Debziere: Need to wean my 10 yo off Prozac

[Debziere]

Child is having bad side effects, dr just increased dosage to 20. Was 10 for about 6 weeks. At this point side effects:

Talking and writing about death

Self injury

Extreme aggression (very uncommon for her)

Nightmares

 

I need help, I know what wd is, was hesitant to put her on meds. She's been on 10 mg capsule Prozac about 6 weeks, upped dose to 20 for 5 days. She is still very fragile any abrupt drop could be adverse. I need to know how to titrate or taper her. Since she's only been on 20 for 5 days, I'm thinking stopping the extra dose, but need to know how to taper 10 mg capsule. Length of time she has been on has not been that long. I have reached out to all her psych people and no one will return calls, and psych wants to keep her on this. I am seeing these Behavoioral changes and will not subject her to this any longer, how to titrate 10 mg Prozac capsule?

Thank you

[nz11]

Welcome to sa

I am so sorry your daughter has been given prozac.

Hopefully a mod will be in soon.

nz11

[Fox]

A mod will be with you soon. But Prozac comes in liquid form for easier tapering.

[KarenB]

Hello Debziere,

 

Such a difficult time for you as a mother, wanting to protect your daughter.  Hopefully the information we have here will help you to build a safe plan.  We recommend a gentle taper, reducing by no more than 10% of your current dose each month.  This allows the brain time to adjust as you go, and lessens any withdrawal.  Some of us reduce by smaller amounts, or follow a micro-taper.  You could have a read of those threads and see if either way resonates better with you. 

 

It's true she has not been on it that long.  Usually we say if a person has been on it for a month or less they can reduce a bit faster, but that may not be advisable with your daughter already being so fragile.  Have there been any changes in your daughter since the increase to 20mg?  If not, then you may indeed be able to simply cut that back to 10mg, as you say.  But if there have been changes, then you might like to approach that more carefully.  Perhaps down to 15mg one week then down to 10mg the following week - but it will depend on exactly what's been happening for your daughter lately.

 

Tips for Tapering Prozac  It comes in a liquid, but if that is difficult for you to obtain, you can make your own.  The instructions are in that link.

 

Many people find Fish oil and Magnesium useful during withdrawal.   

 

Keeping things simple in your daughter's life will also help: 

Keep it Simple; Keep it Slow; Keep it Stable

Non-Drug Techniques to cope with emotional symptoms.

 

Please put your withdrawal history in your signature – all drugs/dates/dosages etc - so we can see your daughter's situation easily whenever you post, and help more accurately.  Thanks.

 

Symptom Checklist

 

Have a read of those and then come back to this thread to discuss things further.  This can be your journal to record your progress and to ask questions. 

 

Welcome to SA,

Karen

[Newbeginning]

Prozac has a risk of causing suicidal ideation/attempts and aggressiveness, particularly among children/teens. This is in the black box warning on the med itself.

 

You said she has been on the higher dose for 5 days only? Then I would just go back to 10mg. The risk of it causing a reaction from changing dose after 5 days is much lower than the risk of being suicidal as a side effect-in my humble opinion.

 

Once she's stable again, I would taper more slowly.

 

Whatever you do, I would make sure she's not alone and keep communicating with her until all this settles.

 

Since it's been just 6 weeks, it should be easier to stabilize her from this bad reaction to the med.

 

Best of luck and hugs

[Debziere]

Prozac has a risk of causing suicidal ideation/attempts and aggressiveness, particularly among children/teens. This is in the black box warning on the med itself.

The school is not accepting this as truth, and put her in ISS without my knowledge yesterday, where can I find this black box warning?

 

You said she has been on the higher dose for 5 days only? Then I would just go back to 10mg. The risk of it causing a reaction from changing dose after 5 days is much lower than the risk of being suicidal as a side effect-in my humble opinion.

Yes, went back to 10 today.

 

Once she's stable again, I would taper more slowly.

 

Whatever you do, I would make sure she's not alone and keep communicating with her until all this settles.

 

Since it's been just 6 weeks, it should be easier to stabilize her from this bad reaction to the med.

