Gifted Issues Discussion homepage Forums Twice Exceptional Prozac and Abilify

DS12, with ASD, anxiety and low self-esteem issues, has been on 10mg Prozac since May. When he started having issues in school this year, we upped it to 20mg (around Sept. 1).

Since upping the Prozac, he has been even more emotionally unstable, manic at times, refusing to go to class, and getting suspended. He has been defiant at school and at home. He has always been a straight A student, but his grades are slipping a bit (most likely due to missing class). I understand that Prozac can make anxiety worse, especially in the short term.

Talked to the psychiatrist today and he wants to add 2 mg of Abilify to the mix.

I'm not crazy about adding even more drugs at this point, though I do understand that medications often require trial and error.

Has anyone else been down this path and if so do you have any advice?

Thanks.

Sounds like you need a new psychiatrist...(we have been there and the doctor, quite frankly, had a mind of her own and any input we gave about side effects was completely disregarded).

It sounds like you have given it a chance and it's not working. We haven't used Prozac but it seems like after a month, you shouldn't see side effects like that.

Is he taking the Prozac regularly? When is he taking it? I would ask to try a different version as Prozac was the worst of the three SSRIs i have taken. I know nothing about abilify but taking more drugs to offset the effects seems like it should come after determining there isn't a better option.

He has been taking 10mg Prozac regularly since May, and we upped it to 20mg at the beginning of the month. We upped it because his in-school behavior was not improving. After we upped it, his behavior has been getting worse. I'm not 100% convinced it is all the fault of the Prozac, but it looks like it is not helping.

Did the psychiatrist discuss whether the behavior might be associated with the Prozac?

I have previously taken SSRIs and had bad experiences with them. I found CBT and similar approaches much more helpful, but that obviously depends on what one needs help with. I think sometimes there is a tendency to dismiss side effects that are worth taking seriously. That type of medication can cause emotional instability, unfortunately.

It is possible to have behavioral changes with media Atkins like that, though, and I think the psychiatrist should discuss them seriously with you. It sounds as though your concerns are reasonable. Other SSRIs may do the same thing or they may not.

I think it is very fair to want to discuss this more and feel confident about the decision about what to do next.

If his behavior hasn't improved at best and has deteriorated at worst, maybe you and his doctor should consider withdrawing the drug and seeing how he does.

Is the psychiatrist responsive to your input? IMO, it would be reasonable to try a different SSRI before adding a second medication to one that might be causing mood lability. It's not unusual at all to have to monkey around with medication--many people have to try different antidepressants before finding one that helps without causing intolerable side effects. I'd be careful and ask for the rationale. Monotherapy is preferable, when possible.

Does your DS take other medication (e.g. stimulant, etc.)? DS here had a really rough year last year with medication for ADHD and my opinion is it was changing body chemistry because of hormonal changes.

Sorry things aren't going well. We had to discontinue SSRI for DS. It wasn't causing the same problems you're describing but was problematic nonetheless. I explained to the psychiatrist we couldn't afford to experiment like this right now, and he was okay with it.

If you aren't comfortable with the physician's approach, do you have other options?

Thanks everyone. The psychiatrist is not convinced that Prozac is the cause of DS's increased anxiety, but I definitely have seen a correlation when he went from 10mg to 20mg. When he started 10mg he was fine, but 10-20 has been very difficult.

As of today, we are dropping him back to 10mg Prozac and adding Abilify. We'll see if that can get us through to the next appointment. I understand that upping the Prozac can cause short-term problems for a few weeks. But in the meantime, DS is suffering - depressed / manic, crying over little things and missing school. This is ridiculous and my wife and I can't just let this go.

I'm tempted to put the plug on meds, but we put him on them because we had a similar episode (though not as intense) when he was off meds this Spring.

I'm very concerned. Ugh.

FWIW DS' psychiatrist said one potential downside to Prozac, specifically, is that it is sometimes too activating. I'd be inclined to trust your instincts on this one.

Sending tons of support to you, your wife, and your DS. This is so trying. It can get better--endeavor to persevere, I guess. Awful watching your child suffer.

Thanks Eco, we will do our best. This is very hard, especially since he was refusing to go to school today. I managed to talk him into it, but I'm waiting for the other shoe to drop. I hope it doesn't.

After spending way too much time reading about various meds, I have concluded that any of them might work, might do nothing, or might have negative side effects including making the thing you are taking them for worse.