Prozac for 5 year old?
, Mar 14 2019 11:13 AM
35 replies to this topic
Posted 14 March 2019 - 11:13 AM
Hi everyone. My 5yo son is having severe behavioural problems - physically and verbally violent and refusal to undertake tasks. We have changed our parenting style at home and found that his behaviours here have decreased.
He started school this year and hit two children approx 2 weeks ago. He also has been swearing when upset, and displays an aggressive reluctance to undertake any school activities when in the classroom.
We met with the school yesterday who advised unless he goes on medication they won't be able to accommodate him any further - and the school has been extremely supportive so far so I do understand their perspective.
We saw a paed last month who said he cannot provide a report to the school as there has yet to be a diagnosis however then (literally after 10 minutes of meeting my son) prescribed Prozac and requested we come back in 6 weeks. I didn't fill the script as I was extremely uncomfortable and we were ushered out the door as soon as the pen dried on the script.
I went to fill the script this morning and the pharmacist was alarmed that a 5 year old was prescribed Prozac, particularly after no behavioural therapy so far (save a weekly visit to the OT - we are waiting on a psych to complete an assessment).
I'm quite distressed at the moment as I don't know whether to administer the Prozac or instead use the two vitamin supplements they recommended. Teachers have reported he has calmed down significantly over the last week.
Would anyone be able to provide feedback on medicating a child at 5 for an undiagnosed condition, or suggest a forum/website that could provide me with further information? Thank you for any advice/guidance you can offer.
Edited by timew, 14 March 2019 - 12:01 PM.
Posted 14 March 2019 - 11:39 AM
You are talking about floxetine right? Did the pead say why he recommended it? For anxiety?
I ask because well, I have a child who takes something slightly similar and though he wasn’t 5, it was the best thing we ever did. We honestly didn’t realise how much stress anxiety was causing him. And when he got highly anxious it turned into aggression and lashing out because he honestly was not coping and everything was completely overwhelming.
However I understand your point of view that it is scary. A child starting in any medication is a scary prospect for parents. If you are concerned I would contact the pead and ask for a phone call or email to go over the reasons for medicating and get their opinion again.
On the psych thing, yeah well, the psych here has only really being making a difference for my child now medication is on board. Before he had the tools and the concepts but the anxiety was too overwhelming for him to actually implement them. Using both, is where we have finally made progress.
I will say however I really don’t agree with the school stating they can’t take him unless medicated. Schools are not health care professionals and have no right and should not ever state that children under their care should be medicated. It’s just not something they should do or be saying.
I won’t mention the “natural supplements” because to be perfectly honest the chemist shouldn’t have voiced their option either, esicoially over selling vitamins vs medication. Supplements which have no research showing they are even effective against a medication which when used appropriately for its reason actually has eveidence to back up its effectiveness.
ETA: I just wanted to say that starting medication now doesn’t mean it’s forever. It might only be 3 months he needs medication support or it could be longer if you choose to go down this path. If you do start don’t jsut stop abruptly, these are medication that take time to build up in the blood stream and then need to be weaned off or you feel absolutely awful.
Edited by mayahlb, 14 March 2019 - 11:41 AM.
Posted 14 March 2019 - 12:15 PM
Thanks so much mayahib, that was incredibly helpful. Yep, it's Fluoroxetine. I contacted the paed to discuss the medication but he was quite abrupt, impatient and a little sarcastic (!) - he said there was 'no other option' and asked me why I thought he'd prescribe something that that wasn't effective. Anyway, I felt like I was interrupting a Genius At Work and have made an appt with a new paed in 6 weeks.
I think it's moreso that he is 5, I'm currently neck-deep in the Google rabbit hole and can't find any info on kids younger than 7 on the medication. Thanks again.
Posted 14 March 2019 - 12:29 PM
Timew yeah that doesn’t sound like a good pead. I’ve seen numerous ones over the years and those type get snapped at back pretty fast from me now.
I don’t know what google will tell you anything. It’s not a medication that I believe has been studied in children younger then 7 due to ethical reasons and nerve number of children under 7 requiring it is small. However in saying that, I am in a few groups for parents of children with adhd/asd etc. and there is a number of children there medicated from about 4 for anxiety. It’s really dependant on the child, the symptoms and how they are functioning and what can help. So it is not unknown. These children are normally under the care or developmental leads though.
