Hi,

We had an appointment with the psychiatrist yesterday to discuss medication. My son refused to go to the session and had a complete meltdown. I felt pretty flustered by the time I turned up at her door. Luckily she has met my son before and her and I have talked more recently about medication - so she prescribed fluvoxamine (comes under various company names). This is what they use at the university in their study of School Refusal (the program my son was not 'bad enough' to join as he hadn't been absent from school for 2-3 months in a row).
Does anyone else use this medication?
He is to take it at night as it can cause drowsiness. She feels that even this might not be enough for him to feel much different. She wants me to make sure he understand that he has to commit to taking it. She told me not to stress if he refuses to take it. I haven't talked to him about it yet - although he knows I went to talk about medication - as last night was so topsy turvy.
How have others found in their children taking the medication. Do they just take it - do they resent having to take it? Do they try on some days not to take it?

The psychiatrist says that it might be another couple of years of much the same as what we are currently going through until he starts to be motivated to help himself manage the anxiety. I'm totally exhausted now - so somehow have to get some strength back to pull through how ever many years it might take....and more.
Anyway - I know I have asked about medication before - but any insight you have, especially on this particular medication would be appreciated.
Thanks,
Linda

Hi Linda, I am glad you have finally found someone willing to at least try medication to see if it helps your son. I think I have mentioned before that we have tried quite a few medications in our search to find one that helped my daughter. The one that helped when she was younger was Fluoxetine (prozac) and the one she is currently taking which has been excellent is Escitalopram (lexapro). We did try fluvoxamine at one time as my sister takes this for panic attacks and finds it really good but unfortunately it didn't help my daughter. Everyone seems to be different and sometimes medication will work for a while but then need the dosage adjusted or even changed. My sister however has been on the fluvoxamine for ages and it is still working for her.
It is very important that your son understands that once he commits to taking medication, he has to take it every day and at the same time. Missing tablets, taking at different times of day can all play havoc with their moods. Everyone is also different in how they respond to medication, side effects etc. My daughter responds quickly if the medication is going to work, but some of the ones we tried actually made her more anxious so it helps if you have a good relationship with your doctor as ours is available to ring and will give advice, change scripts etc over the phone which has helped keep me sane :-) Sometimes they will feel yucky in the first few days of starting a new medication or increasing a dose but this usually wears off quickly.
My daughter has been through stages where she doesn't want to take medication (usually when someone has tried to tell her she doesn't need it :-( but she now realises at this point in her life she can't cope without it. I still mostly have to physically give her the medication but she is good when she is away from home and makes sure she takes it (although I usually confirm via sms
I hope your son is willing to give this a go and that it does help him. The other thing to take into account is that sometimes the medication will help with their overall mood but it is still not enough to overcome the school refusal. With my daughter however, it has enabled her to feel well enough to at least put other things in place that have helped her get back to school whereas before she started taking the medication she is on now, most of her days were spent trying to stay in bed sleeping to avoid the world. Let us know how you go - you are an amazing mum

Hi Sandy,

It is good to hear your story now that I have the script. I have heard from others too that it does sometimes take trials of different medication. It is such a long process - I feel like I have to pace myself and be prepared for whatever happens (or doesn't). It is such a pity that there isn't something that immediately helps. Was it a frustrating time for your daughter- having to trial different medication? What about withdrawals when coming off this medication?
It was really good to hear that your daughter knows she needs it. I think my son isn't at that stage yet in his maturity.

I'm actually also having great problems with him and his anger. He just seems to be angry every day now and snarls and yells at me (is this being a teenager or the frustration of anxiety?). I know some others on here have had difficulty with anger and SR/anxiety. It has just worn me out this last week though as it take me by surprise - and it is so full on as he vents all his anger on me. It is verbal, not physical - but I do worry about it moving into the second stage.
He has always been such a lovely boy - so different than the boy he is now - it breaks my heart to see no improvement after all these years. I feel like we were passed from one to the other as he 'wasn't bad enough' for so long that non of them could see how serious it was until now they suddenly start realising that it shouldn't have gone on for so long.
This has been for 7 years now.
I Know I have to be strong and I usually manage to get my thoughts out there and positive again but just feel a bit worn down right now as I wonder if I will even get him to any social event this year, including the family Christmas dinner. I don't know that I will get him to the cranial osteopath - so haven't booked her yet. We only have 3-4 weeks of school left till the long holiday break but I'm not even looking forward to them as weekends these days are spent with me dragging him off the computer - him yelling at me - and then crying about hating his life and not wanting to go to school. Weekends used to be a break....but not any more! So I guess we have come to a climax as he has tried his hardest to attend school all year. I will start the medication at the end of the school year so that any side effects are not a problem in regards to attending. He has been attending less and less and begging to come home at morning tea or lunch and I have been picking him up but I just don't think it is the right thing any more - I don't know if I know what is the right thing. I know I introduced my 'plan' and everything seemed to fall apart but I think instinct tells me I introduced the plan as I could see things were falling apart - so it was to stop it getting worse - but I think it was too late. So it's just a matter of surviving the next few weeks as best we can and somehow getting him to feel better about himself again. Sorry.....feeling a bit overwhelmed at the moment!!
Always good to hear stories of kids breaking through and taking those steps forward though. I know it was my son who did this earlier this year - but I hadn't thought he'd go backwards.

