Psycho-Babble Medication | about biological treatments | Framed
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TOBY/Other Professionals: ADVICE RE ADOLES. DEP.

Posted by mk on March 23, 1999, at 16:44:10

Toby: after reviewing this site for the past
few days, I've noticed that you are a professional
who seems to keep up to date on psychopharmacology
and actually responds to queries. Hope you
have time to respond to this one.

Our problem: 16-yr-old adolescent with
major depression for past 2 months. Zoloft
at 50 for 2 weeks/100 last 2 weeks and 125
last few days. Not getting a therapeutic
result yet on zoloft but is having some
mild fine hand tremors. One dr. says tremors
are not major and should go away and keep
titrating zoloft to higher dosage since
adolescents tend to need higher dosages and
metabolize AD quicker--other dr. says switch
to Celexa. Researched Celexa and can find
no medical studies of its use in adolescents.
Are there any studies of its use with this
age group? We hate to use an unproven drug
with a teenager. Also, do tremors tend to
come from side effects on neurotransmitters
other than serotonine such as mild effects
on dopamine and/or norepinephrine? Or all
all side effects to SSRIs just very
individualistic? It the tremors are likely
to come from specific chemical pathways it
would seem that if we change we would want
to change to a medication with another pathway.

What are the "practice guidelines" for
major depression with perfectionistic anxiety for
adolescent depression in terms of first line
medications? Note: since the depression,
has been sleepy so don't want an overly
sedating drug. Also, is in Cognitive
Behavioral Therapy which should help long
term but still need some help more immediately
just to get through day to day! Would really, really appreciate your response.




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