Has anyone taken prozac?
TheMachine1
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Joined: 11 Jun 2006
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05 Nov 2006, 11:38 am
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Fluoxetine for childhood anxiety disorders.
Birmaher B, Waterman GS, Ryan N, Cully M, Balach L, Ingram J, Brodsky M.
Department of Psychiatry, University of Pittsburgh, School of Medicine, Western Psychiatric Institute and Clinic, PA 15213.
OBJECTIVE: The objective of this open study was to determine the efficacy and safety of fluoxetine for the treatment of children and adolescents with anxiety disorders. METHOD: Twenty-one patients with overanxious disorders, social phobia, or separation anxiety disorder, who were unresponsive to previous psychopharmacological and psychotherapeutic interventions, were treated openly with fluoxetine for up to 10 months. Patients with lifetime histories of obsessive-compulsive disorder (OCD) or panic disorder, or with current major depression, were excluded. Beneficial and adverse effects of fluoxetine were ascertained using the improvement and severity subscales of the Clinical Global Impression Scale (CGIS) in two ways: (1) independent chart reviews by two child psychiatrists and (2) prospective assessments by the treating nurses and the patients' mothers. RESULTS: Eighty-one percent (n = 17) of patients showed moderate to marked improvement in anxiety symptoms. The severity of anxiety as measured by the CGIS was also significantly reduced from marked to mild (effect size: 2.3). There were no significant side effects. CONCLUSIONS: These results suggest that fluoxetine may be an effective and safe treatment for nondepressed children and adolescents with anxiety disorders other than OCD and panic disorder. Future investigations using double-blind, placebo-controlled methodologies are warranted.
PMID: 7961355 [PubMed - indexed for MEDLINE]
Open fluoxetine treatment of mixed anxiety disorders in children and adolescents.
Fairbanks JM, Pine DS, Tancer NK, Dummit ES 3rd, Kentgen LM, Martin J, Asche BK, Klein RG.
Department of Child Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
An open-label pilot study examined fluoxetine treatment in 16 outpatients (9-18 years old) with mixed anxiety disorders. Following nonresponse to psychotherapy, fluoxetine monotherapy was started at 5 mg daily and was increased weekly by 5 or 10 mg daily for 6-9 weeks until improvement occurred or to a maximum of 40 mg (children under 12) or 80 mg (adolescents). Among patients on fluoxetine, severity of illness ratings were "much improved" (mean final Clinical Global Impression scale score 2.8 +/- 0.7). Clinical improvement occurred in 10 of 10 patients with current separation anxiety disorder, 8 of 10 with social phobia, 4 of 6 with specific phobia, 3 of 5 with panic disorder, and 1 of 7 with generalized anxiety disorder. Mean time to improvement was 5 weeks. Mean doses were 24 mg (0.7 mg/kg) for children and 40 mg (0.71 mg/kg) for adolescents. Side effects were transient and included drowsiness (31% of patients), sleep problems (19%), decreased appetite (13%), nausea (13%), abdominal pain (13%), and excitement (13%). No patient developed disinhibition, akathisia, or suicidality. These preliminary findings suggest fluoxetine effectiveness in separation anxiety disorder and social phobia. Youths with only one anxiety disorder appeared to respond to lower doses of fluoxetine than patients with multiple anxiety disorders (0.49 +/- 0.14 versus 0.80 +/- 0.28 mg/kg, p < 0.05).
PMID: 9192539 [PubMed - indexed for MEDLINE]
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Fluoxetine for the treatment of childhood anxiety disorders.
Birmaher B, Axelson DA, Monk K, Kalas C, Clark DB, Ehmann M, Bridge J, Heo J, Brent DA.
Department of Child Psychiatry, University of Pittsburgh Medical Center, Western Psychiatric Institute and Clinic, Pittsburgh, PA 15213, USA. [email protected].
OBJECTIVE: To assess the efficacy and tolerability of fluoxetine for the acute treatment of children and adolescents with generalized anxiety disorder, separation anxiety disorder, and/or social phobia. METHOD: Anxious youths (7-17 years old) who had significant functional impairment were randomized to fluoxetine (20 mg/day) (n = 37) or placebo (n = 37) for 12 weeks. RESULTS: Fluoxetine was effective in reducing the anxiety symptoms and improving functioning in all measures. Using intent-to-treat analysis, 61% of patients taking fluoxetine and 35% taking placebo showed much to very much improvement. Despite this improvement, a substantial group of patients remained symptomatic. Fluoxetine was well tolerated except for mild and transient headaches and gastrointestinal side effects. Youths with social phobia and generalized anxiety disorder responded better to fluoxetine than placebo, but only social phobia moderated the clinical and functional response. Severity of the anxiety at intake and positive family history for anxiety predicted poorer functioning at the end of the study. CONCLUSIONS: Fluoxetine is useful and well tolerated for the acute treatment of anxious youths. Investigations regarding the optimization of treatment to obtain full anxiety remission and the length of treatment necessary to prevent recurrences are warranted.