If anyone else also has experience with Fluvoxamine (Luvox) - it would be good to hear.

Take care
Linda xx

Hi Linda, so sorry to hear how exhausted you are. I feel the same but some weeks are better than others. My d is suffering side effects of fluoxetine at the moment and in a way it is buying us some time without school pressure.

I'm running out the door in a minute so don't have time to post more right now. We are new to this too, I was so relieved d was prescribed the meds only one week back, but feel a bit disheartened that so far the side effects are quite heavy for her. She was told to take them in the morning but I am going to try changing that to just before bedtime, that way with the tiredness, hopefully she will sleep through the worst of the nausea. Everyone reacts to these meds differently so it doesn't mean your son will experience them.

Will come back to post more later. Try and take some time to put the worries of SR aside if you can. This road is so so tough sometimes. Hugs from across the world, Clarity :)

Hi Linda

As you know my son has been taking meds for about six weeks now. Was started on Citalopram but this didn't seem to be working so the doctor changed it to venlafaxine. The psychiatrist isn't happy with this medication and wanted to change it again but my son got so anxious about the change she agreed to keep him on it and monitor him closely. He is now taking 2 x 75mg tablets in the morning and a 40mg beta blocker at night. He was so frightened about taking them at first and read all about the side effects on the internet, so much so that he refused to take them for the first week. He became so anxious one day though that he decided himself to take them. I think your son has to get to the point where he believes he needs this help in order for him to accept taking them.

At first it was difficult for my son to swallow them but now he takes them with no problem. He has suffered no side effects at all despite convincing himself that he would. The only issue is that he feels lethargic sometimes. We were taking them at night at first but the doctor advised taking them in the morning to get the full effect. My son's meds are slow release so they release into his system slowly throughout the day.

I can sympathise with you about the anger. We spent months treading on egg shells in case my son errupted! I think they are so frustrated with the way they feel that they take their anger out on those close to them.

We are starting to see an improvement in my son. He is nowhere near as angry and some days his mood is really good, although he isn't going to school at the moment and so doesn't have that pressure. The psychiatrist believes he will get much better over the next few weeks but I am not convinced that he will get back to school! He is talking about changing schools for what we call "6th Form". There is a High School near his old school that is for girls but they take boys in for the last two years so I think this will be a much better environment for him. The only thing is we have to get the grades to be accepted - which is a big ask when we are trying to work from home! We can only do our best.

I think we try to think about too many things at once and this is so stressful. I am trying to prioritise my son's wellbeing at the moment until the New Year when we can hopefully get down to some serious work when his mindset is hopefully better.

We, like you, cannot think about socialising at Christmas. I know my son won't be able to cope even going to see family members. My brother wants us all to go out on New Years Eve but there is no way my son will be able to go and we won't go without him so it will be another quiet one for us!!

I really sympathise with the way you are feeling at the moment Linda. Last week I felt as though I had come to the end of the road and didn't know how I was going to get through the coming days, but things do seem a little brighter at the moment. It really is taking one day at a time!!

I hope you can reassure your son about taking the meds, I'm sure they will help.

Let us know how you get on. My thoughts are with you xx

Thanks Clarity and Kathy,

Hearing your stories and reminding me I am not alone is very helpful. Even though I know we all go through this - I sometimes still end up feeling overwhelmed and can't see the way forward. So thanks for helping : )
Our psychiatrist said to take the tablets at night to reduce the side effects of drowsiness. But that does mean that perhaps they are not working to their full potential next day and wearing off? Hopefully not - but perhaps after they get used to them they can change when they take them. It is a pity that there are any side effects at all.
I spoke to my son about the medication last night and he just went quiet and said 'yes' he'd take them.

