Once weekly Prozac in children?

[ryerica22]

Hi,
I was wondering if anyone has used this for kids? I have only seen one adult patient on it but am contemplating using it for a kid who does not want to take medication daily (teenager) due to forgetfulness. This is to address severe anxiety symptoms.

Any efficacy data?

Thanks

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[Crayola227]

if you can't remember to do something daily, I wonder about remembering to do something once a week on the same day

unless you're leaning on the parents and think this makes getting after their teen about meds, easier for them

 

[WisNeuro]

Any way to work with the kid to use other methods to remember? Keeping the medication in the same place? Putting it by their toothbrush (assuming they brush at least once a day). Utilizing smartphone alarms, etc? We run into the same problems with our older adults, and even the ones with mild to moderate dementia can increase compliance with some fairly straightforward behavioral interventions.

 

[TexasPhysician]

Never tried.

 

[singasongofjoy]

Can they learn to associate it with something they never forget to do? e.g., when I started taking a daily med and had a hard time remembering I put tape on top of the toothbrush holder; when I would automatically go to put my toothbrush back and it was blocked I would remember "oh yeah..." and I started keeping my toothbrush in a cup with a pillbox. (may sound a little ridiculous, but it worked! For me it works best if I purposefully disrupt/block my routine any time I am trying to change a habit). If they are generally forgetful, do they use checklists (or are they willing to start?) E.g., making sure they have all homework packed for the next morning, putting a reminder post-it note on the mirror?

 

[Crayola227]

time to start taking responsibility for daily tasks and self-care, never too soon to learn to take a pill everyday
(I'm biased as a female that opted for oral contraception starting at age 15, to say this)

especially given this is for anxiety, not depression

whatever you would do for once weekly would be similar reminders for daily, I would think

if you tied it to a regular weekly medical appt, I could see that

unfortunately I only have thoughts on adherence, not on efficacy

 

[st2205]

Any way to work with the kid to use other methods to remember? Keeping the medication in the same place? Putting it by their toothbrush (assuming they brush at least once a day). Utilizing smartphone alarms, etc? We run into the same problems with our older adults, and even the ones with mild to moderate dementia can increase compliance with some fairly straightforward behavioral interventions.

Either that or after going through effort to try to help them with their problem, they don’t have the heart to tell you they aren’t doing it.

 

[WisNeuro]

Either that or after going through effort to try to help them with their problem, they don’t have the heart to tell you they aren’t doing it.

Luckily, most of the time we have a spouse/caregiver who can double check and whatnot. I imagine in some cases they could both be lying, but I imagine it helps some people. In the case of this teenager, they are presumably of sound enough mind to incorporate simple behavioral strategies for med management. If they can't, there is no reason to suspect that the once weekly will be any better, even if efficacious when adherent.

 

[birchswing]

Hi,
I was wondering if anyone has used this for kids? I have only seen one adult patient on it but am contemplating using it for a kid who does not want to take medication daily (teenager) due to forgetfulness. This is to address severe anxiety symptoms.

Any efficacy data?

Thanks

Parsing this:
severe anxiety symptoms
and this:
does not want to take medication daily due to forgetfulness

There's not a lot to go on here, but not wanting to do something because you're forgetful about doing it doesn't track . . . unless there's something more, like anxiety.

Nothing you wrote indicated OCD, but there could be a hypothetical case in which a person with OCD worries they won't be able to remember to take a medication daily (when they rationally know they will remember to, yet have intrusive thoughts of distrust that can't be managed). Now, while nothing you wrote indicates OCD, it's an example that logically tracks more than not wanting to do something because you're forgetful. I just don't even see the semantics of that. "I don't want to water my plants because I'll forget to" doesn't make sense. A person with OCD saying, "I might make a mistake watering my plants so I won't do it" also doesn't make sense rationally but is a predictable thought pattern given that illness.

Also if the medication does work for anxiety, it's difficult to understand why an anxious person wouldn't be motivated to take it in a way that works . . . unless there's another reason, and given the limited information, maybe that other reason is based in anxiety and not true forgetfulness.

 

[Shikima]

Or climb into a bottle. That's all xanax is.

 

[hamstergang]

I had one adolescent patient who was forgetting to take it daily too often and so switched to weekly. She was then actually consistent with it. The only problem came when we wanted to up the dose and I wasn't sure how. The weekly version only comes in a 90mg pill (I believe somehow different than regular pills at 90mg to reduce GI symptoms) so do you double that up or just add some more (how much?) of the regular stuff?

 

[hamstergang]

"I don't want to water my plants because I'll forget to" doesn't make sense. A person with OCD saying, "I might make a mistake watering my plants so I won't do it" also doesn't make sense rationally but is a predictable thought pattern given that illness.

Both of these statements do make sense without OCD. I don't understand why you think it needs to be a disorder to give up on something you don't think you're doing right.