Posted 14 March 2019 - 12:41 PM
I am saddened to hear that a Pharmacist took it upon themselves to tell you to ignore a Drs prescription . That’s appalling and completely out of line.
However the Paed doesn’t sound like a good fit . Is it a developmental Paed that you’re on the list for?
Posted 14 March 2019 - 01:10 PM
It was surreal as I've never had that experience at a chemist - the pharmacist was completely against the medication and explained his history with his teenage daughter who was only put on the medication at 14 "when all other options were exhausted". The other pharmacists at the chemist agreed.
We're just on the list of a paed, we live in a rural town however I might cast the net further out for a development paed.
I've just found out the the psych who had agreed to undertake an ASD assessment of my son has not moved on the assessment since our initial meeting six weeks ago. Has not contacted his school, his old day care, his paed - nothing. There has not been any suggestion of behavioural therapy and it was only when I contacted her to find out at what stage we were at did she suggest we hold a secondary assessment discussion early next month with my husband (ie. the initial assessment discussion but with my husband present), followed by sessions with my son.
It's a very steep, stressful learning curve and I'm finding it quite difficult not to feel as though I've failed him - to find a good paed, to push for an assessment, to insist on behavioural therapy sessions. I feel that if I had done all that he wouldn't be in the position he is now - in danger of suspension and his stress at school.
Edited by timew, 14 March 2019 - 06:01 PM.
Posted 14 March 2019 - 01:30 PM
My DD started on Lovan (Prozac) at 4yo for crippling anxiety. Best thing we ever did. She’s now 9yo and we have no plans to take her off it. She has anxiety, ASD and ADHD.
That pharmacist should have kept his mouth shut.
Posted 14 March 2019 - 01:56 PM
If I’m perfectly honest I’d be reporting that chemist to the regulatory board. They are employed and qualified to dispense medication, not prescribe medication. There I no way any of the chemists I have an interactions with would say anything like that to me.
Also totally get the rural = limited options on pead. Don’t think that means no options though, even living remote and rural if there is an issues with a pead we can request not to see that one at our pead clinic (we are seen through country health WA, so the paediatricians at the hospital). We see a consultant pead, not a developmental pead. Of which there are only two here, though that likely has something to do with they are the only ones that can write my kids scripts for adhd meds).
Posted 14 March 2019 - 02:01 PM
This would usually be filled at a compounding pharmacy, who do see fluoxetine given to young children.
Posted 14 March 2019 - 03:44 PM
I agree the pharmacist was unprofessional. Sharing his daughter's story was inappropriate too.
Fluoxetine has been an absolute game changer for us. It wasn't started at 5yo though. Our paediatrician has made it VERY clear that medication has been our decision, not his. I encourage you to keep looking for one who will work with your family. You may need to travel to a metro area though.
Posted 14 March 2019 - 04:51 PM
Chicken Penang, on 14 March 2019 - 02:01 PM, said:
This would usually be filled at a compounding pharmacy, who do see fluoxetine given to young children.
No need for a compounding pharmacy. We get DD’s from a regular pharmacy.
Posted 14 March 2019 - 05:13 PM
I don’t know what’s right for your child.
If the school is pushing you into a decision that your not comfortable because you want to get a diagnosis that’s not fair. Can you have another meeting with the school and explain what’s happening, can the write a letter to explain how disruptive your son is? Maybe sending that with a Dr referral will get you into a more supportive Ped quicker?
I understand how hard it is to find the right Drs. When you live rurally, we travel a minimum of 2 hrs to ours. One of mine has a Mental Health problem and is medicated. Best thing we ever did, but it is a huge decision.
We have Skyped with physicists after referrals from GP, which was really helpful with finding the right medication. Also Skyped with physiogist. Don’t forget that as a option.
It sucks but you have to fight for your child the whole time. My question to you is. How do you know your getting the right medication if you don’t have a diagnosis?
Edited by #mocha, 14 March 2019 - 05:15 PM.
Posted 14 March 2019 - 05:17 PM
Oh and I just want to say if you child is autistic anxiety meds won’t change that. It will just let them cope better with the anxiety inducing things that are going on. If anything anxiety med made it more obvious my child was autistic.
Posted 14 March 2019 - 05:18 PM
I'm torn with the chemist in that the sharing of his story was inappropriate but a chemists job is also to pick up possible mistakes in prescriptions (which do happen). A pharmacist would be held accountable if they filled a script for fluoxetine (?) and it was actually a typo and meant to be flixotide (that's a real life example I'm aware of).
