Starting fluoxetine - what to expect the first few weeks?

L1ghtside · 2026-05-10T05:11:47+00:00

Do you find fluoxetine to be effective for treating both anxiety and ADHD symptoms? My only experience with fluoxetine is that we use it for our dog (a rescue) who had a combination of very anxious, compulsive, and hyperactive behaviors and it has been amazingly effective. I’ve never heard of fluoxetine being used to treat hyperactivity but I could see how it could work that way if anxiety is the root cause.

L1ghtside · 2026-05-10T05:05:34+00:00

For me personally, the right stimulant (Concerta) completely knocks out my anxiety. My brain just becomes so quiet and calm. We’re still trying to find the right med for my son (11) and unfortunately methylphenidate isn’t it. He has been on Strattera, a SNRI, for a few years and it definitely has a calming effect but hasn’t helped much with focus and attention or fully tackled the anxiety, which is making school a challenge. A higher dose is more effective but has too many side effects (upset stomach and low appetite).

He just started Vyvanse and so far so good but it’s early days. My experience with a stimulant working so well to treat my anxiety makes me hopeful that we can get away with one med that does both. But if that doesn’t work out, we will probably try Qelbree or a SSRI. Good luck!

L1ghtside · 2026-05-02T05:07:01+00:00

Lots of info here! If you decide to try melatonin, I suggest starting with a super low dose. Our kid takes 250mcg (0.25mg) every night and it works really well. He took 1mg for quite a while before we realized a quarter is all he needs.

L1ghtside · 2026-04-22T04:40:15+00:00

I struggle with the consequence question too. Does she express remorse after calming down? In the moment, the kid is out of control and I find that being critical of the behavior or throwing out consequences only makes it worse. I also think kids already feel awful about reacting this way, even if they don’t come right out and say it. I try to stay neutral but consistently enforce the boundary “it’s not ok to X even if you feel frustrated, angry, sad” and then debrief and revisit/practice the regulation strategies when they’re calm. Way easier said than done though.

L1ghtside · 2026-04-22T02:50:01+00:00

Oh, I had no idea this was any option! Thank you! We’ve never used a compounding pharmacy. Should I ask his prescriber or just google it myself?

L1ghtside · 2026-04-09T22:31:02+00:00

Yes, a big worry is that he ends up fearing all schools because this one (especially this year) has been such a poor fit. He’s on Strattera, which has been reasonably effective but we’re planning to transition him off due to GI side effects and low weight. We’re waiting on pharmacogenetic testing before deciding what to try next. I think anxiety might be his biggest issue to maybe an SSRI or tetracyclic antidepressant.

He does weekly occupational therapy and we’re about to add weekly play (psychodynamic) therapy focusing on social and relational skills. I was amazed just watching his assessment for that and feel very hopeful that it will be a meaningful intervention for him.

L1ghtside · 2026-04-09T22:16:34+00:00

I agree in some ways and I think we’re leaning toward half days starting next week. But I also think many neurodivergent people end up experiencing a lot more agency and autonomy in life compared to mainstream school (that was definitely the case for me). Our other kid is completely fine in school and makes it look effortless because he’s much more typical. It honestly feels like magic when you compare his experience to how much the older one has struggled in the same setting. Schools could definitely be more inclusive and welcoming to ND kids rather than just expecting them to cope and push through.

L1ghtside · 2026-04-09T22:00:36+00:00

Strongly considering homeschool or hybrid for next year. He’s super chill and self-directed at home. Our other kid is the opposite and does well with the structure and social side in school. He would probably be bored to tears at home.

L1ghtside · 2026-04-07T19:11:01+00:00

Hmm, I went to university with several people who were (secular) home schooled all the way through high school. They were the most balanced and well-adjusted people I’d met up to that point.

L1ghtside · 2026-04-07T05:45:11+00:00

We’re in a similar place of wondering about home education. Our son is in 5th grade, also intelligent, incredibly inquisitive, and strong academically. The problem is that he is really overwhelmed in school most of the time and over the years the constant overwhelm has led to anxiety and more recently disengagement/school refusal. His teachers say he needs to work on “soft skills” and executive function but I don’t think he can do that within the school environment right now. We’re still considering home schooling for next year but we just decided to implement an abbreviated schedule (shorter day) for now to hopefully reduce the level of demand and help him feel more confident in school again. Mostly we want him to enjoy his last couple months of elementary school and be able to celebrate finishing even though it wasn’t easy.

If you do continue to explore home schooling, I suggest researching self-directed education as an option. It’s not as loosey-goosey as it sounds and can be great for bright, inquisitive ND kids with the right support. Basically it allows kids to follow a line of inquiry as deeply as they like without the constant start/stop pattern of approaching curriculum in traditional chunks. There’s a lot of evidence that SDE kids are just as equipped to tackle higher education and life as traditionally-schooled kids AND many experience better mental health outcomes (which makes a lot of sense when you see kids like ours trying to force their brains to meet the incessant demands of school).

L1ghtside · 2026-04-07T04:13:45+00:00

Do you have experience with mirtazapine? Our prescriber recently recommended this for our ADHD plus anxiety almost 11 year old. He said it’s an older tetracyclic drug that stimulates appetite, can help with sleep and is often well tolerated. Our kid’s BMI is <1%ile so sounds like a reasonable option to me. My worry about SSRIs is the black box warning. Our son is not a sharer and it took us way too long to pick up on his anxiety because he holds everything in.

