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Prozac for 7 year olds

Discussion in 'Issues Around the World' started by ethics, Jan 6, 2003.

  1. ethics

    ethics Pomp-Dumpster Staff Member

    The U.S. Food and Drug Administration has approved the use of Prozac <a href="http://news.yahoo.com/news?tmpl=story2&cid=571&u=/nm/20030103/hl_nm/prozac_teens_dc&printer=1">for treating depression and obsessive-compulsive disorder in children</a> as young as seven.

    While some doctors have already been legally prescribing the drug for young people, others have <a href="http://dir.salon.com/news/feature/2000/03/21/prozac/index.html">expressed concern about such use.</a>

    The Eli Lilly & Co. drug is the first in its class (selective serotonin reuptake inhibitor) to receive the FDA's green light for treating depression in children. According to the National Institute of Mental Health, depression affects up to 2.5 percent of children and 8.3 percent of adolescents in the U.S.; OCD affects approximately 2 percent of the population and usually begins at an early age.

    I know this is a personal issue with many here, so I'd like to hear some thoughts.

    Is there such thing as too young for this? Or do these real problems demand a treatment with anti-depressants?
     
  2. Misu

    Misu Hey, I saw that.

    Before I made a decision regarding this, I would need to review the studies that were performed on the effects to a youngster's brain development on this kind of medication. Human brains continue to form until a person is in their teens - usually between 16 through 19 years of age. To prescribe a drug that alters how the brain functions to a 7 year old, to me, scares the crap out of me. Brain damage is irreversible, and at 7, based on my assumptions and knowing what I know, I would not allow my children to take prozac to treat depression. I would send my kids to a child therapist and involve the entire family in family therapy before risking my child's brain.
     
  3. ethics

    ethics Pomp-Dumpster Staff Member

    Misu,

    I can tell you for a fact, no such studies exist. This is something totally new.

    Would you?
     
  4. Misu

    Misu Hey, I saw that.

    Well, since no studies exist to calm my fears for my kids' brains, then this line definately nailed the coffin shut on this idea for me:

    <i>The FDA noted that in one of the clinical studies, after 19 weeks of treatment with Prozac, children gained, on average, about 1.1 cm less in height (about a half an inch) and about one kilogram less in weight (about two pounds) compared with children treated with a placebo. According to the agency, "the clinical significance of this observation on long-term growth is unknown." </i>

    The fact that just 19 weeks of treatment stunts growth like this, is enough proof for me that it has adverse effects on a young mind, so forget it. I would NEVER put my child on prozac or any other SSRI. I don't think I'd even put my child on Ritalin, unless the ADD/ADHD was uncontrollable and seriously affecting his/her life.
     
  5. ethics

    ethics Pomp-Dumpster Staff Member

    I can't agree with you more. Physical development stunted? There's good correlation that so will the mental growth.
     
  6. Domh

    Domh Full Member

    Ill chime in just for a moment to say that its fucking INANE.

    How about a clean diet, regular outdoor exercise and lots of clean water?

    That prescription right there, if followed, would put the antidepressant business in the poor house within one fucking month.

    Stuff your child with poison and sit them down to play video games 10 hours a day and then give them drugs when they exhibit depression?

    We are the most ignorant, most bone-chillingly stupid society on the face of the earth.

    :mad:
     
  7. Twingo

    Twingo Registered User

    Yeah I wouldn't suggest ANY medication for a child until all natural avenues have been pursued. The thought that it could inhibit the brain, the body or whatever is just too much of a risk at that age.
     
  8. ethics

    ethics Pomp-Dumpster Staff Member

    Welcome to the forum, Twingo. :)
     
  9. Techie2000

    Techie2000 The crowd would sing:

    I personally don't like the idea. I can't speak from experience as I have never been depressed (in fact people I know say I'm too happy...LoL) but I've personally never liked the idea of popping pills over a long term. Personally I'd rather pursue every other avenue before having to pop a pill every day for more than 6 months...
     
  10. joseftu

    joseftu ORIGINAL Pomp-Dumpster

    This is a very difficult question. I think Twingo (welcome, Twingo! :) ) is right that this kind of medication for children should be a last resort, one that should be pursued only after very careful evaluation and with direct, close supervision of the effects on the child mentally, emotionally, neurologically, biochemically, etc.

