My son just started Effexor and only a small dose of 37.5 mg for anxiety and worry and hx of headaches. He is 18 and has ADHD too. He has had severe insomnia since starting this and is supposed to go up to double the dose after 7 days. Is this normal during the inital phase? what is the best anti anxiety med for an 18 you male?
Hello and welcome to the forum,
I don't have any experience with this medicine but some on here do so if you don't get a response soon keep checking back. The also have anxiety and ADD/ADHD forums that you can post this in.
Honestly, these kinds of meds were never intended to be used on teens and children, as there are some risks. The biggest one is strong suicidal ideations. That doesn't occur with everyone, but it occurs far too much. Also, at that young age, often the meds work in opposite eways than they were intended. You're already seeing some negative effects with the insomnia...anything else going on?
I personally would recommend a non medication approach first (therapy, etc) , and try to hold off on meds like ADs for a few years if possible. In the early 20's, those meds will work much more like thaey are supposed to. Just my opinion.
No matter what, be sure he is being cared for by a child/adolescent psychiatrist, not an adult psych. There is a BIG difference.
Also being that his primary complaint is anxiety and not depression, the SNRIs like Effexor aren't usually the best first line med, as they actually cause or increase anxiety due to the increase in norepinephrine. An SSRI antidepressant, like Zoloft, Prozac, Lexapro...would be FAR more optimal as a first med to try.
Thanks for your response. I was surprised Effexor was the first drug they tried. Maybe because he is 18 but that is young. However my ex husband took him to the appt. The doctor is a pediatric neurologist who is also seeing him for the headaches and ADHD. My son actually hasnt been taking his ADHD for awhile because he has no appetite when he takes it. So i didnt push him to take it either. He was diagnosed at an early age of 5 as borderline ADHD but the pediatric psychologist at the time didnt push meds and i didnt want to give him meds. Things slowly got worse with his behavior and I think our divorce. But he stayed in and out of therapy to no avail. Then last year the ex took him in for the headaches and started pushing the ADHD and the doctor gave him a generic concerta and sumatriptin for the headaches. the concerta helped him tremendously with his work but the headaches havent gotten better. I felt strongly about prophylactic migraine medicine so when his dad took him into the doctor he decided to place him on Effexor because he also had issues with occasional panic attacks, racing heart and dizziness which i think the doctor felt was anxiety. He has been worrying more about college etc. Only issue is now sumatriptin and ibuprofen can't be taken with the effexor. So now when he does get a headache not sure what he will take besides acetaminiopen. since i initially wrote this he is feeling much better he actually increased to the double dose as ordered and is feeling better. less headaches and less everything except dizzines occasionally. He's also sleeping better again. i will keep following and see how it goes. Thanks.
Actually I thought some of his behavior could be caused by the ADHD medicine but even off of it he has become worse so I don't know. I don't think its rebound either because he has been off the medicine quite a while. thank you.
So glad that your son is doing better with everything. With the headaches, you should not take any pain relievers more than twice a week to avoid rebound headaches. There are plenty of daily preventative migraine meds that are not a problem with Effexor which I also take. I personally have terrible chronic migraines, but cannot take any anti-inflammation meds due to kidney failure. Acetaminophen can do a lot for headaches, plus there are other stronger pain relievers available by prescription. Talk to his doctor if he is still having any problems.
Thanks for your comments sara. Yes we have been through the rebound many times and have warned my son about them and he has even had to take the Medrol pack just to stop the rebound symptoms. Now he is purely using Acetaminophen and the migraines have greatly reduced with the use of Effexor. I'm not sure if I want to start an 18 yo on any heavier pain relievers by prescription but we do need to discuss other options than the sumatriptins for relief. We are in close contact with his pediatric neurologist.
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