Re: Meds exploration

[Guest guest]

You already have some good answers on this, but I will offer my thoughts too.

Your ERP therapist should be able to advise you best on this, as he will see

directly your son's ability to do the exposures, and the level of anxiety that

comes up with them. Medication is used to alleviate the level of anxiety, so

that it makes ERP manageable. For some it is a short term need, while others

find they need this support lifelong.

The move to medication also goes to quality of life, and ability to function

fully, which goes to quality of life. If your son is functioning well, and the

OCD is not seriously limiting his life, I would start with ERP only first and

see how that goes. This is the recommendation from the ocfoundation now, I

believe. You can go to their website and read their treatment guidelines, and

we also have this in our " links " .

I would say, why add medication unless it is clearly indicated? If it is needed

that will become apparent as you move forward with the ERP.

Our experience of it was, going the ERP only route first, which caused the

anxiety to go from 10 to 100, if not 1000, and it made the doing of ERP

impossible, never mind any kind of functioning. It may have been the evolving

of the disorder too, don't know for sure. We got stuck in limbo with

medication, as it was not handled well, which sidelined any further ERP for two

years.

However, having gone the ERP only route, our son was clear about what this was,

that it worked, as he did have some success at the outset, and it made clear in

his mind that this was the way out of the endless OCD loop, even if he could not

do it. Ours was a teen, and I think if he had started with medication, he may

well have believed that was the answer, because it would be a whole lot easier

than " just " doing the ERP!!! So, this is something to consider. Medication is

an assist, so that someone can do the ERP, not THE answer, at least not for

many.

If medication does end up being needed I have one recommendation. Go slowly

with dosing, and stay low unless it is indicated that you need to go higher, ie.

lack of function. If this was done with our son we would not have gotten into

the difficulties we did. Everything is in how the medication is handled. It

sounds like you have expert professionals attached, so this should not be an

issue for you, but it is still good to be informed.

Warmly,

Barb

Canada

Son, OCD, LD Plus

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> > So I just talked to the pediatric psychiatrist about my son, Preston,

(8-years-old, just diagnosed with OCD) that the pediatrician also referred us to

(she was on vacation last week). She spent a lot of time with me on the phone

and gave me lots of good info. Although now I'm more confused about what to do.

The discussion is about whether to pursue only Cognitive Behavioral Therapy or

both CBT and medication right now. I had read many studies that show that

medication plus CBT have the best outcomes for children with clinical OCD. But

many kids also have great recovery success with CBT alone. The duration of

recovery (she referred to as " OCD remission " ) looks to be statistically quite a

bit shorter when you combine medication and CBT with ERP And she told me that

the medication is not something they typically have to be on long term, only

short term. She gave me some more info on the stats. She said she is open to

either approach, and talked to me about pros and cons of both. We are going to

do a consult appointment with her and then she will talk with the psychologist

who we are seeing for CBT with ERP to discuss Preston's case specifically so

that she can make a recommendation on if CBT without also adding meds is likely

to work well. She had nothing but wonderful things to say about the

psychologist we chose for the CBT, said she's worked with him for many years and

he's the best around for pediatric OCD. So that was really good to hear. She

was also really glad to hear that Preston really hit it off with him at the

first appointment and was obviously comfortable, as she believes that is a huge

predictor of therapeutic success typically. I'm typically so against

medication, especially for kids, but I also want to make the best decision for

my son. Any insight you all can offer?

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