Posted by Toby on April 6, 1999, at 11:50:23
In reply to Re: TOBY-HOPE YOU CAN RESPOND?, posted by Matt on April 3, 1999, at 0:08:13
Matt is correct about the tremors usually going away after a steady dose is achieved. Also, the dose is being increased fairly quickly in this case. Antidepressants don't usually kick in until 4-6 weeks of being on a therapeutic dose (for Zoloft that's anywhere between 50-200 mg) so it's not surprising that there hasn't been any real change yet. The general consensus is that a person needs to remain on a therapeutic dose of an antidepressant for 6-10 weeks at least before switching to something else. Sometimes switching to another medication in the same class (Zoloft to Celexa for example, both SSRI's) is beneficial, but usually the recommendation is to try a medication from a different class (like Effexor, Serzone, Remeron, Wellbutrin). Most drug companies aren't going to do extra research on children unless they think they are going to get a special niche to boost sales, so there may not be a lot of research data for you to find, but child psychiatrists are using all the newer antidepressants in teens without any more problems than they see in adults. I would think it would be reasonable to let him stay on the meds at least another 4 weeks (perhaps they may even increase the dose to 150 mg) and if no change in the depresssion has happened at all, to then switch to one of the meds listed above; with the anxious component any of those would be a good choice and also, if the doc wants, he could add one of those meds to the Zoloft without switching first and then if there is a response, gradually taper off the Zoloft.
poster:Toby
thread:4337
URL: http://www.dr-bob.org/babble/19990401/msgs/4460.html