F.E.A.S.T's Around The Dinner Table forum

Welcome to F.E.A.S.T's Around The Dinner Table forum. This is a free service provided for parents of those suffering from eating disorders. It is moderated by kind, experienced, parent caregivers trained to guide you in how to use the forum and how to find resources to help you support your family member. This forum is for parents of patients with all eating disorder diagnoses, all ages, around the world.

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elsiejo
Hi my 15 year old daughter presented with AN in June this year. She is now 16. We went to
a therapist who worked with us and coached us on FBT. My daughter did not connect with the therapist who used art therapy. She was restricting and over exercising and self harming. We plated meals and supervised eating and she has maintained a weight that shows normal BMI unfortunately the AN thinking is very strong and she  feels like a failed anorexic.
We were referred to Child Adolescent Mental Health. Prior to that she was prescribed Fluox and Quetiapine, The fluox did not seem to do much and the psychiatrist at adolescent mental health services thought it may not suit. She doubled the dose and daughter didn't cope well so she was completely removed from fluox for a week so she could start new drug. Meanwhile daughter tried to commit suicide which was a combo of ED getting her down and drugs being messed about with. Being new to this we trusted the clinicians but now wonder. She went as an inpatient to adolescent mental health ward and they were brilliant. She was placed on sertraline anti depression and anti anxiety med and staff were great unfortunately they only treated for suicide and depression and kept watch on eating but did not treat ED. She came home in a good space but ED thoughts still present. They have got very strong and she did start purging for a month. We have been following guidelines for supervision and this has stopped. She is also feeling very down and now physiatrist wants to try some drug they use for ADHD to help anxiety and distracted mind due to anorexia. We have not agreed to this at this point. Just wondered what experiences others have had with meds and if they are indeed useful, we are confused.
Thanks
Just one day at a time.
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Foodsupport_AUS
elsiejo, welcome to the forum. Sorry you have had to find here. Your journey so far sounds pretty typical of many. Congratulations on the re-feeding and the management of her purging. It is common for things such as self harm, anxiety, suicidal thoughts and depression to increase around the time of being close to weight restoration. The trick is to ride this wave and keep them safe in the process. 

Many of our children around her are on medications. My own daughter takes medication and has done for several years. No medication has been shown to have a major impact on anorexia, however they have been shown to help with some of the other co-morbids such as anxiety and depression, and to help with anxiety and eating. 

ADHD medications are different again. I would be reluctant to use them unless my D had been weight restored and stable for some time. I imagine your D is weight restored and most for a few months, and from what you have mentioned may still need to gain more. Please look at some of the other information about weight restoration in the Hall of Fame. ADHD medications are stimulants in general. They have a reputation for making it easy to lose weight and difficult to maintain. Given where your D is at the moment I would be very reluctant to use them. 
D diagnosed restrictive AN June 2010 age 13.5. Weight restored July 2012. Relapse and now clawing our way back. Treatment: multiple hospitalisations and individual and family therapy.
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elsiejo
thanks for that as I do not know a lot about ADHD meds. They are also having trouble finding an anti depressant that will help but it is good to know the right one can help with the depression etc. This site has been a source of great strength and encouragement. 
Just one day at a time.
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Red
I am not a doctor, but do know that ADHD meds are stimulants that can often cause lack of appetite. May I ask if you know her weight from 2 years prior to the illness? If you can plot these on a growth chart, you will be able to see what her optimum weight at this age is most likely to be. It has been found by many parents here that our children seem to experience the most distress when trying to maintain a sub-optimal weight. Perhaps this is an avenue you could check?

You are the leader of your daughter's treatment team, so read and learn as much as you can. I recommend Eating with your anorexic, Help your teenager beat an eating disorder, Give food a chance, Brave girl eating & Decoding anorexia.
The future is not set; there is no fate but that which we make for ourselves.

"Not my daughter, you bitch." Mrs. Weasley
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elsiejo
Thank you
Just one day at a time.
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Red
I forgot to say - welcome! This is a wonderful place with amazing people.
The future is not set; there is no fate but that which we make for ourselves.

"Not my daughter, you bitch." Mrs. Weasley
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IdgieThreadgood7USA
I'm not a doctor either. Some people have found helpful results with some meds but I don't think the data reports support for any drug except some short term positive effects with zyprexa. It is an antipsychotic drug and can stimulate appetite in some although didn't for my d.
It did help her in the short term with the the distress of refeeding and also helped her sleep.
We have found NO antidepressant or anti anxiety drug that really countered the distress or depression associated with refeeding.
It may be a different story once your loved one is weight restored but I've seen by daughter hit with high doses of anti anxiety meds with little effect on the anxiety and distress associate with refeeding and maintaining and in the long term serve more harm than good.
I also found that many antidepressants triggered more anxiety which for my d is has underlying co morbid of anxiety and its worsened with time, mostly I think because the restrictive behavior in any form feeds it.
I do think so many of us start this journey with little understanding or clue as to how hard and long this road is.
This is by no means meant to scare you and it is not the same for everyone.
The younger and sooner you aggressively and completely commit to get the best effective care that includes your family, the better the outcome it seems.
I think your strongest ally to helping your daughter is building a strong supportive team around your family.
You will all need the support. Medications are a small secondary adjunct for some but can also serve to complicate the illness.
My d was diagnosed at 19 and we didn't get the best treatment or fully understand our role until the illness had a strong grip on our d.
We are hopeful for the future because we know now, that it takes long term full nutritional support and good evidenced based current therapy to help our d recover.

My hope for you is that you educate yourself and believe that you can and should be a vital part of your ds recovery plan.
"Sometimes you just have to be your own hero"
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momof4_US
Medications are tricky and different for everyone.  My daughter was started on lexapro last year starting at 5 mg and eventually increased to 20mg.  This was supposed to help with depression and anxiety.  At the initiation of the medication she was not fully weight restored but is now.  I never really saw a decrease in anxiety and in fact in retrospect the anxiety seemed to increase.  I would call the psychiatrist and he recommended increasing the dose and adding buspar.  Throughout my dtr had persistent suicidal ideation which I was told was a transient side effect.  My dtr. too had a suicide attempt in October.  In November the psychiatrist agreed to taper the lexapro to see if the suicidal ideation decreased.  It did indeed decrease.  My dtr is still struggling with the tapering so she is not completely off. She takes 5 mg every other day. 
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momon
Our 10 yo d dx in March 2013 was prescribed zoloft (sertreline) in about early May, she was by then at a good weight-- but having a lot of anxiety and depression problems that made her unable to deal with school, kids, to sleep and she was in deep psychic/emotional pain.  At first the med made her suicidal which was terrifying, but within a few weeks it really helped her a lot, took away the deep pain and let her be with kids again and smile and laugh and sleep at night. Hard to tease out how much of the improvement is brain recovery and excellent therapy but certainly the medication sped the process. We plan to transition her off it next summer or maybe begin sooner. But the med was not given to help her eat. I hated and still hate putting her on meds but feel sure it really helped her. 
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elsiejo
Thank you all for your responses. I am not opposed to medication but it has been hard for them to find one that works for my D so you responses have confirmed that each individual does have different reactions to meds. She is receiving good therapy from someone who works on CBT and mindfulness and we continue to support her on a daily basis. Thanks again for this forum and for being able to chat to people who have been there.
Just one day at a time.
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