Posted by Chairman_MAO on January 29, 2004, at 21:28:26
In reply to Question RE: Lexapro for 14 year old, posted by PoohBear on January 27, 2004, at 11:51:33
IMO (this opinion is one of my few that AREN'T humble) medicating a child or adolescent with an SSRI should only be done as a last resort. The emotional blunting, apathy, and agitation (often all three, gee, what a great thing of an adolescent <sarcasm>) that may result are not worth the possible benefits. How would you like it if someone blunted your emotions and quite possibly your SEXUALITY just as you were coming of age? It sickens me to think that kids these days have to go through that.
A mood stabilizer with minimal effects on cognition should be tried first, alone. Lamictal has antidepressant properties. Trileptal may, too. If an antidepressant is necessary, I'd go with an NE agent--if you're in the US, the only one that's good to use in a kid is Strattera. Another possible choice is Wellbutrin, but this can be quite agitating. It is important that you use the lowest dose of medication possible--these things have side effects that it is unlikely a doctor will talk about--and the drug company, forget about it! For instance, Strattera and other NE agents often potentiate NE activity in the male bladder and reproductive system, leading to urinary retention, possible ejaculatory difficulties/ failure, and impotence. At the tender age of 14, this could be a self-esteem catastrophe. Another important option would be Remeron--raise the dosage carefully, it can be agitating at higher doses--because it would likely stimulate appetite, works quickly, and has no sexual effects.
Your best option would be to avoid drugs altogether unless ABSOLUTELY necessary. Despite what the commercials and some doctors may tell you, depression and suicide attempts are (usually) PSYCHOSPIRITUAL conditions. Warn your friend that if she decides to have her son treated with antidepressants, the course of treatment should be kept as SHORT AS POSSIBLE to minimize the drug's effect on her child's emotional development. Psychotherapy, and, more important, good support systems at home/school should be the primary tools.
poster:Chairman_MAO
thread:306043
URL: http://www.dr-bob.org/babble/20040127/msgs/307084.html