Zoloft for children?

nurs2bhopefully · May 30, 2002

By the way, didnt' think to include her age! She's 12 years old!

Lulu · May 30, 2002

dear rn2b

I take Zoloft (at 49), but I've never heard of it being given to children. I'll ask around at work tomarrow and get back if I find anything out. I know it's not addictive but, personally, I couldn't go back to preZoloft days.

Lulu

ArleneG · May 30, 2002

Zoloft is an antidepressant (SSRI). I see it routinely administered to children in the hospital where I work. What kind of behavioral problems are you experiencing with your daughter? Did the doctor recommend any other treatment such as counseling in addition to meds? Does she experience mood swings? If this is a major problem you may want to look into mental health services in addition to the pediatrician.

nurs2bhopefully · May 30, 2002

Lulu, thank you, anything you find out will be greatly appreciated.

ArleneG, thank you for responding. Yes, the counseling was the main reason I took her to her pediatrician, If I just take it upon myself to take her to a child psychologist/psychiatrist, the insurance doesn't pay. But if her Doctor refers her, the insurance will help pay for it. Her pediatrician agreed that she needed some kind of counseling, but couldn't understand why she's the way she is, is why she said she wanted to prescribe the zoloft. As far as her behavior problems, she's hateful, disrespectful, doesn't care about anyone but herself, destructive to property, verbally and physically abusive to her younger siblings, continuously dishonest ( lies about silly little things that don't amount to anything!), failing grades in school, mainly because of not trying and not turning in homework assignments. Every time she gets in trouble, it's never her fault, someone else is always to blame. She cannot keep friends. She has a different friend every week until she does something to make them not want anything to do with her. As far as our home and our family situation, My husband and I have been married for 4 years. He has a 9 year old son from his 1st marriage, and I have two other girls 5 and 2. We make sure that we spend the same amount of money , and the same amount of time with each and every one of them, so I know that's not the problem. As a matter of fact, I've tried to let her do more lately to try and give her things to focus on and keep her busy. For instance, I agreed to let her try out for basketball, as bad as her grades were: the 2nd day of practice the coach sent a letter home saying that if her attitude didn't straighten up she'd have no chance of making the team. Big pep talk- went to pick her up from practice the next day, coach sent note home saying "I regret to inform you that your child has been disqualified from basketball tryouts. We cannot tolerate someone who is not willing to work as a team, and not willing to respect the other children." Every thing I try to help her do, ends up in disaster, and needless to say it doesn't help her self esteem. I feel so sorry for her, but I get so angry with her at the same time. I'm just at a loss as to what to do. I've tried reward systems, restriction, actually spanking her with the belt, which about killed me, nothing seems to work, she gets worse and worse. So does the Zoloft sound like a good decision, or should I wait until she is seen by a psychologist to see what they think?

Sorry such a long drawn out paragraph! Just feels good to vent!

ArleneG · May 30, 2002

I would go with the Zoloft for now and definately pursue the counseling. She sounds very angry and you'll need to get to the root of this. Make sure you dole out the meds so you know she is taking it and also takes it as prescribed. I know how tough it can be with the insurance and sometimes the better therapists don't even accept insurance. Good luck, I know how rough this can be.

lkushen · May 30, 2002

Nursetobhopefully,

sounds like you are living in my house. My daughter is 11 with similar problems, except for the grades. You did not indicate at what age her symptoms reared their head. Also, is anyone else in the family experiencing similar issues (sometimes have a genetic influence).

we started when she was 5 with the pediatrician, who was willing to send me out the door that day with Ritalin. I said no, I wanted a psychological evaluation, which we did. We also saw a pediatric neurologist, psychologist, behavioral counselor, and now have moved up to a child psychiatrist. She has undergone bloodwork, CT scans of the brain, and EEGs. She lies, steals, hourds, is obsessive, cannot make and keep friends, is aggressive, however is smart as all get out (but no common sense - aaahhhh!). She binged and purged when she was 8, wrote about suicide when she was 10, and recently stole from Wal-Mart. We also have the school counselor and community police officer working with her. Of course, she is now on a mixture of polypharmacy. She has had multiple diagnoses, including ADHD and Aspergers syndrome as the current consensus. However in the past they have included depression, obsessive compulsive disorder, and oppositional defiant disorder.

We have tried Zoloft in the past, as well as Luvox, both SSRI class meds - with horrible effects, not to say that is what will happen if your daughter tries them. The psychiatrist has just concluded that this classification of meds makes my daughter worse with her symptoms.

She is numb to any and all forms of punishment. We've tried it all - and then some according to the psychiatrist.

Push for the referrals you want, or change physicians! In nursing, it is our responsibility to be our patient advocates, and in this case - the patient is our children. Educate yourself by getting your hands on as much materials as possible. Be prepared for road blocks from the "uneducated," especially your family members. Never stop searching for answers. Good luck.

