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 and sometimes bipolar disorder.

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. 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.

Side Effects 

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 may include:

• Appetite changes (increase or decrease)
• Gastrointestinal symptoms (e.g., nausea, upset stomach, diarrhea)
• Headaches
• Restless legs
• Restlessness
• Sedation
• Sleep changes (e.g., insomnia, somnolence, vivid dreams, nightmares, 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 your healthcare provider immediately:

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

Increased Thoughts of Suicide

Another serious side effect 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

According to reviews reported by the National Institute of Mental Health, the benefits of antidepressants most likely outweigh the risks for children and adolescents with major depression and anxiety disorders. Like all medications, the decision to start treatment with an SSRI 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.

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 treatment options. 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.