And even if they just take the edge off that frustration so that the anger subsides somewhat. Interesting that your son is not as angry, Kathy. It is awful when we have to walk on eggshells. It is bad enough parents facing teenagers mood, but with the anxiety - our experience is something else again. My son has begged to be picked up early again today. I think my main aim at the moment is to just get him through the next few weeks as best I can. He may refuse to go in on Friday when I take him - so I have to be glad that at least he is getting to school when his dad takes him, even if he does come home early. Haven't been able to let his dad know about all these times but I did tell him about yesterday. He was ok about it but that is because he thought it was just a one off. Oh well....the things we get tied up in as we try to help our children!

I haven't had trouble with Christmas in the past - at least lets say - he hasn't wanted to go - but he has gone and I knew he would. This year looks different as he is older and more stubborn. My back up is my nephews (in their 20s) coming round to help get him there. I can't not go and I can't leave him home - that would be awful!
New Year is always quiet for us as we get invited to a friend's down the road every year and every year my son absolutely refuses to go as there are other kids there (we don't all stay till midnight). So we stay home and listen to them all partying (it is a bit weird...and the first time I felt very teary but I am used to it now!!). I don't blame him for not wanting to join a party - he has never been able to cope with parties - even kids parties - so nothing new there.

I hope you are able to work through your son's education, Kathy, and that the school does take him on. They have no idea what we got through just to get our kids to have some education!
Sandy, Kathy and Clarity - hope the rest of the week is a good one for you. Thank you for your support - I feel a bit stronger now.
Take care,
Linda xx

Hi Clarity,

How are the side effects going now? Have they subsided?
Our two drugs sound similar - but they are different. I wonder what makes them decide what to prescribe to teenagers? I am hoping the fluvoxamine have less side effects when we start them.
How long did they say your daughter had to be on these before she might feel a bit better?
Let me know how you go and if she is able to keep on them or needs to change because of the side effects.

My son isn't going today. I feel a bit flat about it as he has only made one and two half days this week. But I have not been able to tell his father (who texts every morning to ask has he gone). I hope he doesn't read this forum!
I just think it is like checking up. I know he thinks we are working on the same plan and that getting our son to school is the main thing but I also know there are days when my son just cannot make it without too much stress. So we lie...and I hate that - it is a horrible feeling. Do you think I should just be telling my ex when he doesn't go? But then he is very likely to turn up at the house and force him to school - which is why we don't tell him.
I then can't communicate with the Year level coordinator as he always includes my ex in his reply emails (Even though I asked him not to!!). He made me feel so small when I said that it was important that I could email him without my ex always being included - he said there was no way he would ever do that. Do you think they'd do that to a man? I have a sneaking feeling it is this 'she is a soleparent and she is too soft' attitude that drives him to make sure my ex is included in everything. Anyway - just having a whinge here. As if it isn't bad enough with my son home when I wanted him at school - I have to go through the guilt of lying. Aghh....we can just never quite win as mums .....or parents. Does anyone else go through this? My ex texts me every morning (except the mornings he takes him).
The school are liable at any moment to text both of us and say 'why has your son been absent for so many days?'...then what do I do!? Face the firing squad : ( We have enough to deal with without feeling like we are doing the wrong thing all the time. It really really wears me down.

Hope all is well Clarity and that your daughter is more able to handle the medication as time goes by.
Take care,
Linda xx

Linda I so so get where you are coming from. My ex is similar to yours and leans more towards tough love (sometimes authoritarian) style and even though my aim is to be a balanced healthy parent as far as I possibly can be, I do fall into the gentle category. As hard as it is, being as united as possible as parents is something I am realising we need to keep working towards. Until now I have been keeping x out of the picture as much as poss but this is frowned upon by profs.

With x and I, our parenting styles are poles apart and could do with both of us stepping more towards middle ground when dealing with our kids - of course being longtime separated makes that difficult too - we separated because we are so different in many areas. Over the years I have told lots of white lies too to save my girls from his finger wagging telling off's. Shaming is a big no no in my book and in the past their dad has used this tactic with them a lot, in a big voice! Thankfully as they get older they are finding ways to set their own boundaries with him, they know that shaming is not ok.

