10-Year-Old with Panic (PANS)

(Week 12 of Prozac, 3.7 ml's given at 4pm) Ewen is still dealing with agonizing tics while trying to fall asleep. I am slowly bringing his prozac down from 4ml's. We are at 3.7 now. We stopped giving him the guanfacine at night 2 days ago and it helped a little. But watching him tonight, stick his butt in the air and bury his face in his hands in his pillow and huff and huff, then kick around and ask me to sit on his legs so they stop moving then kick the air over and over while flexing his foot muscles repeatedly... huffing every second or more...for me is is exhausting to watch but he wants me there, in the comfy chair next to his bed. And I feel like if he is suffering through all this then I need to suffer through it with him since I am responsible, and must not turn a blind eye to what is going on. When he is finally asleep I feel a rage that I don't know what to do about this. It is all still better than when he couldn't go to sleep because he was so anxious bec...

After last night I think we will have to bring Ewen way down on the Prozac. I don't want to put him back on the guanfacine during the day because it made him so depressed. But now I am wondering if we didn't give it enough time? So the plan is the bring the Prozac way down and we could either try the guanfacine during the day again, or I might give him the same dose of buspar that his sister takes, which is 2,  5mg pills a day...minute does. There is 1 reason I might not give him the buspar.  I read study that said that only 1 child dropped out due to side effects and the side effects were involuntary movements. That worried me because right now he is full of involuntary movements. http://www.ncbi.nlm.nih.gov/pubmed/9501886 We evaluated the efficacy and safety of buspirone in the management of anxiety and irritability in children with pervasive developmental disorders (PDD). METHOD:  Twenty-two subjects, 6 to 17 years old, with DSM-III-R diagnosed PDD-NOS (N ...

It was another horrible night for going to sleep. He is a mess. Giving him 1/4 guanfacine at night has not helped at all. H went to bed at 9:30 and is still awake. Mike is sitting with him now. He can't stop his body from moving and that keeps him awake. I need to taper off the dose until he is off the prozac or way down. I wonder if he is sick. I don't know what to do. It is awful.

Ewen is fast asleep and it is 9:20am. He said he wasn't feeling well this morning and after last night I wasn't going to question it.  I'm glad he is sleeping. His poor body needs to just rest. My other two are at school. It is a quiet morning. I wish I had answers.

It feels like he is going through utter hell when he is trying to fall asleep. He feels wired and tired and he is twitching and huffing. He is mess and it it painful to watch. It takes him an hour to fall asleep and tonight I sat with him. I had to take an ativan to help him through it calmly with humor and to hide any worry. But the truth is I am devastated to see him like this. Even after he falls asleep, his whole body twitches and jerks. It doesn't seem right. So after Ewen was finally asleep I went to the couch and asked DH what he thought we should do and that we need a plan. We are at 4.2ml's of Prozac and he said we should just bring it down until he feels anxious again...or doesn't. I'm not sure about that exactly but he is right that we need to bring it down again. Tonight Ewen also took a little more than1/4 guanfacine and he said he thought that made him feel awful and wired and tired. I think it increases his anxiety a bit. That should stop in a couple o...

Today Ewen had a good day but his tics were back again this evening now that the Guanfacine has worn off completely. So we gave him 1/4 of it at 8:30pm. I hope he sleeps ok tonight and we will see how it goes. I am hoping that he sleeps well and that the depressive effects wear off by the morning but the suppression of tics stays in his system throughout the day? If he wakes up miserable then we will probably just stop the Guanfacine for good.

It seems that some of the jitteriness and spaciness and some huffing has come back this afternoon/evening after being off the Guanfacine for 2 days now. It still isn't as bad as it was last week but I think the lingering effects of the Guanfacine are just wearing off and so Ewen is going back to huffing and ticking. I suggested to Mike that we give Ewen just 1/4 mg of Guanfacine at night before bed, then it will be in his system and it will have worn off enough to not make him sullen the next day, since it is supposed to wear off in 6 hours.  But Mike didn't want to do it. He wants to see how Ewen is tomorrow without the Guanfacine again and if the huffing stays at bay, he doesn't want to use the Guanfacine at all anymore. I think that the Guanfacine helped with Ewen not seeming so fight or flight all the time. I think we should have given it to him this evening but I can't ignore Mike's intuition either and so we will give it another day without it. I really don...