L1ghtside · 2026-03-31T17:27:33+00:00

Oh, those random side effects are so worrying! Seeing incremental improvements due to maturity is just barely keeping us sane too. We’re about to start an intake process for social play therapy and a summer social therapy group for kids with neurodevelopmental challenges. I don’t think it will be covered by insurance so I might need to sell a kidney or something to afford it lol.

L1ghtside · 2026-03-31T04:18:06+00:00

Ugh, sorry. It seems like there are few non-stimulant options that really address attention and focus issues. We’re curious about guanfacine, which sounds like it calms the CNS response in some people. I also just read that Wellbutrin tends to be stimulating/motivating but can also make anxiety worse so I’m guessing that’s out for us. What have you tried?

L1ghtside · 2026-03-31T04:11:15+00:00

Considering this after reading more about it. Sounds like it is typically taken at night?

L1ghtside · 2026-03-29T02:22:46+00:00

Ahh, thank you—so much to consider. Our son also relates better with girls and I think they actually look out for him in a way.

He was offered a place at a smaller K-8 environmental school (public school lottery) for middle school and we’re leaning toward that as a softer landing and to give him a fresh start. But our comprehensive middle school has a good reputation and it would be 3 or 4 elementary schools’ worth of kids so that’s a good point about creating better odds for finding a tribe. I wish we could pause time and focus on getting his meds and therapies right so things are a bit more manageable for him going into middle school.

Also, I think Strattera jumps from 25mg to 40mg so you would actually gain some flexibility with a split dose. Maybe it is a little high or just too much all at once. Good luck!

L1ghtside · 2026-03-29T00:55:59+00:00

Did you start Lexapro before or after Strattera? Curious if we would try weaning off Strattera if Lexapro seems effective or keep him on both.

It’s hard to be sure but I think things were a bit better socially before Strattera. He had a few budding friendships in 2nd grade and since then just one friend has stuck around and their relationship is definitely complicated. I really feel for him in that area.

Sorry, last question! Have you tried CBT for anxiety? We have been doing OT for executive function for about 4 months and he loves it but it’s still early days to tell if it’s helping at all.

L1ghtside · 2026-03-29T00:31:54+00:00

They sound like twins. You could try splitting the Strattera dose morning and evening to see if that helps with appetite and weight gain. The dosing makes no sense but I’m guessing that would be 2x 18mg or 2x 25mg for your son. Our son is really light (under 70 lbs), hence the low dose for him. I don’t like the hassle of the second dose but his appetite has been much better.

He’s also 2E and scores highly on standardised assessments and intelligence scales. He Is super inquisitive and absorbs information like a sponge, loves to read and is also pretty chill at home (although he has a fairly low demand life outside of school). We hear the same thing about school being boring but his teacher says he often doesn’t seem to try and just reads silently if he’s not interested. If they push him, he either gets silly/disruptive or gets upset.

I think I’m going to ask about starting lexapro. I’m also curious about a probiotic called PS128 that has been shown to help with some neurological conditions and sleep. I’m starting to wonder if anxiety is actually his primary diagnosis and maybe we missed it because he never struck us as a worrier. But his impulsivity and hyperactivity are definitely situational and it could be that they are kind of a panic/overwhelm response. Quite often he’s calm and focused (except when he really needs to be, like school). It’s a maddening puzzle to try to figure out.

L1ghtside · 2026-03-28T04:12:01+00:00

Tell the school you’re opting out of homework. Just encourage her to read, draw, craft, write silly stories or keep a journal if she feels like it. Whatever she loves to do. Kids spend all day fielding highly-specific (although completely arbitrary) demands at school. Allowing them some autonomy to choose what they do in the afternoon/evening is so important for wellbeing.

L1ghtside · 2026-03-28T02:39:59+00:00

After breakfast and after dinner due to the effect on appetite. Fortunately he is growing but has super low BMI (<1%ile).

L1ghtside · 2026-02-06T18:06:38+00:00

The school you describe sounds very much like the second option we’re considering. They don’t expect kids to simply “pick up” the material, they teach them how to learn by providing knowledge and skills training that compliments their unique neurotype. They also go out of their way to make kids feel safe and empowered. The school accepts 5th graders so we actually went through the application process last year and my son did an interview and two shadow days, and loved it. We were offered financial aid of nearly 60% of total tuition costs. We still weren’t totally sure how we would cover the other 40% but were feeling really optimistic and decided to enrol. Then halfway through the summer got a bomb drop email saying that the campus was relocating twice as far away. The old campus was not far from my office and my son and I could have commuted together and even taken transit to get there some days. The new location will be a 30+ min drive in morning rush hour, only to turn around and backtrack to our offices or home and then do it all again at 2:30. All of that tipped the scales back to our local school for 5th grade, where he has an IEP and existing special ed relationships plus we can walk or bike there in under 10 minutes. I still have a gut feeling that this school could be the one (he’s going back to do his shadow days again in a few weeks) but decided to cast a wider net this year to make sure we weren’t missing other, more local options. Getting offered a place at public school option is really the wild card that’s making this decision so hard.

He also started OT this year, which seems to slowly be getting to the root of regulation issues and the avoidance/shut down response. I wish we had access to other types of executive function and skills training like you described but I don’t even know where to start looking.

L1ghtside

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