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Re: Remeron and Zoloft for MDD, my 13 yo daughter jono_in_adelaide

Posted by laurah952 on June 23, 2013, at 8:40:57

In reply to Re: Remeron and Zoloft for MDD, my 13 yo daughter, posted by jono_in_adelaide on June 22, 2013, at 22:14:30

Remeron + Zoloft seems a reasonable combination, but if it doesn't work, there are plenty of other combinations out there that work on diferent neurotransmitters etc - for example, Zoloft + Welbutrin in the morning, and Risperidone at night.

A child/adolescent psychiatrist would seem an obvious choice, with some pretty intense therapy.

Hi and thanks for the reply,

My daughter's pdoc (yes, an adolescent psychiatrist for 22 yrs) advised me to continue Zoloft 100mg, stop Seroquel, start Remeron, and if Remeron wasn't tolerated, to re-start the Seroquel again. I just don't understand why an anti-psychotic or tetracyclic antidepressant as opposed to a mood stabilizer.

One thing to note about my daughter's thinking, and perhaps why Seroquel was chosen at first. She was completely consumed and obsessed with thoughts of suicide. She was supposed to keep a diary, so to speak, as per her therapist, but she wrote over and over and over; pages upon pages of ways she was going to kill herself. She had an exact date set, and made her plan "foolproof" in that she was going to do three things to end her life; suffocate herself while cutting her wrists while swallowing a bottle of pills. (that's when she became an inpatient at an adolescent psych unit)

This is not the case now, but suicidal thoughts still enter her mind, approx. 10% of the time. The seroquel zeroed out these thoughts, but at the price of becoming a zombie at the higher doses. She also has insomnia which doesn't help - she just needs to get up in the am.

Bottom line - she is much more outgoing now, finds happiness in her friends and life again, yet her moods are up and down all day long (not overly so in either direction, but just enough to need something more) She's been on Zoloft 100mg for 7 weeks, and Seroquel 50mg for maybe a week or two. (after coming down from 200mg started at the same time as the Zoloft)

I apologize for, well... babbling on (pun intended) and hope I've made some sense.

Thanks for any and all help - I've got to corner the pdoc, ask her to listen carefully to my questions, and give me answers w/o deviating from the topic at hand. Been difficult.

Thank you all!
Laura


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poster:laurah952 thread:1045685
URL: http://www.dr-bob.org/babble/20130617/msgs/1045722.html