    But, Domhain, this

    "How about a clean diet, regular outdoor exercise and lots of clean water?

    That prescription right there, if followed, would put the antidepressant business in the poor house within one fucking month."

    is an argument that really scares me. Clean diet, regular outdoor exercise and lots of clean water will have <b>absolutely no effect</b> on true depression. I know that there are some doctors who prescribe anti-depressants inappropriately, and I abhor that practice.

    It's unfortunate that we don't have another name for depression, because it's too easy to confuse it with just "feeling depressed" or "sad" or "down in the dumps." Those feelings happen to everyone, and they certainly don't need medication. But depression is very real, very tragic, and there are far too many people who suffer from it. It's an incredibly devastating illness, for kids or adults. It has nothing to do with video games. It destroys people, and their families. Far too often, people who are depressed suffer needlessly because the very attitude you're describing ("all you need is some fresh air! cheer up! don't fill yourself with poison") prevents them from getting the help (including medication) that they so desperately need.

    I know for a fact that this is true for adults, and I suspect that there are kids, too, who can be helped by these drugs. We need to be careful about medicating kids, absolutely, but we also need to be sure we don't shut kids off from treatments that can help them.
     
  11. Misu

    Misu Hey, I saw that.

    Joseftu, I completely agree with what you said in the above statement. However, I worry about the affects these meds will have on a developing child's brain.

    If 19 weeks of medication with prozac resulted in an average stunt growth of half an inch and 2 pounds, what are the physical effects that we CAN'T readily see?

    Were these children given any sort of cognitive tests, and then remeasured again after the 19 weeks? According to the article, no mention of that was made, so for right now, I'm assuming that these kinds of studies don't exist.

    Actual depression that needs to be treated with powerful meds like Prozac is more of a chemical imbalance than just feeling 'sad' or 'depressed'. However, regular doctors (not psychiatrists, who are more qualified to diagnose a real case of depression versus a general down in the dumps) are prescribing these things as if they were candy. And with the FDA now approving Prozac for use in small little kids, what we're being told as a society is that there's a pill to fix any ailment.

    Sure there's no need to suffer needlessly if you are truly suffering from depression - I highly recommend meds for adults and older kids, kids in their late teens. But because there are no studies proving that this is safe for younger developing brains, and these meds work precisely because they play around with seratonin levels and absorption rates, I honestly would prefer my child to suffer through depression with therapy rather than risk my kid's brain be turned to something resembling scrambled eggs.

    I think the FDA messed up with this decision, like they did with Phen-Fen, which was supposedly safe, yet they had no clue that long-term use would be fatal until women all over the country started dying because of massive heartattacks.
     
  12. Coriolis

    Coriolis Bob's your uncle

    Excellent point joseftu. Clinical depression in adults is due to a chemical (ie. serotonin) imbalance in the brain that no amount of fresh air, clean water and exercise will cure. My wife has lived with chronic clinical depression for most of her adult life, and its effects can be truly devastating if left pharmcologically untreated. She fought against this for a long time, trying everything "natural" but eventually succumbed to the reality that she'll probably be on anti-depressants for the rest of her life. Although she's otherwise very healthy, it's the long term side effects we worry about the most now... which brings me to the topic at hand:

    Would I go so far as to allow my kids to be prescribed anti-depressants? Currently, no. I think I'd stick more to Domhian's prescriptions, at least until there's some followup studies (the phase IV clinical trials are currently under way, according to the article).
     
  13. immortal one

    immortal one 501st Geronimo

    Prescription drugs have their place, and some folks have a better quality of life because of them.

    But...I don't think the large drug manufacturers really give a damn about a youngster's brain development...only about selling their drugs. I'm convinced that if the corporate pharmaceutical moguls had their way, each and every one of us would be medicated on one drug or another. The majority of the medical profession are just too quick to write the scripts any more. The drug companies cater to the physicians as if they were royalty.

    Easier to write a script for the symptoms, rather than attempting to discover the underlying cause.

    Morning TV has nearly as much time devoted to pharmaceutical commercials as to programming.
     
  14. joseftu

    joseftu ORIGINAL Pomp-Dumpster

    It's so true, and so sad. To have a child suffering from depression would be so hard, so terrible. It's painful to even think about the "what would you do?" question. I would certainly be afraid of the drugs. And afraid of the illness.
    sigh.
    I'm going to go and give my healthy, happy, (thank God, and knock on wood) sleeping seven-year-old a kiss, tuck in her blankets, and thank God that I'm not having to consider this issue for real.
     