From the sounds of it OP you haven't been explained the purpose of the medication, what improvements you are likely to see, possible side effects etc. That's dodgy on behalf of the paed.
I was recently questioned about my medication. Based on the scripts I'd handed in I was taking almost double the daily maximum. It was only through an extensive chat that I could explain the dr was trialling dose changes and exactly how I was taking it and the chemist filled the script.
Mind you I'd expect the chemist to ring the dr for clarification if they have concerns about the medication/dose or the patient can't answer questions about it rather than just refuse to fill it.
Posted 14 March 2019 - 05:45 PM
My daughter started on this at 8 after an experienced disability teacher said she had never seen such a high level of anxiety - we had already talked about it (she had GDD from 2 yo then ASD diagnosis at 6). Again life changing but was only the tip of the diagnosis/medication roundabout. We started on an 1/8 of a tab and gradually increased watching for improvements (and it takes at least 6 weeks to kick in). What dosage did your child get prescribed? And yes you should have been briefed on side effects as children can suffer from SSRI poisoning (friend had massive scare when one of her children grabbed a double dose so we sat in emergency watching this child giggling and waving her hands in front of her face - funny but potentially deadly which is why we headed straight to the hospital).
Posted 14 March 2019 - 05:45 PM
OP if you'd taken that prescription to the retail pharmacy of a children's hospital you would have had a different response. They would be familiar with seeing this prescribed for children by paediatricians.
MooGuru I absolutely agree that a pharmacist should query an unusual prescription. The Flixotide / fluoxetine error would get picked up quickly - one is a brand name inhaler, while the other is a generic name of an oral medication.
Posted 14 March 2019 - 06:06 PM
Two of my children are on floxetine (Lovan). They have been on it since they were 10.
I agonised for years over the decision wondering what it would do to their developing brain. I am on medication for mental health issues including anxiety so eventually I thought that I shouldn't deny my children pharmacological respite given I know how debilitating anxiety is.
When I saw the change in the number and severity of meltdowns I actually realised how severe their anxiety must be and then I beat myself up wondering how much they missed out on because of their anxiety and behavioral problems. I wondered how much of their development got stunted because I didn't make the decision sooner?
I think the paed should have explained how the medication works, side effects, etc. Our paed explained how it works to me like this: serotonin is a happy hormone and when we get stressed we chew through this hormone and they think that by enabling more of it to be available, it helps people stay calmer during periods of high stress. (Hopefully some one will call me out on that description is too inaccurate).
I hope our experience has helped you in some small way.
Posted 14 March 2019 - 08:04 PM
We started my then 6yo day on Lovan half way through prep and it made a huge change...
We were getting violent also. We’ve since started other meds but also have ADHD/ASD/ODD but we take it daily.
Posted 14 March 2019 - 08:06 PM
Thank you all so much for your comments and experiences. It has really meant a lot to me to realise this is not an untrodden path.
I'm leaning towards putting my son on the Fluoxetine - as a number of you have said I can always take him off it, and there are a number of really positive stories above. My beloved GP has agreed to see us on Monday and can talk me through what she knows about Fluoxetine, and if she doesn't have the knowledge I'm confident she will try and access someone who does.
It does come back to what you've written though - what are we medicating? I've seen his psych briefly in unrelated situations over the last month (in a hallway, 10 second discussions). The first time she said she assumes it will be "ASD and ODD", the second time "Just ASD". The third time she said that "she's on to it", today she looked the other way and walked into a room. One teacher at school told me she thinks he is ODD - but when I've looked at ODD markers a lot doesn't add up. I'm obviously quite confused at the moment. And I feel I'm drowning in acronyms that may or may not be relevant to how I can help him at the moment. All I know is at the moment he's not coping at school.
You've made a really good point regarding the pharmacist. Now I've had a think about it I've realised the pharmacy is based in a large medical facility for older people. I will report him to the regulatory board tomorrow, good intentions or not his advice and comments were beyond his remit (and expertise?).
Thanks again everyone.
Edited by timew, 14 March 2019 - 08:07 PM.
Posted 14 March 2019 - 08:12 PM
Everything seems so wrong here.
The school is wrong to have said that - as PP says they are not health professionals. I can see why they might have felt it was their last resort but it's not appropriate to force medications.
