What You Should Know About Prozac for Kids

If your child or teen has been diagnosed with depression, obsessive-compulsive disorder, or panic disorder, your doctor may have recommended Prozac. 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 mood and behavior carefully if they do start taking it.

Prozac for Kids and Teens: 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.

SSRIs can make it easier for people to cope with various conditions like mood disorders, 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.

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.

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.

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 different treatment options that can help minimize the potential for these side effects.

How do Kids and Teens Take Prozac?

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.

Prozac comes in capsule form; however, the generic versions that contain fluoxetine come in liquid, tablet, or capsule form.

Dosage of Prozac

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 it to 20 mg or 30mg per day if their symptoms don't improve. Teens are also started out on 10mg per day, and it is then increased to 20mg within a few weeks. Adolescents may need to take 40mg or 60mg per day to achieve the desired effect.

For children with OCD, the dosing is similar to treating depression. 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.

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.

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.