Re: Should we go off Lexapro after only 7 weeks for fear of possible tics?

[Guest guest]

Hi everyone,

(warning...long email question...sorry! and thanks to any who read

all the way through!)

We are in need of some help...

Our OCD therapist recommends considering taking our dd off Lexapro

due to possible tics in future. And I need any & all advice I can

get to make the best informed decision I can for our dd (even though

everyone is different and there is no crystal ball to look into the

future).

Sigh...

Our 11yo dd has the " just needs to feel right " & reassurance OCD.

She started ERP Therapy and Lexapro only 7 weeks ago. She has been

going very slow & low with the lexapro (liquid). She started at 1ml,

increasing every 5 days a ml, and is now at 10ml. She is supposed to

go to 15ml and stay there for awhile per her child psychiatrist. So

she's not on a therapeutic dose level yet.

However, we recently learned from her ERP Therapist that she has a

cough tic, that meds can bring about tics, and that the " just needs

to feel right " OCD is closer to TS on the OCD spectrum line and so

more tics is a definite possibility if we keep her on meds.

Her therapist also said that if she develops more tics, that going

off the meds will not stop the tics and that if it was her child she

would go off the medicine as developing tics would be worse than what

she has now. I guess meaning we could " give " (for lack of a better

term) her TS with the meds even though she " only " has OCD now.

It seems her therapist may believe our dd can attack her ocd without

the meds and just with the ERP Therapy. But she really doesn't know

for sure and she can't tell us what to do.

In the past 7 weeks on Lexapro & ERP therapy, our dd has improved

about 15% but still has severe OCD that affects her entire life.

Has anyone weaned off meds completely before even reaching a

therapeutic dose (with the first-ever med) just to not get possible

tics and fight with the ERP therapy only after?

I'm so confused as to what to do that I just need any & all

advice/comments etc.

Thanks SO much in advance if anyone has any words of wisdom for us!

Staci

[Guest guest]

Is she saying the tic is solely from Lexapro?  What about other meds?

 

 

~~Kathy

 

gkathy40@...

http://www.myspace.com/clearingachannel

yahoo messenger id  gkathy40@...

Courage is not living without fear.

Courage is being scared to death and doing the right thing anyway.

-Chae

Subject: re: Should we go off Lexapro after only 7 weeks for

fear of possible tics?

To:

Date: Tuesday, December 9, 2008, 3:21 PM

Hi everyone,

(warning...long email question...sorry! and thanks to any who read

all the way through!)

We are in need of some help...

Our OCD therapist recommends considering taking our dd off Lexapro

due to possible tics in future. And I need any & all advice I can

get to make the best informed decision I can for our dd (even though

everyone is different and there is no crystal ball to look into the

future).

Sigh...

Our 11yo dd has the " just needs to feel right " & reassurance OCD.

She started ERP Therapy and Lexapro only 7 weeks ago. She has been

going very slow & low with the lexapro (liquid). She started at 1ml,

increasing every 5 days a ml, and is now at 10ml. She is supposed to

go to 15ml and stay there for awhile per her child psychiatrist. So

she's not on a therapeutic dose level yet.

However, we recently learned from her ERP Therapist that she has a

cough tic, that meds can bring about tics, and that the " just needs

to feel right " OCD is closer to TS on the OCD spectrum line and so

more tics is a definite possibility if we keep her on meds.

Her therapist also said that if she develops more tics, that going

off the meds will not stop the tics and that if it was her child she

would go off the medicine as developing tics would be worse than what

she has now. I guess meaning we could " give " (for lack of a better

term) her TS with the meds even though she " only " has OCD now.

It seems her therapist may believe our dd can attack her ocd without

the meds and just with the ERP Therapy. But she really doesn't know

for sure and she can't tell us what to do.

In the past 7 weeks on Lexapro & ERP therapy, our dd has improved

about 15% but still has severe OCD that affects her entire life.

Has anyone weaned off meds completely before even reaching a

therapeutic dose (with the first-ever med) just to not get possible

tics and fight with the ERP therapy only after?

I'm so confused as to what to do that I just need any & all

advice/comments etc.

Thanks SO much in advance if anyone has any words of wisdom for us!

Staci

[Guest guest]

Staci,

I have zero experience with meds or even an OCD situation that

interferes so much with daily life. So please take my comments with a

grain of salt. I'm naive when it comes to how hard it is to live with

full blown OCD.

I can only tell you that my son had a tic (maybe PANDAS induced) that

lasted 5 weeks and was an extreme twitch that made his whole upper body

jerk. If he was holding something, it would fly or spill out of his

hand. Some of the kids in his class asked him about it. Thankfully, in

1st grade, they were happy to just have an explanation and they then

mostly ignored it. We were spared any cruelty. But it was awful and he

got very upset by the end of the episode. We actually welcomed the

return of just the moods and tantrums because at least no one saw it at

school and we could learn to control our own responses to a flair up.

