Psycho-Babble Medication | about biological treatments | Framed
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Re: Lack of Pediatric Psych Options Discussion

Posted by SLS on September 10, 2015, at 8:36:16

In reply to Lack of Pediatric Psych Options Discussion, posted by FloydAS on September 10, 2015, at 7:31:13

Despite its lack of success with your daughter, psychotherapy was the right choice as a first-line treatment. Perhaps something other than CBT would be more helpful. I found interpersonal therapy (IPT) or more eclectic approaches to be most helpful. In any event, I would make psychotherapy part of an integrative treatment for your daughter, even in combination with medication. Chronic anxiety and depression can leave quite a mess in their wake, so even it a medication remedies the biology, psychotherapy will help clean up that mess.

Medication? SSRIs and SNRIs demontrate an ability to improve symptoms in GAD. Personally, I like the way SNRIs treatments affect me more than SSRIs. The SNRIs, Effexor (venlafaxine) and Cymbalta (duloxetine) have been studied for pediatric GAD, and have demonstrated some efficacy. I would also check out Pristiq (desvenlafaxine). The dosages of Pristiq used for depression is much lower than for Effexor. Among the SSRIs, Paxil (paroxetine) is probably most effective for GAD, but side effects can be problematic and it will increase blood levels of Elavil (amitriptyline) by a factor of two. (This is also true of Prozac (fluoxetine).

Some treatments being studied that do not inhibit the reuptake of serotonin include Lyrica (pregabalin) and Valdoxan (agomelatine). Valdoxan would be an interesting choice. It is less likely to induce euphoria and is perhaps less likely to poop-out quickly (tachyphylaxis). Buspar (buspirone) might be helpful.

- Scott

Some see things as they are and ask why.
I dream of things that never were and ask why not.

- George Bernard Shaw




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