I firmly believe kids need as much love, understanding, validation, support and guidance as they can possibly get and sometimes that clouds my judgement when it comes to boundaries and discipline. Having said that, neither of my d's are difficult kids, they are polite and kind and not poorly behaved - a bit lazy with helping round the house etc and I don't enforce too much (working on it!), but last time I checked that is 'normal' behaviour for any teen.

Re the meds - the side effects got worse for d and she was just becoming more zombie like, sleeping all day, very low mood and feeling too sick to eat. Two days ago she told me she did not want any more of the meds, she would not adhere to a tapering off (she'd only had 9 doses in total) plan and said she didn't want any more of it in her body. Yesterday she actually seemed a bit brighter and even made it out with me and a friend to see xmas lights switched on and later pizza - for her that is huge! She hasn't been in to school at all for a couple of weeks now.

I had a melt down the other day as it looked like an intervention had been planned with x and school. It wasn't the case but a lot of crossed wires led me to believe it was for a while and I lost my cool and laid out exactly why I am not ready to hand my vulnerable d over to her dad so I can have respite and he can be the white knight that gets her into school 'kicking and screaming in her pyjamas if necessary' - his words to me when I told him his tough approach would not work on d, she would need a lot of understanding and emotional support too. It was at that point I lost it and phoned the SC to say the respite plans were off.

There is another professionals meeting nxt week, her dad and I will both be there alongside around 6 multi agency folks. D is writing a letter to be read out at the meeting and her dad and I are going to spend time this weekend going through paper trails so we can point out very relevant errors on the part of various departments that have added to d's slow recovery and school refusal. It is hard to try and be united with her dad but I am going to try my very best - I keep reminding myself that his intentions for her are good, as are the profs involved and as are mine. It's the fight along the way to get people who are there to support us to really 'get it' about SR and in my case the longterm affects of bullying.

Like you, I am exhausted Linda and I feel misunderstood and unsupported (in the ways that would benefit me and d) - It feels like pushing against this huge wall of misunderstanding, just one person trying to prevent it from falling on top of our kids. While 'the wall' see us as a big part of the problem that is preventing our children's recovery. I am not happy about being labelled an enmeshed parent - I am tired because of their continued misunderstanding, scrutinies and judgements NOT by my child's trauma - that I can handle. We get drained and our kids get lost in this tug of war and that is what is so very sad because it leaves us less and less positive energy to give to them.

I wish the people involved your end could see that your son's attendance for one and then two half days is a big success, something he should feel good about. It is this heavy energy of 'it's not enough, try harder, our expectations are higher' that doesn't help - how can there be a sense of achievement for our children in the face of all that pressure, it just makes them feel like they are continuously failing so why try at all - So clear to those of us with eyes to see

Ranting it out really helps - your turn Big warm understanding hugs coming your way, Clarity

Thanks for your lovely long reply, Clarity. I have read it a couple of times and am very thankful of your support. Hugs going your way too ...hopefully on a fast plane.
I need to make a correction regarding the medication used by Monash University for their research into School Refusal - they actually used fluoxatine - which of course seems to be perhaps more commonly used by others on here. We might end up on that.

I had a really good chat with one of the people who run the research program yesterday and they were very supportive. The results for their research will come out next year. I will keep you all posted on any link to that or quote some in a post in regard to what they found. They worked with 60 kids at high school age and I think I may have mentioned in a much older post that (and apologies if I have any of this not quite accurate). They all received CBT but some received medication and some received a placebo and some received no med. He did emphasise the support parents need and said that they recommend to the parents they work with that they receive their own counselling of some sort and talk to their doctor or a psychologist.

They found the schools were quite flexible and cooperative (perhaps because it was a research project from a university rather than just individual parents?). They had an equal amount of boys and girls in the study who had applied. The students had to have been absent for more than a couple of months I think - some had been absent for a year from school. It is the most recent study done on this. It was focused on the best way to get students back to school. We will put a link to the research when it comes out. It was lovely to talk to talk to an academic who knew exactly where I was coming from.
Keep your eye out for any other research being undertaken anywhere.
Hope you are going ok Clarity. I have cheered up a bit as each day passes closer to holidays. My son still has angry outbursts though and some of that may also be just down to not having eaten enough during the day due to the anxiety. So a catch 22 situation really.
Take care,
Linda
There is a powerpoint presentation that some may find interesting/helpful that they have used in their program.
http://www.med.monash.edu.au/spppm/research/devpsych/download/rdudley.pdf