My 16 year old son was treated for depression in mid august with Welbutrin and reached a dose of 300 mg. by mid september with little benefit. He also was in weekly psychotherapy since August.. He then was switched to Lexapro, 10 mg with welbutrin 150 mg. and quickly developed constant shaking, for four days. The psychiatrist said to discontinue the lexaparo, but my son then began showing a seizure-like presentation, with grimacing, teeth clenching and fist tightening, head jerking, eyes rolling back and when brought to the emergency room, his b/p was 150/90. He was given IV Benedryl and Ativan and he calmed down and went to sleep. These episodes have not stopped since then. We took him of Welbutrin and he was med free for 8 days. His seizure-like episodes continued and were prompted by any negative thought or stressor. He then began Zoloft therapy, with slow titration until reaching 175mg. Along with this, he was given Buspar, clonopin, and cogentin to help him with these supposed panic attacks that the dr. was treating. We found no improvement with these meds. Two weeks ago he obtained 36 hr. continuous eeg. monitoring and video taping in an epilepsy unit in a hospital. The neurologist found no EEg abnormalities, and a psychiatrist who works with epileptic patients evaluated my son as well. Both doctors concurred that my son has pseudosiezures and a conversion reaction. They felt that once my son was made aware of no physical cause for his siezures, he would improve with psychotherapy. Two weeks have passed. He takes only Zoloft, 150 mg. daily now. Symptoms have not subsided and we are now going to see a doctor who specializes in hypnosis and conversion disorders. We wonder if any other tests should be performed to rule out any organic problems. He has had a cat scan of the brain-no significant findings. We wonder if an MRI would be more conlusive. No doctor is recommending this. We also wonder about the adrenal gland-tumor? or any endocrinological imbalances-He took a 24 hrs urine VMA test and found elevated catacolymine and VMA levels but dr. felt this was of no concern based on volume of urine collected.
Do you feel psych testing could confirm this diagnosis?. How could psych testing be helpful? We don't want to miss a medical condtion that may be causing these spasms. What other tests should he take? Could a sensitivity to SSRI medications cause an extra sensitivity in a person to stressful stimuli. These symptoms all occured after his dystonic or extreme shaking for 4 days from Lexapro. We wonder whether we should stop all SSRI medication(Zoloft) and see if these spasms stop. It was recommended that we first pursue treatment for conversion reaction before taking him off Zoloft since he has experienced positive mood elevation from it. He has missed 2 months of school. Has just begun home tutoring in limited subjects-he has spasms during instructions but can regroup after an attack and resume instruction.Please advise us.Thanks