 

Best of luck and hugs

[Debziere]

Thank you for the information here on the microtapering, etc., and liquid conversions. The psychiatrist will probably demand that she stay on this Med., I am not keeping her on this Med., she has never been in trouble a day in her life, ever, she has extreme anxiety, began self injury with objects to my knowledge yesterday. The school put her in ISS without my knowledge yesterday, they called after school was over and told me. Left her in a cubical to self harm. A liaison counselor was aware of the situation did not address this with the school. I did not want To send her to school today. The school does not care about the medicine side effects. Where do I find the black box warning? What other Med would be "ok" as I know her psych will put her on something else or insist keep her on this. Since it's been 6 weeks exactly once her symptoms began I know it's effecting this behavior.i don't want her to go through we but would prefer to get this out of her system what would be the best way, every other day dosing? What I said advisable? Thank you

[Debziere]

Hello Debziere,

 

Such a difficult time for you as a mother, wanting to protect your daughter.  Hopefully the information we have here will help you to build a safe plan.  We recommend a gentle taper, reducing by no more than 10% of your current dose each month.  This allows the brain time to adjust as you go, and lessens any withdrawal.  Some of us reduce by smaller amounts, or follow a micro-taper.  You could have a read of those threads and see if either way resonates better with you. 

 

It's true she has not been on it that long.  Usually we say if a person has been on it for a month or less they can reduce a bit faster, but that may not be advisable with your daughter already being so fragile.  Have there been any changes in your daughter since the increase to 20mg?  If not, then you may indeed be able to simply cut that back to 10mg, as you say.  But if there have been changes, then you might like to approach that more carefully.  Perhaps down to 15mg one week then down to 10mg the following week - but it will depend on exactly what's been happening for your daughter lately.

 

Tips for Tapering Prozac  It comes in a liquid, but if that is difficult for you to obtain, you can make your own.  The instructions are in that link.

 

Many people find Fish oil and Magnesium useful during withdrawal.   

 

Keeping things simple in your daughter's life will also help: 

Keep it Simple; Keep it Slow; Keep it Stable

Non-Drug Techniques to cope with emotional symptoms.

 

Please put your withdrawal history in your signature – all drugs/dates/dosages etc - so we can see your daughter's situation easily whenever you post, and help more accurately.  Thanks.

 

Symptom Checklist

 

Have a read of those and then come back to this thread to discuss things further.  This can be your journal to record your progress and to ask questions. 

 

Welcome to SA,

Karen

thank you I have printed lot of this and appreciate the Information

[nz11]

Debz if you read that great link from Karen on keep it simple you will see that every other day dosing is not the way to go.

 

Its an illusion to think that 'there is another med that can help' (its actually a doctor talk originating from the flawed tailoring hypothesis) they are all dangerously the same.

I think that sounds a safe idea to keep her home from school for a while. Many people lose their jobs going through this.

[nz11]

This is what the doctor , pdoc should have informed you of:

.....................................

On September 14, 2004 the FDA added a Black Box Warning in regard to antidepressants & suicidality in those under age 18.

 

On September 14, 2004 the FDA mandated that pharmacies provide to all parents or guardians for those younger than 18 an Antidepressant Patient Medication Guide.  This guide reads (in part) “Call healthcare provider right away if you or your family member has any of the following symptoms: Acting aggressive, being angry, or violent & acting on dangerous impulses.”  This Antidepressant Patient Medication Guide also states “Never stop an antidepressant medicine without first talking to a healthcare provider.  Stopping an antidepressant medicine suddenly can cause other symptoms.”

 

On September 14, 2004 the FDA mandated that pharmacies provide to all parents or guardians for those younger than 18 an Antidepressant Patient Medication Guide.  This guide reads (in part) “Call healthcare provider right away if you or your family member has any of the following symptoms: Acting aggressive, being angry, or violent & acting on dangerous impulses.”  This Antidepressant Patient Medication Guide also states “Never stop an antidepressant medicine without first talking to a healthcare provider.  Stopping an antidepressant medicine suddenly can cause other symptoms.”

 

On December 13, 2006, the Black Box Warning for suicidality was updated to include those under age 25. The Black Box Warning is included in the insert to the drugs and in the Physicians’ Desk reference.

...............

Heres the thing the risk of drug induced suicidality is there for all ages -  doctors and pharma dont tell you this they have kept it hidden.

[Altostrata]

Welcome, Debziere.

 

If your daughter has been on 20mg for only about a week, you can back down to 15mg by taking one capsule and making a liquid with the rest. Do this for a week. Then back down to 10mg, taking one capsule per day only. We can talk further about tapering after that.

 

Any doctor can prescribe Prozac, it doesn't have to be a psychiatrist. If you don't think you can work with that psychiatrist, perhaps you can talk to your family doctor about your daughter's apparent adverse reaction to Prozac.

 

It is very well known that there is a heightened risk of adverse effects from antidepressants among adolescents and teens. If your psychiatrist denies this, you definitely need another doctor.

 

Ask your daughter to tell you how she's feeling every 4 hours (not while she's sleeping) as you make changes in the drug, particularly after she takes her daily dose. Keep notes on paper about her symptoms, the dosage, and the time of day she takes it. Please let us know how she's doing.