Paediatric ocd and mean dose for sertraline - OCD-UK

OCD-UK

4,515 members1,352 posts

Paediatric ocd and mean dose for sertraline

Bunchy180 profile image
Bunchy180

My daughter is 14 and suffered from ocd since the age of 9 then it was intrusive thoughts which seems to ease and at 13 1/2 came back as xo rmaintion ocd withntriggers beinh Moses bogies my strands of hair. She wouldn’t move fromone sofa fofnfwae of touching something. She has come far and is under Camhs - she is now on sertraline, increase every four weeks to 100mg that shebis now on. She is now going for drives in the car, walks, passes me stuff, doing her make up, some schoolwork at home, not having major meltdowns and going from

Not speaking or wanting to spend time with us- to doing exactly that so am feeling she is on the road to recovery.

I just wondered why the sr has said now to Alston at 100mg and work more on the bah our side of things as I have read that the therapeutic dose for paediatric ocd is 200 mg. I know it is diff for everyone but have heard that it takes quite high doses for relief. She is speaking to the dr again on the app at Dec. I just wondered how lo b it takes to see if the 100mgnreallhnis the correct dose and after next 6 weeks what would be the reason for her to increase the meds. Does it sometimes take longer than 3-4 weeks to see a difference ?

She has suffered

No side effects and I know do my daughter has relief at a lower dose that’s better for her, nest step is getting her used to being around people again and then introducing her back to school - at the mo this isn’t an option and just wondered if an increase may help with this !!

Many thanks , any advice greatly received

8 Replies

Am so sorry about all typos !!!!!! Wrote

On

My phone and didn’t check before posting!!!!!

It does sound as though she has made progress. Prescribing strong medication for children and young people is something doctors and psychiatrists are often reluctant to do. Children and adolescents are more likely to have really bad side effects and the effects on a rapidly developing adolescent brain are not yet properly understood. Normally sertraline is only prescribed to under 18s in cases of OCD, and not other mental disorders.

It can take high doses of sertraline to deal with OCD, and 200 mg is not unusual. But be careful before assuming that a bigger dose is better for your daughter, although she hasn't had side effects. It can take more than a few weeks or a month for it to start working properly, so give it a go at the current dose.

Keep in touch with the mental health team about this, and they may consider she should increase the dose in the future.

Medication can only do so much, and to really get the full effect of its benefits it needs to be used in conjunction with CBT. Keep on with this!

It must feel really good to watch her go from the sofa to participating in life again. There may be a few setbacks, as OCD does fluctuate, not to mention normal teenage behaviour, but she does sound a lot better!

Hi there - I’m 33 and on 200mg of Sertraline for OCD - my doctor was reluctant to go that high as that is considered the maximum dosage. I would be surprised if they prescribed a minor such a high dosage. Also, from experience it is good to have somewhere to go when setbacks happen. OCD is incredibly hard and medication definitely helps but it is the CBT that has the long lasting effects. That said - I’m not sure I’ll ever feel ready to go medication free. On the positive side, your daughter is getting help so young which is amazing - I wish my OCD had been diagnosed at a younger age. Hope she continues to improve.

Bunchy180 profile image
Bunchy180 in reply to LH1987

Many thanks for your reply.

I hope you don’t mind me asking, what form did your ocd take and how long was it before you noticed or others noticed changes.

I am so glad that the medication helps. OCD is awful and getting help is a nightmare. I thought it took ages for Us to get help, we went private to begin with but that didn’t help and thus far CAMHS and meds are the things that have pulled through for us. I hope they continue to work.

Wishing you all the best and thankyou for taking the time to reply.

You’re welcome. I know how difficult it is.

I’ve been through various obsessions - the first ones from as young as 4 or 5 I would say but the most prevalent ones still are unwanted intrusive thoughts (this is what I find hardest) and contamination. I have been on medication since I was about 20 - fluoxetine at first and then sertraline for about the last 5 years. I had a massive setback last April and was increased to 150mg and then this year I increased to 200mg as lockdown took its inevitable toll on me. Honestly I’d be lying if I said I didn’t still have some bad days but they are so much fewer than they were. I have two young children myself and they have been a massive incentive for getting better. After medication increases I find it takes 6-12 weeks to see optimum benefit.

