Prozac and Autism and Tics

[lucigo]

Anyone have any experience? My DS8 has autism, is verbal, in an ESE class but on the verge of being able to function in a typical class, at least part of the day. He had never been on any meds before we started Prozac about 3 months ago. His behavior at school has been better and he has tried a new food (turkey sandwich made at home as opposed to Subway). The bad...his tics are worse and he has had mouth sores off and on all winter. He has a new tic tonight and I'm 2nd guessing the med. Would appreciate any input!

 

[clanmcculloch]

This is going to sound like a strange thing to say, but have you ever considered dietary changes? My DD14 and I both have Asperger Syndrome. She and I both get mouth sores whenever we accidentally ingest gluten. We also both have worse issues associated with our autism when we ingest gluten. We do get other symptoms from other foods but the mouth sores from gluten. The incidence of gluten intollerance is much higher in people on the spectrum than in the general public.

I'd also consider possibly a vitamin D and B12 supplement as deficiencies in either of these can lead to worstening tics. DD14's very minor tics went away when we started treating her vitamin D deficiency and mind didn't go away until I got my B12 deficiency under control (the deficiencies are tied to the food intollerances which cause GI damage which doesn't necessarily have any GI symptoms until the damage gets bad). You can definitely request these be tested before beginning supplements if you're concerned about supplementing though these really are harmless supplements to give.

My DD14's psych doc gave me the choice between Prozac and Zoloft for her OCD issues associated with her autism (we weren't just treating autism in general; it was a very specific aspect of it which had completely taken over her life not to mention the rest of our family's lives). We chose Zoloft to be start since she has a half sister who did well on that med for her OCD. It did help but we switched to Prozac when she plateaued but that was REALLY bad and we very quickly went back to Zoloft (not saying it's a bad med, just the wrong one for her). I do believe tics are one of the things we were supposed to watch for as less common side effects. I would discuss the possibility with the pharmacist and prescribing doctor to see if there's another similar med that maybe you can try.

 

[bookwormde]

Tics are not a typical side effect of Prozac, tremors or shaking are signs of overdosing. Convulsions (seizures) are also a rare side effect. Tremors are a common side effect.

Although not typically from Prozac, pharmacologically generated tics can become permanent, so you should take it seriously. I would talk to you pharmacist ASAP and schedule an appointment with your prescribing physician.

 

[lucigo]

This is going to sound like a strange thing to say, but have you ever considered dietary changes? My DD14 and I both have Asperger Syndrome. She and I both get mouth sores whenever we accidentally ingest gluten. We also both have worse issues associated with our autism when we ingest gluten. We do get other symptoms from other foods but the mouth sores from gluten. The incidence of gluten intollerance is much higher in people on the spectrum than in the general public.

I'd also consider possibly a vitamin D and B12 supplement as deficiencies in either of these can lead to worstening tics. DD14's very minor tics went away when we started treating her vitamin D deficiency and mind didn't go away until I got my B12 deficiency under control (the deficiencies are tied to the food intollerances which cause GI damage which doesn't necessarily have any GI symptoms until the damage gets bad). You can definitely request these be tested before beginning supplements if you're concerned about supplementing though these really are harmless supplements to give.

My DD14's psych doc gave me the choice between Prozac and Zoloft for her OCD issues associated with her autism (we weren't just treating autism in general; it was a very specific aspect of it which had completely taken over her life not to mention the rest of our family's lives). We chose Zoloft to be start since she has a half sister who did well on that med for her OCD. It did help but we switched to Prozac when she plateaued but that was REALLY bad and we very quickly went back to Zoloft (not saying it's a bad med, just the wrong one for her). I do believe tics are one of the things we were supposed to watch for as less common side effects. I would discuss the possibility with the pharmacist and prescribing doctor to see if there's another similar med that maybe you can try.

Thank you so much for your reply. I do have a B12 gummy that I give him whenever he has the mouth sores, but I could try everyday and see if they might keep them away. His gummy multivitamin says it has 100% of the Vitamin D, is that enough? I have some D3 gummies that I had bought him but stopped giving him when I suspected they stressed him out, but I could try again. It is interesting that he gets the mouth sores in the winter but not in the summer.

I have considered trying gluten-free, however he is on such a limited diet already that I am afraid to take any foods away. He has brand specific food choices, and only eats a handful of foods.