PMID: 12649628 [PubMed - indexed for MEDLINE]
Clark DB, Birmaher B, Axelson D, Monk K, Kalas C, Ehmann M, Bridge J, Wood DS, Muthen B, Brent D.
Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, PA 15213, USA. [email protected]
OBJECTIVE: To assess the efficacy of fluoxetine for the long-term treatment of children and adolescents with anxiety disorders, including generalized anxiety disorder, separation anxiety disorder, and/or social phobia. METHOD: Children and adolescents (7-17 years old) with anxiety disorders were studied in open treatment for 1 year after they completed a randomized, controlled trial (RCT) comparing fluoxetine and placebo. The follow-up phase assessments included clinician, parent, and child ratings with measures of global severity, global improvement, and anxiety symptoms. RESULTS: Subjects taking fluoxetine (n = 42) were compared with those taking no medication (n = 10) during follow-up on anxiety changes from the end of the RCT through the follow-up period. Statistical models included RCT assignment and follow-up psychological treatment. Excluded subjects took other medications (n = 4) or did not complete follow-up (n = 18 ). Compared with subjects taking no medication, subjects taking fluoxetine showed significantly superior follow-up outcomes on most measures, including clinician, parent, and child ratings. CONCLUSIONS: The results suggest that fluoxetine is clinically effective for the maintenance treatment of anxiety disorders in children and adolescents. A major limitation, however, was the lack of RCT methodology in the follow-up phase. RCTs are needed to determine the long-term risks and benefits of fluoxetine for this group.
PMID: 16292118 [PubMed - indexed for MEDLINE]
Sonawalla SB, Farabaugh A, Johnson MW, Morray M, Delgado ML, Pingol MG, Rosenbaum JF, Fava M.
Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA. [email protected]
Major depression with comorbid anxiety disorder is associated with poor antidepressant outcome compared to major depression without comorbid anxiety disorder. The purpose of our study was to assess changes in severity of both depressive and anxiety symptoms in outpatients with major depression with comorbid anxiety disorder following fluoxetine treatment. We enrolled 123 outpatients (mean age 38.9 +/- 10.8 years; 49% women) with major depressive disorder accompanied by one or more current comorbid anxiety disorders in our study. Patients were treated openly with fluoxetine 20 mg/day for 8 weeks. Efficacy assessments included the 17-item Hamilton Rating Scale for Depression (HAM-D) and the patient-rated Symptom Questionnaire (SQ) Scales for Depression and Anxiety. The mood and anxiety disorder modules of the Structured Clinical Interview for DSM-III-R were administered at screen and endpoint. We used 'intent-to-treat' analysis in examining all patients assigned to treatment and completing the baseline visit. The mean number of comorbid anxiety disorders per patient was 1.5 +/- 0.68. The mean HAM-D-17 score and mean Clinical Global Impressions-Severity scores decreased significantly from baseline to endpoint (week 8 ) following fluoxetine treatment (p < 0.0001). There were significant decreases in all four SQ scale scores, from baseline to endpoint: depression, anxiety, somatic symptoms and anger-hostility (p < 0.0001). Fifty-three percent of patients (n = 65) were depression responders (i.e. > or = 50% decrease in HAM-D-17 score at endpoint) and 46% (n = 57) were remitters (HAM-D-17 < or = 7 at endpoint). Patients with panic disorder had significantly higher baseline HAM-D-17 scores compared to those without panic disorder (p < 0.01). Patients with comorbid obsessive-compulsive disorder (OCD) were significantly less likely to be responders to fluoxetine at endpoint (> or = 50% decrease in HAM-D-17) and to be remitters (HAM-D-17 score of s 7 at endpoint) compared to patients without comorbid OCD (p < 0.01). Of the 41 patients on whom endpoint Structured Clinical Interview for DSM-III-R modules for anxiety disorders were available, 49% (n = 20) no longer met criteria for one or more of their anxiety disorder diagnoses at endpoint. Our preliminary findings suggest that fluoxetine is effective in treating outpatients with major depression with comorbid anxiety disorders, with a significant effect on both depression and anxiety symptoms. Further double-blind, placebo-controlled trials are required in larger samples to confirm our findings.
PMID: 12236627 [PubMed - indexed for MEDLINE]
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Efficacy of usual antidepressant dosing regimens of fluoxetine in panic disorder: randomised, placebo-controlled trial.
Michelson D, Allgulander C, Dantendorfer K, Knezevic A, Maierhofer D, Micev V, Paunovic VR, Timotijevic I, Sarkar N, Skoglund L, Pemberton SC.