Lynn

nurs2bhopefully · May 30, 2002

This definitely sounds like my daughter! Exactly like her! I'm sorry for you and your family, but it's such a relief to hear that my daughter isn't the only one going through this. She has been having trouble since the age of 4, they called me each and every day at daycare and threatened kicking her out. They did kick her out of kindergarden for stabbing a little boy in the arm with a fork at the lunch table. When asked why, she merely replied, "I just wanted to see what would happen to him". I then placed her in a private christian school with only 9 students per class. Constant problems there too. Her derrogatory behavior has just progressed as she's gotten older. She's never been sexually abused, physically or emotionally abused, or any thing else that I can think of. The only mistake that I can think of that may have triggered this behavior is not letting anyone else discipline her, and I'd act just like a mama Tiger defending her cub if anyone dare tried. I think I was wrong in doing this, and this may have caused her to disrespect elders and resent authority. I've tried for the past 2 years to let her know that I have been wrong all these years defending her when she was wrong, and changing my defensive ways. I've put my foot down and let her know how it is and how it's going to be, and it seems to go right over her head. I'm just tired. Her grandmother wants her to come and live with her, but if she acts ten times worse during visits, I know that living with her is not going to solve the problem. Besides, she's my responsibility. Thanks again for all the advice to both of you- Take care and good luck also.

kids · May 31, 2002

My 11 year old stepson has ADHD and has had ongoing problems with aggression when provoked. After many years he has settled on Paxil (another SSRI), Zyprexa and Adderal SR. The only side effects have been constipation. I have a HUGE problem with the Zyprexa (we don't have custody and as his Mother says we "don't have to deal with him". I have noticed a marked improvement in his impulsiveness since starting on the Paxil.

I have seen the SSRIs prescribed to help impulse control in CVA and TBI patients.

NannaNurse · May 31, 2002

First of all.....I hope the new med works.....Now..I'm not suggesting anything, but has the possibility of any type of abuse....mainly sexual abuse, been addressed? Again, I hope I'm not sounding 'out of line' here and I'm certianly not insinuating something within the family, but in some cases where there is behavior such as this, there are some instances of sexual abuse. I know of a friend who's daughter was acting the same way....found out that an Uncle had been abusing her for a couple of years.

I'm truly hoping that that has not happened here and that you find help. I will be thinking of you and praying for you too....if you don't mind.

I wish you much peace and strength.

MollyJ · May 31, 2002

I have all respect for all of the parents/nurses that have responded here. Dealing with a multiply involved child that turns your household upside down periodically/daily is frazzling.

I'm not here to tell you NOT to do something. But I would suggest that you do it with care. I'm disturbed by seeing such young children on multiple drug therapy. They are not without side effect profiles. If you are interested in hearing from an anti-drug perspective, try http://www.breggin.com Dr. Breggin is (in my view) a little radical because he has spent his career crusading against interventional psychiatry of just about any kind: ECT, anti-psychotics, and now SSRI's and stimulants in children. While my own view is a little more middle of the road--I'm not willing to say psychiatric drug therapy NEVER has a role in the care of a child--I think he brings an important perspective to the table.

To you, your blended family represents an average American family doing the best it can. To that little girl, it may represent the loss of her perfect family--her bio dad, her bio mom. She's mad as hell. She acts out. You've noticed that. You and your hubby can be doing everything right and living with the facts as they are but she's fighting that reality.

These kids can be hard to reach just because they are so closed off. "talk therapy" I think may be something they're not ready to take advantage of. (I mean, if it works, don't fight it but if it doesn't this can be the reality.) THEY start to see themselves as "hopeless cases". Spiral effect.

Things to try:

*Consistency

*Catch 'em being good (you know, from toddlehood parenting)

*Family Meetings (Parenting for the Drug Free Years training). Helps kids feel they have a voice in family decisions.

*Teach 'em to use "I statements".

*Practice active listening

*Don't forget to touch your child. One NP I know would prescribe 60 pats on the shoulder a day. That takes a second to do, so we're talking a minute of investment. Even for teens, a pat can be acceptable (not too huggy).

*Help your child practice positive self-talk

*Model good control of your own emotions: anger, frustration

*Keep them physically active, even if you have to do it with them. Bicycle, camp, exercise as a family. Excercise promotes secretion of natural positive affect chemicals.

*Do hold your child accountable for their behaviors. They kick the door in, they repair it. (They may need your help but owning solutions help them own problems.) They shatter something, they clean it up (when they are calm). Model saying "I'm sorry" and remind them that a simple apology helps de-escalate things.

*View meds as an augmentation to other behavioral and thinking interventions

*With our adult alcoholic (my step) daughter, we did a lot of expressing expectations such as expectation of sobriety, expectation of school attendance, expectation of meeting attendance. As an adult, we tied our expectations to cash assistance and told her that if she was drinking and not working on things, we would withdraw this from her.

None of these things are likely to help quickly and they are fairly labor intensive WHILE YOU ARE HABITUATING THEM. They get easier after that. I like to view these kids as needing explicit instruction in life-skills, but they will take that the best from someone they care about. She loves you.

Good luck to all of you. My own unique, high spirited little boy is 10 and I sense we are on the threshold of pre-adolescence.

donmurray · May 31, 2002

I agree. In wider terms, the direct alteration of a person's brain chemistry can't be a good thing. People are concerned about genetic engineering, but with the use of SSRI's and the newer antipsychotics becoming widespread, we are seeing something akin to social engineering, the aim of which would appear to be a docile, compliant population that feels good about itself.

Molly's advice is practical and without side effects, but will be very hard to implement at first, as she said. The timescale is going to be more than July, however.

Rant over, Good Luck in whatever you decide!