Q: My son has severe autism and has been on zoloft for years. Because of his crying and anxiety, we have switched him to Lexapro. He is now showing signs of severe OCD. Can he take zoloft AND lexapro?
Hi Sharon
I am in a similar boat. My son has severe autism too. May I ask...how old is your son?
How long had he been taking the Zoloft?
We had a similar experience with prozac...it worked well for some time (almost two years) and then it pooped out. Upping it did not help. We did a simultaneous taper where he took prozac and Celexa at the same time...lowering the prozac and then upping the celexa until he was only on Celexa. For my son...he was also showing extreme aggression. We also put him on Risperdal. The Risperdal and Celexa combo has been a miracle for my son. But it took some time to get the right dosage. He has gained weight so we are back to adjusting some.
Please know that I am not a doctor or a pharmacist. I am a parent just like you.
I would suggest the following:
Write a daily log of his behaviors and mood. Take this information with you to his doctor. Remember that medications normally take 6-8 weeks to reach their full therapeutic...potential. If you are just starting the Lexapro it might take some time for it to kick in. If the OCD is really out of control though...you may want to call the doctor to ask what to do. If your son did well on Zoloft...there are other medications in this class of antidepressant that may work just as well.
Let us know more details and I can try to give more suggestions on this.
I hear you....I am going through the same thing with my son. It is very difficult.
Thanks for reaching out here.
Hi, and I hope you are making progress with your son's treatment. I am a practicing psychiatrist but mainly deal with adults, so take this with a grain of salt!
in general serotonin reuptake inhibitors (zoloft, paxil, lexapro, etc) can be very helpful, though there is much debate about how high to push the dose in this context. If one is helping partially with symptoms or behaviors, then adding a second agent such as an atypical (risperdal or seroquel are useful) or possibly an ADD agent (think clonidine or a new one, intuniv) can be helpful. If lexapro is not working so well, then I would consider another serotonin-based agent, such as prozac or luvox, which are both usually helpful with anxiety, depression and ocd.
in general I have not seen good results with sedatives such as valium, klonopin, xanax etc. since these tend to trigger sedation and impair cognitive function, which is not a good thing for most of us. sedatives can also have an opposite effect at times and trigger increased agitation, so that needs to be considered.
adding 2 ssri's together can lead to nausea, headache, insomnia, and flushing so this should be avoided other than perhaps a 5 to 10-day crossover, when one is being reduced and the other increased.
keep me posted and good luck with your efforts! I hope you have a good behaviorist as well, since this goes a long way.
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