Potential Prozac Side Effects in Children

Prozac (fluoxetine) is an approved antidepressant for children ages 8 and older. It 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.

What Is Prozac and 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 work by increasing the amount of serotonin in the brain.

Serotonin is a neurotransmitter that regulates our mood and emotions, sleep, and appetite. Experts believe that depression may be caused by an imbalance in neurotransmitters like serotonin. 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 a variety of conditions like depression, eating disorders, obsessive-compulsive disorder (OCD), and panic attacks.

Side Effects of Prozac for Kids 

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.

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

How to Take Prozac for Kids

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

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

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.

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 in any place where someone else could access it and consume it. You can talk to your local pharmacist to learn about the best way to dispose of Prozac. Some pharmacies participate in a "take-back" program, and they can safely dispose of Prozac for you.

A Word From Verywell

Generally, it is still preferred that children with depression only use antidepressants as a last resort; therapy remains the first line of defense among depression treatment options for kids. Although most side effects of Prozac in children are usually mild and temporary, discuss all side effects, regardless of severity, with your child's clinician. As a team, you can work together to figure out the best treatment.