Down & Out: The story of one mother's journey through her son's depression -- Part 5
The Medication Journey Continues
“Imagine walking down a dark, deserted alley late at night,” Dr. Thornton once told me. “Now imagine someone or something suddenly coming up behind you. How would you feel? What kind of physical sensations would you have? Well, that is how your son feels all the time. This type of anxious suffering often leads to depression.”
And so we began our journey through the medicine maze. While I always considered medicine a science, I soon realized that it was an art form, especially when it came to treating children with adult medications.
At first Valium provided the calm to help Nicholas sleep. This calmness translated into stillness during the day as well, a feeling at first welcomed then questioned. Nicholas no longer seemed driven to do well at school. What was once a need for perfectionism became a blasé approach to class work. No longer did he keep himself fastidiously clean due to his obsessive compulsive nature. Now he required reminding to wash his hair, change his clothes, and brush his teeth.
“This should take the edge off,” Dr. Thornton told us when she first prescribed the medication. That “edge” had a purpose I realized. I began to wonder if this was the right approach.
A month before our next appointment with Dr. Thornton, when I intended to discuss my concerns, the positive effects of the prescription wore off. The calm no longer lasted, not even through the night. The dose was increased and then increased again. Both times the Valium would return Nicholas to a state of controlled quiet for two weeks, then abruptly end, having no effect at all.
I was convinced that if only my son slept through the night, if only his anxieties did not force him to toss and turn or wake up screaming from a night terror, all his troubles would end. I envisioned a Nicholas who enjoyed learning at school and showed pleasure when a friend wanted to play. I held this theory: Because he suffered sleepless nights, he held no reserves to function happily during the day.
“Let’s try another avenue.” Dr. Thornton offered. “I understand your concern and you are right. Quality sleep is key when dealing with stressful situations. Your son is handling many different issues; anxiety is only one of them. Are you willing to try another medication?”
“Such as?”
“Such as Trazodone. Trazodone is used to treat depression and to help a patient sleep. It is in a class of medications called Serotonin Modulators. It works by increasing the amount of serotonin, a natural substance in the brain that helps maintain mental balance.”
This time the effect lasted longer, but not without end. After six months on Trazodone, with an occasional need for Valium and little improvement, the doctor offered another medication: Remeron. Again, she cautioned us not to expect immediate results. It took weeks before we would notice the effects of this medication.
At each visit, Dr. Thornton discussed openly that the medications she prescribed for Nicholas did not have benefit of clinical trials, as few parents would subject their child to such testing. With Remeron he may have an allergic reaction such as swelling of the lips, face or tongue. He may have difficulty breathing or flu-like symptoms.
“If any of these occur, stop giving him the medication and call me immediately. You should know that other less serious side effects may occur such as nausea, increase in appetite, dizziness, dry mouth or constipation. Let me know if he has problems like these but don’t take him off the meds until we talk.”
Our journey continued. When the Remeron didn’t work, he tried Wellbutrin. On this medication, Nicholas suffered severe headaches, acted agitated, and slept even less. Dr. Thornton reacted promptly, suggesting Clonidine, an anti-hypertensive medication used to treat high blood pressure but recently prescribed for insomnia. This time the nausea was intolerable.
He tried Zoloft, an FDA approved drug used to treat depression, social anxiety disorder, Posttraumatic Traumatic Stress Disorder (PTSD), panic disorder, Obsessive-Compulsive Disorder (OCD). On Zoloft Nicholas slept well at night but was unable to shake the drowsiness until noon each day, and the hard candy Nicholas sucked to relieve dry mouth could easily become a dental nightmare. The only upside to Zoloft was that it was approved for OCD in children and adolescents age 6-17 years, but OCD was not Nicholas’ main problem.
Finally, Dr. Thornton suggested an antidepressant called Paxil, another Selective Serotonin Reuptake Inhibitor (SSRI). Paxil seemed the perfect solution. Improvement was gradual yet steady. We thought we found our magic pill.
Part Six: The Paxil Problem and Other Therapy Solutions
Read the beginning of the series:
Part One -- Pre-diagnosis
Part Two -- Diagnosis
Part Three -- Alternative Therapies
Part Four -- Medication
