What You Should Know About Prozac for Kids

Potential side effects of fluoxetine in kids

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What do I need to know about fluoxetine side effects in kids?

  • Common side effects include changes in appetite and sleep, headaches, and stomach upset, which typically lessen as kids get used to their medication. 
  • Watch kids for signs of serious side effects, including changes in mood and behavior.

If your child has been diagnosed with depression, your doctor may have recommended Prozac for teens or kids. While Prozac (fluoxetine) is often prescribed for adults, it is also an approved antidepressant for children ages 8 and older.

Prozac is a commonly prescribed medication for children and teens with major depressive disorder (MDD) and sometimes bipolar disorder. While it's not advised that Prozac be prescribed to every child with depression, it can be part of a successful treatment plan for some.

Before your child begins taking Prozac, it's important that you understand its potential side effects. Have a conversation with your child's doctor and be sure to monitor your child's behavior carefully if they do start taking it.

Prozac for Kids: What Does It Do?

Prozac is one of the most commonly prescribed selective serotonin reuptake inhibitor (SSRI) medications for adults, and it has been shown to also be effective for kids. SSRIs may help improve mood by increasing the amount of serotonin in the brain.

Serotonin is a neurotransmitter that helps regulate mood and emotions, sleep, and appetite. SSRIs work to make serotonin accessible again so that the body can receive its benefits.

While current evidence indicates that chemical imbalances in the brain do not cause depression, it is still believed that antidepressants can play an essential role in improving mood and relieving other symptoms of depression.

SSRIs can make it easier for people to cope with various conditions like depression, eating disorders, obsessive-compulsive disorder (OCD), and panic attacks.

Side Effects of Prozac for Kids  and Teens

Prozac is generally well-tolerated in children, and few stop taking it because of bothersome side effects. The side effects of Prozac are often mild and short-lasting. If side effects occur, they usually show up at the start of treatment and often resolve within a few weeks without any need for additional intervention.

Common Side Effects

Common side effects associated with Prozac may include:

  • Appetite changes (increase or decrease)
  • Gastrointestinal symptoms (e.g., nausea, upset stomach, and diarrhea)
  • Headaches
  • Restless legs
  • Restlessness
  • Sedation
  • Sleep changes (e.g., insomnia, somnolence, vivid dreams, nightmares, and impaired sleep)
  • Sweating

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 in children with bipolar disorder or those who are predisposed to develop it.

Be sure to let your child's healthcare provider know if they have 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 a healthcare provider immediately:

  • New or worsening anxiety or depression symptoms
  • Panic attacks (e.g., difficulty breathing or racing heartbeat)
  • Problems with coordination
  • Severe agitation or restlessness
  • Symptoms of mania (e.g., racing thoughts, pressured and fast speech, or excessive risk-taking)
  • Uncontrollable anger or violence
  • Unusual changes in behavior or mood

Increased Thoughts of Suicide

Another serious side effect associated with Prozac that warrants special attention is the risk of suicidal thoughts or behavior. Though it's important for everyone to be aware of suicidal ideation and self-harm signs in youth, it's even more imperative when children are taking an SSRI.

The Food and Drug Administration (FDA) has issued a public warning that suicidal thoughts and behavior may increase in children and adolescents up to age 25 who are taking SSRI antidepressant medications. The risk is highest when the medication is first taken and whenever the dose is changed.

Some of the warning signs include an increase in sadness, isolation, panic attacks, or aggressiveness. These may be subtle and lead to thoughts about suicide or dying, suicide attempts, or self-injury.

If your child is having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Risks and Benefits of Prozac for Kids

Compared to other common antidepressants, Prozac appears to carry fewer risks for children with depression. However, before making the decision to start treatment with an SSRI, you should carefully weigh the expected benefits and risks—including potential side effects—of the drug.

While many side effects may resolve with time, a child should not suffer unnecessarily from additional complications. There are many depression treatment options that can help minimize the potential for these side effects.

How to Take Prozac for Kids and Teens

If your child is taking Prozac, there are some safety precautions to keep in mind. Make sure they are only taking their prescribed dosage, supervise them when they take Prozac, and store the medication properly.

