply to Re: can someone give me some advice??, posted by MarieMurph on May 6, 2001, at 9:25:40
> > My brother is on paxil because about 3 years ago he had a stomach virus, and the doctors kept misdiagnosing and mistreating him. He eventually, due to mistreatment, had to hospitilized for over a week in 2nd grade, and get every type of internal/gastrointestinal test done to him. A colonoscopy at age 7 isnt very fun. Anyway, with a history of anxiety in my family anyway, and then the experience, my brother suffered panic attacks/anxiety/post traumatic stress. He wouldn't go anywhere withought my mother. He wouldn't even go to school without her She had to eventually find a job at the school so he would go. so anyway, he just turned 11 , and has been on Paxil for 2 years. When i said that he doesnt feel like himself i meant that now he is almost too bold in school. He used to be a shy and almost timid kid. Im not saying that him being bold is bad, becuase it's great that he can do things now without my mother. However, it's more than just that. He feels like he's crawling out of his skin, he cannot concentrate, he's getting into trouble and fights at school almost everyday, and that's not my brother, he's not like that. And my mom has taken him to MANY MANY doctors, and is seeing a few right now. They all say that those are all side effects of the drug. When my mother first went to them, they initailly tried to get him off of it, but the withdrawal was unbearable, so then they thought that they would increase his dose, that sisnt really work either. So now my mom, my brother, and the doctors, think that it is a good idea to get him off of the medicine and see how he is. If he needs more, then they will switch him to something else. Now they gave him ativan because his withdrawal symptoms are awful, making him 100 times more anxious. The ativan will calm him down for the time being until the withdrawal is over, He is not permanantely on it. Why do you act like that is a bad thing?? Anyway, and about my mother, you don't even know how upset she is over this, and I sorta just used the nervous breakdown thing as an expression... thanks
Hi Marie. I'm not going to have a go @ you:-)
The symptoms described in yr 1st post sound v. much like std anti-depressant withdrawal. The fact yr brother is so young & has been on the drug for so long makes it understandable the effects are so severe.
I don't think *short-term* use of a benzo (Ativan) to ameliorate these syptoms is such a bad thing. Only sadists wld wish the boy to suffer unnecessarily. Having said that, JohnL's idea of simultaneously decreasing & increasing the 2 ADs has some merit. Shame yr doc doesn't see it that way...
The symptoms described above (boldness, crawling out of skin) are most definitely NOT std AD effects. To these (medically) uneducated ears it sounds a little like HYPOMANIA, a symptom of Bipolar Disorder. SSRIs (ie Paxil) can induce this symptom, particularly as the drug is being ramped down. This has been my own personal experience, & that of a few others on this board.
I am not for a second suggesting yr bro' *is* Bipolar, but in the light of the current confoundment surrounding his case, IMO it's definitely a suggestion worth bringing up.
Hope *this* helps,
Jah.
This is the end of the thread.
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