I really can't wait until he can get in the pool everyday, we are so close!

 

[lucigo]

Tics are not a typical side effect of Prozac, tremors or shaking are signs of overdosing. Convulsions (seizures) are also a rare side effect. Tremors are a common side effect.

Although not typically from Prozac, pharmacologically generated tics can become permanent, so you should take it seriously. I would talk to you pharmacist ASAP and schedule an appointment with your prescribing physician.

He had tics before starting the Prozac. I was hoping the Prozac would help calm them,but if anything they are worse. Its probably just the normal progression of the tics, I just didn't want to take for granted that they were part of his autism and miss that they could be related to the Prozac.

I should add he is only on 5 mg (he is 8 years old and weighs around 48-50 pounds).

 

[bookwormde]

For other medications increased in frequency, duration and new sites of tics becoming permanent is a concern for individuals who already had tics. Still odd with prozac, but could be a secondary of other side effects.

 

[lucigo]

For other medications increased in frequency, duration and new sites of tics becoming permanent is a concern for individuals who already had tics. Still odd with prozac, but could be a secondary of other side effects.

This is frustrating, but good to know. The main reason we have tried the Prozac is because although he can function pretty well at home and in an ESE classroom, the anxiety of push-in for reading was a bit much for him, and yet academically he is an early reader and can hold his own.

I think I need to explore different options, I don't want to risk permanent tics just for more inclusion time.

 

[clanmcculloch]

Thank you so much for your reply. I do have a B12 gummy that I give him whenever he has the mouth sores, but I could try everyday and see if they might keep them away. His gummy multivitamin says it has 100% of the Vitamin D, is that enough? I have some D3 gummies that I had bought him but stopped giving him when I suspected they stressed him out, but I could try again. It is interesting that he gets the mouth sores in the winter but not in the summer.

The fact that he gets the sores in the summer and not winter suggests to me that vitamin D is involved since most people in first world countries become at least somewhat deficient in the winter due to lack of sun (the body's natural way of creating it is from sun exposure so being in side all winter results in not enough D synthesis).

When you say 100% of the RD of vitamin D, how much is that, 200 IU? RD is generally a lot lower than a supplement would involve. My DD14 is on 2000 IU per day based on a diagnosed deficiency while I'm on 5000 IU per day for a worse deficiency. Without a diagnosis, I'd likely go with 1000 IU per day as that's a harmless does if not needed but is enough to counter the winter lows. There's absolutely no harm in giving the B12 every day as well so I'd try that just to see if it helps. A sublingual would be a better supplement but that may be something he wouldn't be willing to try to so the gummy's better than nothing, especially if it does seem to help get rid of the sores faster.

If the vitamin D gummy seems to result in added stress then I'd speak with the pharmacist about possible alternatives as it may be the form of D or medium or something else about the particular supplement. Pharmacists are my go-to people for questions about these kinds of things, much more so than doctors most of the time.

 

[Hasil72]

lucigo, I'm late with this but did you follow up with the doc? Just wanted to see if you needed to switch him. My DS (12) has been on Prozac for almost 2 years now with a good deal of success. It was to the point that he wouldn't leave the house because any flying insect within supersonic earshot was out to get him. No history of tics while he's been on it but he's never had them to begin with.

Good luck to you! I hope you find something that helps.

 

[lucigo]

I just wanted to give an update and thank everyone for your input. We kept him on a low dose of Prozac (5 mg) through the school year. The tics seemed to stay manageable. His doctor suggested upping his dose to 10 mg as he was having trouble adjusting to summer break, so I did...and the tics increased. However, it could also be due to more computer and ipad time during his break though, so I'm going to give him a couple of weeks (autism camp starts Monday) before I decide for sure, but I am considering stopping the medication completely and seeing where we are without it. He did have tics before starting the medication, so I don't expect them to go away completely, but just still not sure we are doing the right thing, even though the psychiatrist insists the medication is not the cause.

Interestingly, I have also noticed the tics do seem to subside at least to an extent while we are in the pool each evening.

The medication is for anxiety, not depression.

 

[clanmcculloch]

Are you sure these are tics and not stims? What kinds of tics is he experiencing? I'm wondering because you said that the tics subside when he's in the pool. Pools can be sensory relieving which is also the purpose that stims serve to autistic kids.

Did you ever try the increase in vitamin D and/or B12?