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How safe is Paxil For Children?

Mar 14, 2003

MY 5 year old daughter has OCD with ODD.(obsessive compulsive /oppositional defiant disorders). She was on respirdol did not work. We had her on prozac but she had the rare side effect of agitation to the point she could not stay still. Try as she did she just could not stay still or focus. Her psychiatrist told me to stop prozac immediately and to switch her to paxil. Her dosage was 20mg of prozac and now she will be taking 20mg of paxil. I am scared. Especially seeing her on the prozac. I understand there is not much study done on pediatric uses of these types of medicine. Should I wait a couple of weeks before starting her on the paxil? I just want to do right by my child. I would hate to give her something that would permanently harm her for the rest of her life.

Response from Dr. Horwath

Unfortunately, the amount of research done on the efficacy and safety of psychotropic medication in children is insufficient. Data on paroxetine use in children is limited. However, it has been used to treat OCD and major depression in children. In children over 8 years old, the dosage guidelines suggest starting with 5-10 mg/day and titrating up to a maximum of 20-30 mg/day, if needed.

In adults, Paxil has been used for some time with a good safety record. Among the psychotropic drugs, Paxil (and other drugs in this medication class - SSRI's) has a very favorable safety profile. Unfortunately, in children its safety is less well established. To date, however, there are no reasons to suspect a problem. Of course, in the case of your child, you need to weigh the seriousness of the OCD and the potential benefit of the drug against the possibility of harmful side effects. This should be done in consultation with the physician providing the treatment.

It is worth noting that the side effect of agitation is somewhat more common with Prozac than with Paxil.

telling the kids

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