Lilly Research Laboratories, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, Indiana 46285, USA.
BACKGROUND: Although serotonin reuptake inhibitors are effective in panic disorder, questions concerning whether doses associated with antidepressant efficacy are also effective for panic disorder remain. AIMS: To assess the efficacy of the usual antidepressant dose of fluoxetine in treating full panic attacks. METHOD: Patients with panic disorder were randomised to placebo or to fluoxetine initiated at 10 mg daily for 1 week and then increased to 20 mg daily. The trial lasted 12 weeks, but after 6 weeks patients who had failed to achieve a satisfactory response were eligible for dose escalation to a maximum of 60 mg of fluoxetine daily. RESULTS: Fluoxetine was associated with a statistically significantly greater proportion of panic-free patients compared with placebo after 6 weeks and at end-point. CONCLUSIONS: Fluoxetine at a dose of 20 mg daily is safe and efficacious in reducing symptoms of panic disorder. Patients who fail to obtain a satisfactory response at 20 mg daily may benefit from further dose increases.
PMID: 11731354 [PubMed - indexed for MEDLINE]
Last edited by TheMachine1 on 05 Nov 2006, 11:56 am, edited 4 times in total.
05 Nov 2006, 11:44 am
The problem is my son will not partake in any therapies in fact he wont leave the house and I am using prozac as a final option in the hope that it may change the dynamics for him and lift him out of a rut. That is not to say that I am absalutely terrified about giving it to him especially since he is still developing and at a very import developmental stage of puberty.
He seems to be interested in absalutely nothing only certain computer games. he plays them night and day and can't sleep at night. He has been like this for about 2 yrs now. He is failing at school as he refuses to go as he hates school. He is not bullied it is just that he can not take anything in.
Everyday i worry about him and what sort of future he will have.
Thanks to everyone I hope my sons response to prozac is good like yours Kosmonaut.
05 Nov 2006, 11:52 am
Thank you for all the info you posted for me. It gives me hope as it is really the anxiety and social phobia that I am trying to deal with for my son, so maybe it will help. Time will tell.
I know there were some tests done on adolescant rats and there was some evidence of effects on growth. This worries me as the doctors etc don't seem to know anything about this.
I just realised that it is 2am in the morning with you it is only 5pm here are you in Australia?
07 Nov 2006, 9:43 am
Prozac was the first anti-depressant i was on. It helped me a little with depression but did nothing for my social anxiety. One side effect was i lost weight, which i attribute to the increase in seratonin so i was not binging on carbs as much to increase my seratonin and feelings of wellbeing.
Now i am on Zoloft which has help me much more so with depression and social anxiety, except i have gained 20 lbs with it!
07 Nov 2006, 6:58 pm
Thank you all so much. You have given me plenty of insight and I really really appreciate all your opinons and advice. I
t is hard to know but in my son's case I was determind that he would never go on medication, however things have got so bad for him, with social phobia and have no enjoyment in his life. He hates this world and lives in a fantasy world of computer games almost 24hrs a day.
I am sad when I see all the other boys his age starting to go out and explore and test the world and socialising.
He now goes to school very little for me and I am a complete wreak worrying about his future and what he is ever going to do as a job. He has developed no skills for the outside world as all he wants to do is play fantasy computer games. He even says that he wishes 'Kingdom Hearts' was the real world and it makes him sad that he will never ever be able to go there.
Thank you all so much. You have given me plenty of insight and I really really appreciate all your opinons and advice. I
t is hard to know but in my son's case I was determind that he would never go on medication, however things have got so bad for him, with social phobia and have no enjoyment in his life. He hates this world and lives in a fantasy world of computer games almost 24hrs a day.
I am sad when I see all the other boys his age starting to go out and explore and test the world and socialising.
He now goes to school very little for me and I am a complete wreak worrying about his future and what he is ever going to do as a job. He has developed no skills for the outside world as all he wants to do is play fantasy computer games. He even says that he wishes 'Kingdom Hearts' was the real world and it makes him sad that he will never ever be able to go there.Thank you all so much. You have given me plenty of insight and I really really appreciate all your opinons and advice. I
t is hard to know but in my son's case I was determind that he would never go on medication, however things have got so bad for him, with social phobia and have no enjoyment in his life. He hates this world and lives in a fantasy world of computer games almost 24hrs a day.
I am sad when I see all the other boys his age starting to go out and explore and test the world and socialising.
He now goes to school very little for me and I am a complete wreak worrying about his future and what he is ever going to do as a job. He has developed no skills for the outside world as all he wants to do is play fantasy computer games. He even says that he wishes 'Kingdom Hearts' was the real world and it makes him sad that he will never ever be able to go there.
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