University of Virginia Health System

Prozac Approved By FDA For Depressed Children

Drug can also be used for obsessive-compulsive disorder

< January 7, 2003 > Physicians can now prescribe the popular antidepressant Prozac (fluoxetine) to children suffering from depression (major depressive disorder) and obsessive-compulsive disorder (OCD) the US Food and Drug Administration (FDA) has ruled.

The decision, which covers children and teens 7 to 17 years of age, marks the first approval of one of the newer types of antidepressants—called selective serotonin reuptake inhibitors, or SSRIs—for treating depression in children.

Depression affects up to 25 percent of children and about 8 percent of teens in the United States. Symptoms of depression include general emotional dejection, withdrawal, and restlessness that usually interferes with daily functioning. A clinical diagnosis of major depressive disorders, according to the American Psychiatric Association's Diagnostic and Statistical Manual also includes at least five of the following nine symptoms:

• depressed mood
  
  
• loss of interest in usual activities
  
  
• significant change in weight and/or appetite
  
  
• insomnia or hypersomnia (abnormally excessive sleep)
  
  
• psychomotor agitation or retardation
  
  
• increased fatigue
  
  
• feelings of guilt or worthlessness
  
  
• slowed thinking or impaired concentration
  
  
• a suicide attempt or suicidal ideation

Obsessive-compulsive disorder is an anxiety disorder in which a person has an unreasonable thought, fear, or worry that he/she tries to manage by performing a ritual activity to reduce the anxiety. Frequently occurring disturbing thoughts or images are called obsessions, and the repeated rituals performed to try to prevent or dispel them are called compulsions. These behaviors are recognized by the person (their parent/guardian) as excessive or unreasonable.

OCD affects about 2 percent of the population, and typically begins during adolescence or childhood. At least one-third of the cases of adult OCD begin in childhood, reports the National Institute of Mental Health (NIMH), part of the National Institutes of Medicine (NIH).

Clinical trials revealed that the side effects of Prozac use in children and teens were similar to those typically experienced by adults, including nausea, fatigue, nervousness, dizziness, and difficulty concentrating, the FDA says.

However, one trial involving children and adolescents ages 8 to 17 years found that after 19 weeks of treatment with Prozac, the study participants gained, on average, about .5 inches less in height and about 2 pounds less in weight compared with children taking a placebo.

The drug's maker, Eli Lilly, has agreed to conduct a follow-up study to further evaluate any potential impact of Prozac's use on long-term growth in children, the FDA says.

Always consult your child's physician for more information.

Risk Factors For Major Depression in Children

The following are the most common risk factors for major depression in children:

• family history of depression (especially if a parent experienced depression as a child or adolescent)
  
  
• excessive stress
  
  
• abuse or neglect
  
  
• trauma (physical and/or emotional)
  
  
• other psychiatric disorders
  
  
• loss of a parent, caregiver, or other loved one
  
  
• cigarette smoking
  
  
• loss of a relationship (e.g., moving away, loss of boyfriend/girlfriend)
  
  
• other chronic illnesses (e.g., diabetes)
  
  
• other developmental, learning, or conduct disorders

Always consult your child's physician for more information.

Online Resources

(Our Organization is not responsible for the content of Internet sites.)

American Psychiatric Association

National Institute of Mental Health (NIMH)

National Institutes of Medicine (NIH)

National Mental Health Association

US Food and Drug Administration (FDA)

For more information on depression, obsessive-compulsive disorder, or seasonal affective disorder, please visit the Mental Health Disorders information module on this Web site.

In Other News About Your Mental Health:

SAD and Don't Know Why?

Treating seasonal affective disorder

The days are short, the nights long, and you are feeling blue. No matter how many hours you sleep, you still wake up tired. You are irritable and have poor concentration.

Also, you are eating too much, craving carbs, and packing on the pounds. If this sounds like you or someone in your family, seasonal affective disorder (SAD) may be to blame.

SAD a mood disorder characterized by depression related to a certain season of the year—especially winter. However, SAD is often not described as a separate mood disorder but as a "specifier," referring to the seasonal pattern of major depressive episodes that can occur within major depression and manic depression. SAD is a clinical diagnosis accepted in the medical community.

Onset usually occurs during adulthood (with the average onset occurring at approximately age 23), and is four times more likely to affect women than men. According to the National Mental Health Association, approximately 25 percent of the population suffers from mild winter SAD, and nearly 5 percent suffer from a more severe form of the disorder.

Some experts agree that the most effective treatment for SAD is light therapy, either with lights specifically tailored for phototherapy or with 4-lamp fluorescent light fixtures—beginning with 10- to 15-minute light sessions, and gradually increase to average 30 to 45 minutes a day. But sometimes, a brisk walk in morning sunlight can be just as effective as a light box.

Always consult your physician for more information.