I know that if the tic never went away or if it comes back with another

strep infection, we'll learn to deal with it. And maybe others who live

with TS can offer more insight. But if there's another med that carries

less risk, or if your therapist thinks you have enough support and

stamina to try going a different route, you may want to give it some

thought. Especially if she's only 15% improved with the Lexapro. Living

with a severe tic was very hard.

But you ultimately need to trust your own instincts on this one. You'll

be in my thoughts...

Has anyone weaned off meds completely before even reaching a

> therapeutic dose (with the first-ever med) just to not get possible

> tics and fight with the ERP therapy only after?

>

> I'm so confused as to what to do that I just need any & all

> advice/comments etc.

>

[Guest guest]

I don't know if you should stop Lexapro.  All I can tell you is our daughter has

been taking 5mg Lexapro for over a year now, w/ zero side effects and is

virtually OCD symptom free.  She has what I now see from reading in this group,

what must have been some tics when her OCD was at its worst.  One was a constant

throat clearing...I thought it was a nervous habit at the time b/c she was so

nerved out about everything.  Now I think it was probably  a ' just right' tic. 

It has completely stopped w/ the Lexapro.

The OCD specialist in Indy said he would absolutely put his child on Lexapro,

and it is the drug he has the most success with.  He did not mention anything

about tics at the time, but then again, we didn't discuss tics w/ him. 

But like you said every kid reacts differently to medications, and there just

isn't a crystal ball.  I truly wish everyone could have the success w/ Lexapro

that we have had.  But I also know from reading posts, my daughter can relapse

at any moment.  Good luck and keep me posted w/ what you find out about the

Lexapro.

Thank you,

Amy

Subject: re: Should we go off Lexapro after only 7 weeks for

fear of possible tics?

To:

Date: Tuesday, December 9, 2008, 6:21 PM

Hi everyone,

(warning...long email question...sorry! and thanks to any who read

all the way through!)

We are in need of some help...

Our OCD therapist recommends considering taking our dd off Lexapro

due to possible tics in future. And I need any & all advice I can

get to make the best informed decision I can for our dd (even though

everyone is different and there is no crystal ball to look into the

future).

Sigh...

Our 11yo dd has the " just needs to feel right " & reassurance OCD.

She started ERP Therapy and Lexapro only 7 weeks ago. She has been

going very slow & low with the lexapro (liquid). She started at 1ml,

increasing every 5 days a ml, and is now at 10ml. She is supposed to

go to 15ml and stay there for awhile per her child psychiatrist. So

she's not on a therapeutic dose level yet.

However, we recently learned from her ERP Therapist that she has a

cough tic, that meds can bring about tics, and that the " just needs

to feel right " OCD is closer to TS on the OCD spectrum line and so

more tics is a definite possibility if we keep her on meds.

Her therapist also said that if she develops more tics, that going

off the meds will not stop the tics and that if it was her child she

would go off the medicine as developing tics would be worse than what

she has now. I guess meaning we could " give " (for lack of a better

term) her TS with the meds even though she " only " has OCD now.

It seems her therapist may believe our dd can attack her ocd without

the meds and just with the ERP Therapy. But she really doesn't know

for sure and she can't tell us what to do.

In the past 7 weeks on Lexapro & ERP therapy, our dd has improved

about 15% but still has severe OCD that affects her entire life.

Has anyone weaned off meds completely before even reaching a

therapeutic dose (with the first-ever med) just to not get possible

tics and fight with the ERP therapy only after?

I'm so confused as to what to do that I just need any & all

advice/comments etc.

Thanks SO much in advance if anyone has any words of wisdom for us!

Staci

[Guest guest]

Joei had tics in the beginning (hers was flexing/twitching her pecs). They were

trying to give her a TS diagnosis. I am glad we waited for the meds to kick in.

She doesn't flex anymore, but she does have hum/cough noise when her anxiety

level gets high, but it is rare.

[Guest guest]

Hi, Staci. I was just thinking about you today and wondering how

things were going. )

I've not heard or read that before about the SSRI antidepressants, but

I'm no expert so can't really say one way or another.

Josh has had tics that have come and gone. It's happened on and off

of medication, for him. Sometimes they've stayed for a long time,

then disappear or change to something new. Honestly, some docs have

thought it is TS, others have said they don't think so. It's never

been a definite diagnosis.

For some, it can be a ritual rather than a tic. It really depends on

why it's happening, or if they are even aware that it is happening.

You might want to, for your peace of mind, speak to the prescribing

doctor about it, to verify whether or not that is definite. Not that

I'm saying your therapist doesn't know, but if it were me, I'd want a

second opinion. And possibly even talk to a pharmacist, they can be

really helpful where medication is concerned. Another thought is you

could even ask some of the experts we have available to our group, to

get their input.