  15. ShinyTop

    ShinyTop I know what is right or wrong!

    Hell, my 27 year came home last week for a while. And he might get tucked and a kiss.
     
  16. LissaKay

    LissaKay Oh ... Really???

    Ahh ... a subject I can well relate to. Unfortunately, I came across this just as the brain cells are shutting down for the night. I will return with more coherent thoughts, tons of links and perhaps some insight into what it is like to live with a child who has a mental disorder.

    First of all ... children CAN have mental disorders. This is well documented. Depression and ADHD are the leaders in numbers with Bipolar, ODD, OCD, Autistic-spectrum and Tourettes rounding out the list of the most commonly seen mood and behavioral disorders. The greatest challenge is accurate and correct diagnosis. The next is finding appropriate treatments.

    Depression in children is usually a symptom of a larger issue. Rarely does it occur on its own. In the very young (2-5 years), it is often a precursor to Bipolar, ADHD or OCD. As these children age, the accompanying symptoms begin to emerge. However, mental illness in children is poorly misunderstood. Treatments often miss their intended target of therapy. The correct diagnosis very often comes too late and the damage to the brain from being depressed or otherwise disordered has been done. Depression in kids is all too often misdiagnosed Bipolar disorder. The manic cycles are often mistaken for natural youthful exuberance ... the depressive cycles are more readily apparent. Adding to the confusion is the huge difference from Bipolar disorder as it is manifested in adults. The DSM-IV published in 1995 was the first to include bipolar disorder in children, but the criteria was the same as for adults.

    Children have a great deal of difficulty in expressing their feelings. They simply do not have the development of personal insight to be able to say, "I'm feeling really sad/mad/frustrated/scared about ____." As a result, these feelings are either internalized or they are acted out. In either case, it becomes a vicious cycle unless steps are taken to remedy the situation. School often becomes a major issue, home life can be horrifyingly disrupted by a mentally disturbed child.

    Sometimes it is the home life that contributes to the child's issues, more often it becomes a self-perpetuating cycle. Eventually the cycle spirals outward and begins to affect other members of the family. Siblings once considered "normal" often also become depressed as the over-worked, exhausted parents try to cope with the ill child.

    If I had life to do all over again, the ONE and only one thing I would change would be to rescue my son from what I knew was a toxic environment for him years ago. However, lacking the legal capability to just go and take him, all I could do was worry and try to limit the damage in the little ways I could. It was not until toxic turned to physically abusive that anyone was granted the legal right to step in and intervene. By then, the damage was done. My son was severely depressed even before things at home turned bad. The trauma of being taken from his father's home to foster care and the ensuing legal drama I believe initiated his final downward spiral to a psychotic break that included suicide attempts. Now he is being treated with the right kind of medications, is stable and is working hard at achieving some sense of normalcy so he can succeed in life. I, however, continue to be eaten alive by guilt and "what ifs."

    When thought to be only depressed, my son was placed on Paxil, also an SSRI like Prozac. For about 3 or 4 months, he made a startling turn-around and was doing amazingly well. However, as has been seen many times, the mood elevation of the Paxil helped to push him into full-blown cycling mania. He was on the verge, Paxil pushed him over the edge. In a way, this was good, but it was such a terrifying journey getting to the correct diagnosis ... I am still recovering.

    From my research of Early-Onset Bipolar Disorder, I agree with many prominent child psychiatrists that it should be ruled out before any other diagnosis is made when children present with mood or behavioral issues. The spectrum of traits and symptoms is shared by so many other mental disorders and illnesses, it is truly mind-boggling. It can look like ADHD, it can look like depression, it can look like Obsessive-Compulsive Disorder, Oppositional-Defiant Disorder, Tourettes and Aspergers. However, if a child with Bipolar is treated as if depressed, or ADHD, the results can be devastating ... even deadly.
     
  17. ethics

    ethics Pomp-Dumpster Staff Member

    Thanks Demi. Personal information like yours is priceless to a conversation like this.
     
  18. Misu

    Misu Hey, I saw that.

    Demi, since you've been in the trenches with this, and have had to live through it, I am curious - knowing what you know, and if your child was not bipolar but was suffering from regular depression, would you put your child on an SSRI med?