The paed does not sound professional. AD's have their uses but there should be a diagnosis of something that is helped with AD's before prescribing them - let alone that age. Perhaps he has suspicions of what it is that he's testing out... but he hasn't shared them.
The pharmacist... I'm torn because what they did is unprofessional but complying with a script they think is irresponsible without saying anything is unethical.
Does your son need to be in school this year? Is it a possibility to take him out, work on a diagnosis, and start again next year? I would not (if you have the option) be medicating him to keep him in school until you have an actual diagnosis that you know you are medicating him FOR.
Posted 14 March 2019 - 08:49 PM
Oh OP, sounds like such a rough time.
I am really angry about the pharmacist’s response. I have had them give their opinion when I was in a vulnerable situation and really think they should keep their opinions to themselves. If the dose was at an unsafe level or the prescription against regulations, they should ring up your doctor and discuss. I don’t think there is a place for their opinion when you have consulted with a specialist. It brings doubt that is not needed and causes anxiety.
With the paed prescribing medication after not much contact with your son, I see them as having a role of reviewing all the information available to them andassessing this, rather than carrying out assessments themselves. Despite there being no diagnosis yet, it does sound like your son is struggling and the school cannot manage him.
Bit different to you, but my kid is on ADHD medication, which prior to actually using and seeing how marvellous it was, I was against. The paed was quite clear when I saw him and he asked my views on medication, that when he had all the test results in front of him that he would be recommending medication if the results were severe enough, which I knew they would be. So when he had done his assessment he told me we needed to try medication. I could have refused, but by this stage life was so hard and things were clearly not going well, and I figured if a professional was telling me I needed to do this, I should try it. And the paed was good by naming it up as a trial, which made it sound better. He was totally correct, but was not smug or arrogant about it, but at the same time I was at a point where I probably needed him to tell me what to do rather than leaving it up to me and me making a decision based on stereotypes and what I had read in the media.
Edited by Prancer is coming, 14 March 2019 - 08:51 PM.
Posted 14 March 2019 - 08:54 PM
My son started on it at 7 for GAD. He is the poster child for prozac/lovan. He went from anxious and violent before school, to within a week waking up singing and relaxed before school. He has thrived, been on a very low dose for years and receives the gold award for behaviour and is on the principal’s honour roll for academics. It was life changing. I myself should have been on it as a child, so am grateful for the progress in medicine that allows my son to benefit.
Posted 14 March 2019 - 09:59 PM
Thanks again everyone. PP - to imagine my son thriving in a school environment would be a dream and I'm glad he has thrived.
More than ever, this entire process feels back to front. Do I call the psych daily to push her along? My eldest was diagnosed with ASD 2 years ago and the process was seamless - met up with the (different) psych, he spoke to the us, the school and other specialists and obtained relevant reports, spoke to my eldest for a few hours and in a month we received a detailed, articulate and accurate assessment. I assumed this psych would do the same - but as I mentioned above it's been 6 weeks and she hasn't moved on this.
I have thought about holding him off for a year. And to be brutally honest, I have thought about putting him on the med if simply to tide him over at school until he has a formal diagnosis. Which is an awful thing to consider, I know that. And given the paed prescribed meds after a 10 minute (if that!) conversation with me and a 4-line referral letter from my GP it would be a dangerous and selfish path for me to take.
Posted 15 March 2019 - 09:57 AM
This whole situation seems to raise red flags. The school should not be pushing you to medicate your child (they are not qualified to do so) and I would certainly take on board what your pharmacist has told you particularly in light of your paed’s appalling attitude. He sounds like exactly the kind of doctor who would prescribe carelessly/inappropriately and you clearly don’t trust his judgement. If your child is not coping st school and is only 5 would it be possible to withdraw from school and take some time to get these matters sorted with input from a variety of professionals to perhaps combine medication, therapy, parenting strategies etc and start school afresh next year. Five is very young and maybe school can be put on hold for now (??).
Posted 15 March 2019 - 11:33 AM
I am not really able to offer advice on the medication front but you are doing a great job by considering all the options and trying to get more information. It is tough and lonely sometimes and I can read the love in your posts.
Edited to add I would also ring the new paed every morning asking if there has been a cancellation. If the second one is a dud too then you are cutting your lost time back. If they can see you early and are good then less time of intense stress not moving forward.
Edited by 123tree, 15 March 2019 - 11:35 AM.
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