To ask the a question of the doctors available here, you can go into

the " Home " page. You will find their website address listed next to

their names so you can read about them, to decide who you'd like to

ask. Then just put " Ask Dr. . .(whomever you choose) " in the subject

line. Louis will get the message to them and they will reply to the

group. You can ask more than one if you like too.

Hugs,

BJ

>

> Hi everyone,

>

> (warning...long email question...sorry! and thanks to any who read

> all the way through!)

>

> We are in need of some help...

>

> Our OCD therapist recommends considering taking our dd off Lexapro

> due to possible tics in future. And I need any & all advice I can

> get to make the best informed decision I can for our dd (even though

> everyone is different and there is no crystal ball to look into the

> future).

> Sigh...

>

> Our 11yo dd has the " just needs to feel right " & reassurance OCD.

> She started ERP Therapy and Lexapro only 7 weeks ago. She has been

> going very slow & low with the lexapro (liquid). She started at 1ml,

> increasing every 5 days a ml, and is now at 10ml. She is supposed to

> go to 15ml and stay there for awhile per her child psychiatrist. So

> she's not on a therapeutic dose level yet.

>

> However, we recently learned from her ERP Therapist that she has a

> cough tic, that meds can bring about tics, and that the " just needs

> to feel right " OCD is closer to TS on the OCD spectrum line and so

> more tics is a definite possibility if we keep her on meds.

>

> Her therapist also said that if she develops more tics, that going

> off the meds will not stop the tics and that if it was her child she

> would go off the medicine as developing tics would be worse than what

> she has now. I guess meaning we could " give " (for lack of a better

> term) her TS with the meds even though she " only " has OCD now.

>

> It seems her therapist may believe our dd can attack her ocd without

> the meds and just with the ERP Therapy. But she really doesn't know

> for sure and she can't tell us what to do.

>

> In the past 7 weeks on Lexapro & ERP therapy, our dd has improved

> about 15% but still has severe OCD that affects her entire life.

>

> Has anyone weaned off meds completely before even reaching a

> therapeutic dose (with the first-ever med) just to not get possible

> tics and fight with the ERP therapy only after?

>

> I'm so confused as to what to do that I just need any & all

> advice/comments etc.

>

> Thanks SO much in advance if anyone has any words of wisdom for us!

>

> Staci

>

[Guest guest]

Her therapist also said that if she develops more tics, that going off

the meds will not stop the tics and that if it was her child she

would go off the medicine as developing tics would be worse than what

she has now.

Staci,

I've got three boys with an alphabet soup of diagnoses and we've spent

the past four years figuring out what which meds will work for all

three of them. Thankfully, they're stable on their current cocktails.

We have had many side effects but we have NEVER had one that didn't

stop when the medication stopped. That said, if I were you, I'd check

with the doc writing the script and get his/her opinion.

in MO

[Guest guest]

Hi Staci,

I am just wondering if the ERP therapist is an MD doctor. I wonder,

if they are not, about their recommendations at all on this. I would

discuss this with the doctor who prescibed this medication, assuming

this is not one and the same person.

Generally medication enables them to participate in ERP. If the OCD

is not that severe, or anxiety or depression a consideration then

often someone can not use medication. I'm guessing that your

daughter must be severe enough to warrant the medication or you would

not have taken that step.

It's hard to predict side effects, and if she does have tics it's

possible it might make it worse, but it also might make it better,

esp if the tic is not really a tic but OCD. As I read someone else

say, you can always stop the medication if it is problematic. I don't

remember hearing anyone say an ssri made tics worse, not to say that

it can't. Unfortunately the only way to know if you will receive

positive benefits from a drug is to try it, and unfortunately often

there are side effects. With time you see if the positive outweighs

any negative.

We did go off and on many medications and I can tell you that the

instability of that was hard. If you think the medication is helping

I would stick with it. Our son takes celexa low dose, and while he

had immediate benefits I think the long term effects were seen after

three months if not more. Also, improvement with OCD can be slow

going, generally the arc is about two years if you find a med that

works, ERP can be done, and things go smoothly(well, relatively...

nothing easy about OCD). But the real answer is learning how to

manage it, ie ERP, and the medication is an assist to this.

Even once a state of recovery is reached the recommendation is that

you stay on medication for one year after and then try reducing to

see impact.

Sounds like you are having a bit of a tough time with this decision

and knowing what to do. It is hard and as you say you just can't

know for sure often. Hope you can get more professional input on

this decision.

Barb

>

> Hi everyone,

>

> (warning...long email question...sorry! and thanks to any who read

> all the way through!)

>

> We are in need of some help...

>

> Our OCD therapist recommends considering taking our dd off Lexapro

> due to possible tics in future. And I need any & all advice I can

> get to make the best informed decision I can for our dd (even

though

> everyone is different and there is no crystal ball to look into the

> future).

> Sigh...

>