    I'm only going by what the article says, so I'm basing my whole opinion on the FDA approving Prozac for use on young kids diagnosed with <i>depression</i>. However, since kids are misdiagnosed more often than they are correctly diagnosed, I am wondering if more damage is being done by putting a child on a med that's meant to treat depression rather than bipolar or adhd or any other mental disorder.

    I'm not familiar with the meds that children are put on for other disorders, but the SSRI seems to be the 'miracle cure-all' for adults. If you're depressed-BAM, Paxil. If you're suffering from anxiety attacks - BAM, Paxil. I went on my own med rollercoaster last year, when my anxiety attacks got extremely bad, that my husband stayed home from work for a few days because I wasn't all well - I think that's the closest I've been to being suicidal since my highschool days - and my doctor started on the chemical cocktails - first he started with Zoloft, but that gave me weird side effects. Then Paxil, which was much worse. He then put me on something else, which I can't remember now but the effects were really really bad, and then Celexa, which was like a miracle for me, until I had to stop because of the meds I was taking for my back. But I'm an adult, and more research has been done on adults, plus *I* choose what happens to *me*. I accept the risks for myself. I don't think I'd be able to do that for my child, especially given the fact that misdiagnosing a mental disorder in children is almost EXPECTED. "Ok, let's try this for 3 weeks, and if it doesn't work, it's not ADHD. It's probably ODD, in which case we will try this. If that doesn't work, it's probably something else." PROBABLY doesn't cut it.
     
  19. mikepd

    mikepd Veteran Member

    We need to see more studies on meds for children, women, the elderly, all the groups who are not white males as they are the ones most studied for most non-specific drugs. Children are not little adults. You can't just titrate down a dose of an adult med and give it to a child then step back and see what happens.
     
  20. LissaKay

    LissaKay Oh ... Really???

    Given the level of depression he was displaying about a year ago, yes I would have allowed him to be prescribed the Paxil. He was at high-risk for suicide, and in fact, attempted three times in 6 months. It has also been documented that chronic or repetitive bouts of depression can actually cause damage to the brain if left untreated.

    However, even then, in my heart of mother's hearts, I knew depression and PTSD didn't explain *all* of it. But he had such an amazing improvement in the first two months on Paxil, I became a almost-believer. Of course in retrospect, now that I know how horribly those with Bipolar react to anti-depressants, I would have insisted on more in-depth diagnosis before prescribing an anti-depressant.

    You are right. Probably doesn't cut it. My view *may* be a bit skewed, but like I said before, I believe that Bipolar should be ruled out before any other mood/behavioral disorder is diagnosed. Bipolar Disorder is not just about mood swings - happy vs sad, depressed vs manic, stuporous vs enraged. Bipolar Disorder encompasses at least a portion of the symptomology nearly every other mood and behavioral disorder there is. ADHD, Oppositional-Defiant Disorder, Obsessive-Compulsive Disorder, Conduct Disorder, Autistic-spectrum, Aspergers Syndrome, Tourettes, Anxiety, Depression, PTSD ... Bipolar kids have symptoms of each of these. Hyperactivity, restlessness, distractibility, difficulty focusing and concentrating, defiance, impulsiveity, anxiety, hypersexuality, paranoia, irritability ... the list goes on and on. Many of these kids also display schizophrenic symptomology. Whether Bipolar is co-morbid with other conditions or is displaying similar symptoms, it needs to be treated first and foremost, primarily with a mood stabilizer, secondarily with an anti-psychotic. Yes, the medications my son takes have risks and side-effects, but they are negligible in the face of the 20% mortality rate of Bipolar Disorder.

    Unfortunately, as you experienced, Misu, even having an accurate diagnosis does not afford easy treatment. Some medications work miracles in some people, others have horrendous results, others still see no change. Sometimes it takes a combination of medications to affect relief of symptoms. Often there needs to be adjunctive therapy such as ECT, neurofeedback or light therapy (Seasonal Affective Disorder). Changes in diet and lifestyle can also make a difference in conjunction with other therapies.

    The art of psychiatry and mental health care is inexact at best. The brain and its functions are, even in this day of modern medicine, poorly understood. In this practice, more than in any other medical specialty, one should heed the adage of "When one hears the beat of galloping hooves, look not only for horses, but also for zebras."
     

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