Other things I find helpful if they’re any use are:

Taking vitamin b6 (for hormone regulation) as my symptoms worsen when I am due on.

Mindfulness techniques - headspace is really good - also reading, colouring etc

Minimising caffeine as it made me more anxious

Getting enough sleep

Self help books - Jon Hershfield has written some really good books and there are lots of other good self help books on amazon.

Wishing her well x

Bunchy180 profile image
Bunchy180 in reply to LH1987

Thankyou so much, you are very kind in sharing what helps.

My daughters main one now is contamination, triggers of noses bogies nose breath, anything like that and when younger 8/9 intrusive thoughts which were quite bad but she managed to see these as what they were , so we cut down gradually on the reassurance then wham at 13 just before major lockdown, contamination, noses bogies breathing contamination toon hit in a big way and we lost every essence odour gorgeous girl to the ocd monster. Thankfully CAMHs have helped and medication too, she is trying now and we even went to a shop yesterday, she didn’t touch anything g but even leavi ng the house to go in garden was a no no 3 months ago!

So that was amazing , small steps, she is happy smiley and chatty now and not so avoidance of every trigger.

I cannot believe the effect this form of ocd had not only our daughter but the whole family too. I can now stand near her and breathe but touching her or hugging her is way out!

I am sorry to ask but how did your family help you ?

I am quite soft and can’t bare to see anyone I. Distress and when my daughter said I don’t want to do this anymore,mummy please help, I couldn’t do anything g but accommodate and clean ,not touch face etc .i know this is the worse thing for ocd but watching her so distressed was awful. I am doing my best not to accommodate now, sometimes I have to and the meds seem to help with this but she is having cbt and she u set stands what she should do and should challenge herself but it still is there.

Thankyou so much,you have given light o the whole ocd monster and I am so pleased your children help.

My husband suffers with checking ocd and tapping but it doesn’t interfere during the day only when he is locking up etc, OCD tells the biggest lies and is such a bully. You are amazing to have achieved all you have so be kind to your self because you are amazing and I truly hope my little girl can get to where you are x thankyou

Oldbury1 profile image
Oldbury1 in reply to Bunchy180

I sound like your Daughter I find everything dirty and after touching basic things like books, paper, own crisps, toys etc.. I have the urge to handwash immediately to feel I'm clean again. I have had OCD for 35 yrs It got so bad recently where I didn't let my kids hug kiss me as there hands or mouth might have food on and I'll have the urge to handwash again. So i sit slot on the sofa to avoid basic things touched. I am having CBT and my Doctor has tried a few different ones medication like proxatine, strepaline. I didn't notice any benefits from them even after CBT session I feel it was nice to talk and share your problem but I felt the same still my brain telling me to handwash still even if I hadn't moved off the sofa it felt I needed to. I wish there was a tablet to control the mind and say no no no. Im taking fluoxtine 20mg at started today I know it's going to take few months to work but. Worried OCD will obviously always be there and creep up and Ill be back to my usual rituals again. I've done it for so long various rituals checking counting repeating cleaning, handwashing. My family think I need to be put in a hospital for 24 hr treatment as they are tired and have tried to help by switching the water off from the mains but I still end up back to where I started. Can any other medication help or further CBT or any other OCD books or treatment as I would like to reduce my OCD I know it will never go away but i would like to get abit of a normal life back? As I'm afraid my 7 old daughter has started alittle OCD here and there and it horrible to watch as it's me she has learnt it off. I Carnt bare her going through it like me for years.

Hello, I’m so sorry to hear that ocd is causing so many problems for you and your family, it truly is a horrible illness and after experiencing my husbands ocd over the years, just thought that is was an inconvenience for him, like taking him slightly longer to leave the house ofSwitch off all of the appliances and checking of taps. We also joked a lot about it, now after experiencing my daughters ocd it really is not to be joked about.

