Currently, Prozac (fluoxetine) is the only approved selective serotonin reuptake inhibitor (SSRI) medication for children with major depressive disorder. As such, it is a commonly prescribed medication for children with depression and sometimes bipolar disorder. Despite its proven success in the treatment of childhood depression, many parents and children alike are rightfully concerned with its potential side effects.
Common Side Effects
Prozac is generally well-tolerated in children, and few stop taking it because of bothersome side effects. Prozac's side effects are often mild and short-lasting. If they occur, side effects usually happen at the start of treatment and often resolve within a few weeks without any need for additional treatment.
Common side effects may include:
- Gastrointestinal symptoms (e.g., nausea, upset stomach, diarrhea)
- Sleep changes (e.g., insomnia, somnolence, vivid dreams, nightmares, impaired sleep)
- Restless legs
- Appetite changes (increase or decrease)
- Changes in libido and sexual dysfunction
Less Common Side Effects
Additionally, a small percentage of children who take Prozac may show increased impulsivity, agitation, or irritability. These symptoms appear to be more likely to appear in children with, or who are predisposed to develop, bipolar disorder. Be sure to let your child's provider know if she has ever experienced a manic or hypomanic state, or if there is a family history of bipolar disorder.
Serious Side Effects
Although rare, Prozac is associated with certain more serious side effects. If you notice any of the following in your child, contact her healthcare provider immediately:
- Thoughts about suicide or dying
- Suicide attempts or self injury
- New or worsening anxiety or depression symptoms
- Severe agitation or restlessness
- Uncontrollable anger or violence
- Panic attacks (e.g., difficulty breathing, racing heart beat)
- Symptoms of mania (e.g., racing thoughts, pressured and fast speech, excessive risk taking)
- Unusual changes in behavior or mood
- Problems with coordination
Although most side effects of Prozac in children are mild and short-lasting, all side effects, regardless of severity, should be thoroughly discussed with your child's clinician. Knowing what to expect from your child's depression treatment helps with the compliance that is essential for recovery.
While many side effects may resolve with time, a child should not unnecessarily suffer with bothersome side effects. There are many depression treatment options that can help minimize the potential for these side effects. You and your child's doctor should work together to figure out the best treatment.
Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers. National Institute on Mental Health. Accessed: July 27, 2010. http://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/antidepressant-medications-for-children-and-adolescents-information-for-parents-and-caregivers.shtml
Antidepressant Use in Children, Adolescents, and Adults. U.S. Food and Drug Administration. Accessed: May 28, 2010. http://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/UCM096273
Boris Birmaher, MD, David Brent, MD, et al.Practice Parameter for the Assessment and Treatment of Children and Adolescents With Depressive Disorders. The Journal of American Academy of Child and Adolescent Psychiatry. 46(11). November 2007. 1503-1526.
Eli Lily. Product Monograph: Prozac. August 07, 2008. Accessed: June 15, 2011.
Food and Drug Administration. Medication Guide: Prozac. Accessed: June 15, 2011. http://www.fda.gov/downloads/Drugs/DrugSafety/ucm088999.pdf