Dosage of Prozac for Teens and Kids

For kids with major depressive disorder, 10 or 20 milligrams (mg) of Prozac per day is the general recommendation by the FDA.

A doctor will usually start a child off on a lower dose (10 mg per day) of Prozac and increase to 20 mg per day if their symptoms don't improve. Some children, especially children of a lower weight, will be kept on 10 mg per day.

Be sure you only administer to your child the dosage of Prozac that their doctor prescribes. Never give your child a higher dose.

For children with OCD, the FDA recommends they start at 10 mg per day and increase in a few weeks to 20 mg per day. For adolescents and children of a higher weight, the FDA has approved treatment of up to 60 mg per day if lower doses are not effective.

Children of a lower weight may be treated with up to 30 mg per day. However, 20 mg per day is the most commonly prescribed dosage for children taking Prozac.

Supervising Your Child

A child shouldn't take Prozac alone. It's best that you, or another trusted adult, oversee its administration.

Prozac is taken once per day. Your child may take the medication with food, but it is not necessary. If your child is taking a liquid form of Prozac, be sure you measure it with a dosing spoon or oral syringe before administering it.

Prozac should be taken at around the same time every day. Try using an alarm on your phone or writing a note on your calendar to remember to have your child take it. If your child misses a dose of Prozac, they may take another dose—unless it is closer to the time of the next dose. You should never double your child's Prozac dose.

After starting Prozac, all children should be monitored closely for any side effects, especially changes in behavior.

Storage

Prozac should be stored in a room-temperature location. Avoid any place with too much light, heat, and/or moisture. For instance, it's best not to keep Prozac in the bathroom.

Keep Prozac in the container provided to you by your pharmacist and make sure the lid is tightly closed. Be sure to keep Prozac out of reach of your child or any other children or pets in the house—especially if the medication isn't kept in a childproof container.

If your child is no longer taking Prozac, don't dispose of it in the toilet or anywhere else could access it and consume it. You can talk to your local pharmacist to learn the best way to dispose of Prozac. Some pharmacies participate in a "take-back" program and can safely dispose of Prozac for you.

Frequently Asked Questions

  • Should my teenager take Prozac?

    Prozac can be part of an effective treatment plan for depression, anxiety, OCD, and other mental health conditions. However, it is important to work with your doctor to determine which treatments are right for your teen. It is important to weigh the potential benefits against the possible risks, as well as consider your child's individual needs.

  • What is the best antidepressant for a teenager?

    Prozac (fluoxetine) is often considered the best antidepressant for treating depression in teens. It can be effective on its own, but it may produce better outcomes when used alongside cognitive behavioral therapy (CBT). Effexor (venlafaxine) is an antidepressant that is not recommended for teens due to its increased risk of suicidal thoughts and behaviors.

  • How much Prozac should an adolescent take?

    The starting dose for teens taking Prozac is 20 milligrams per day. This amount may be increased up to 60 milligrams per day. 

9 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Institute for Quality and Efficiency in Health Care. Depression: How Effective Are Antidepressants?.

  3. Moncrieff J, Cooper RE, Stockmann T, Amendola S, Hengartner MP, Horowitz MA. The serotonin theory of depression: A systematic umbrella review of the evidenceMol Psychiatry. 2022. doi:10.1038/s41380-022-01661-0

  4. National Library of Medicine. Fluoxetine.

  5. Cipriani A, et al. Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents: A network meta-analysis. Lancet. 2016;388(10047):881–90. doi:10.1016/S0140-6736(16)30385-3

  6. Food and Drug Administration (FDA). Label for PROZAC (fluoxetine).

  7. Food and Drug Administration. Suicidality in children and adolescents being treated with antidepressant medications.

  8. National Alliance on Mental Health. Fluoxetine (Prozac).

  9. Coupland C, Hill T, Morriss R, Arthur A, Moore M, Hippisley-Cox J. Antidepressant use and risk of suicide and attempted suicide or self harm in people aged 20 to 64: cohort study using a primary care database. BMJ. 2015;350(feb18 32):h517-h517. doi:10.1136/bmj.h517

By Lauren DiMaria
Lauren DiMaria is a member of the Society of Clinical Research Associates and childhood psychology expert.