It was awful to see our beautiful 13 year old who always has been anxious about certain things but always happy and funny disappear and someone who wouldn’t leave her seat or room, or allow us in there or even allow us to breath near her or look in the direction of her door. She couldn’t put her foot in her room unless she had cleaned her feet even after having a shower and school has been a no no for nearly 10 months now. She didn’t speak to us, avoided all triggers etc etc then even showers became too much as it was so complicated having one after we had Etc, she then didn’t have one and didn’t brush her hair as couldn’t use a new hairbrush more than once!

She is with CAMHS - they tried EMDR which didn’t work as she was not

Motivated and basically couldn’t do it. I read about inositol - and it’s effects on ocd and as it said it was pretty in harmful and any excess came out of your body but helped with panic attacks etc which she was having daily even if she thought I touched my face or if she thought my hair touched my

Nose. We built up to a large dose of 12 grams per day, to start with she was a little bloated and had to use the loo more

Often but this passed and in about 6 weeks she started to calm down and brushed her hair and didn’t get into such distressed state. In the meantime CAMHS put her on sertraline at 25 mg and built up to 100mg increasing by 25 mg every four weeks.

She has now Managed to start having sensible showers again, allow us in her room, pass us things, go for walks, allow her sister into the house even having stayed for the night, us also to use the toilet upstairs, go in the car, she is now practically sitting on diff chairs in the house ( at mo am still having to wipe them over quickly ) but hopefully as with the other things this will come. She has even managed to go into CAMHS now - before everything was done over zoom. She hasn’t sat down but again this is what we are working on. Now she is in a better place I thing her care coordinator is going to try EMDR again. Please look on line, there are some videos on the internet about his and different studies.

She has also managed to go in to school only reception and into another room, we started this by driving into car park and sitting, then getting v out to a rand waking in car park, then standing outside reception and so forth. I will add a link about exposure response prevention, the idea is to make a ladder with your least trigger at the bottom and your hardest and the top, go to wards the trigger and then sit with the discomfort and anxiety seeing it as a feeling and observe, eventually the anxiety will

Come down and each time you do the exposure the anxiety will decrease.

We did pay a lot of money for an intense course with the ocd centre in Taunton but it was done via zoom because of covid, we were increasingly desperate and at that time had no help. This is intense exposure and also explains the blip in your brain and how after repeating things your brain grows new pathways ( like when someone has a stroke and physio s make you repeat little actions over and over and your brain retains itself to move your arm/leg / swallow etc.)

This I think was too much to soon for my daughter and after an Initial improvement, she fell ill again and couldn’t move or do anything. So the steady slow step by step approach has been best for her.

I would ask you family not to accommodate what triggers you or not to reassure you.

I found it hard to not accommodate or clean for my daughter as it made me ill see I v her so distressed but I know this is the best thing for her. Your family will

Need to be there for you, not got cross With you when you have to do your compulsions but try to encourage you to delay them or not do them and sit with the anxiety and not right feeling or feeling of disgust. It is only a feeling/ thought that everyone has but it is the way you act on that thought.

iocdf.org/expert-opinions/e...

The medication has definitely helped her to be able to do the exposures and sometime the ocd is worse than others ie before her period or on the last day or when she is stressed.

Books talking back to ocd John s march

Freeing your child from obsessive compulsive disorder tamar e chansky.

She still takes the inositol only 4 Grams per day now as no interaction with sertraline but it also said that it doesn’t benefit or make the sertraline work any better.

She was also diagnosed with severely low vit d levels and iron at the start of this so don’t think this helped but as said previously she had ocd intrusive thoughts at age of 8/9 .

The books I have mentioned are for children but I think the therapy is pretty much the same. She wouldn’t use as wouldn’t touch but I do try and work from them I think erma of ERP etc.

Hope some of this helps!!!

The thing is you and my daughter are the ones who have to want to do it - it. Teams my heart not to hold her or hug her as it must your family, it is not you it is OCD and it lies and if you can do the opposite of what if tells you then that’s amazing, it will get fed up of bothering you if you accept the thought the feeling and say it’s dirty so what, thanks for that - easier said than done but it can be done. You are stronger than you think and your love for your family even stronger.

Take care and I hope that you and my daughter can free yourselves from this horrible bully.

Sorry for any typos - am using phone and am useless with it!

You may also like...