Posted by Cairo on April 27, 2005, at 17:41:24
Just came from an intense appointment with my daughter's psychiatrist. She's been on Lexapro 10mg + Provigil 200mg for Social Anxiety for over a year with only moderate success. Higher doses of Lex cause incredible fatigue and cognitive side effects which we cannot afford b/c she has learning and language disabilities and a chronic fatigue/fibromyalgia type thing going on. CBT doesn't generalize.
A pediatric Psychiatrist we saw at UPenn last summer suggested Seroquel as an add on to Lexapro for the anxiety, but said we need someone local to follow us up. We switched to someone new who headed the Anxiety clinic at our state Medical School and who tried her on Librium and added the Provigil. Provigil helped fatigue some and thereby, I think made her more prosocial. Low dose Librium helped only a little and she balked at needing to take a pill every "frickin' time I want to talk to someone". Increasing the dose is not an option and MAOIs aren't either.
We pressed him on the Seroquel and he said absolutely no way due to sedation, which is the last thing we need in her as she is underaroused and he hasn't heard of Seroquel being used for social anxiety. He wants to switch her to Zoloft, which I'm game to try, but I'm afraid we'll get only a partial response to that too. Dosing may be an issue as she's sensitive to side effects.
We'll give Zoloft a whirl, but after that we need referral to a pediatric clinic that specializes in social anxiety. Who is the best? Are there any places that do intensive CBT specifically for pediatric SP? Research on atypicals as adjuncts for SP?
BTW, he won't consider discussing Pregabalin when it's released as it's "new". What's the latest news on ocinaplon?
Thank you for any help you can give!
Tired, worried, and confused,
Cairo
poster:Cairo
thread:490475
URL: http://www.dr-bob.org/babble/20050423/msgs/490475.html