The P word

Prozac for kids.

It sounds absurd, almost like a joke – like Viagra for kids, or HRT for kids. But I wasn’t laughing last Friday when I turned on the evening news to hear that the FDA had approved Prozac for the treatment of depression and obsessive compulsive disorder in children aged 7 to 17.

They must have broken out the good champagne over at Eli Lilly & Company (maker of Prozac) to toast the expansion of an already lucrative market. But the sad fact is that hundreds of thousands of kids have already been taking Prozac (and other types of SSRIs – selective serotonin reuptake inhibitors) for several years. Friday’s announcement by the FDA simply gives a regulatory stamp of approval for something that has been available (although not officially sanctioned) all along. But now doctors can reassure parents that they shouldn’t worry a bit about giving Prozac to their second grader – because the FDA says this drug is just fine for a 7-year-old.

Into the unknown

The FDA based its approval on two studies of children that showed Prozac was more effective than placebo in fighting depression. But in one of those studies, over a 19-week period, the children taking Prozac grew about half an inch less (on average) than the children taking placebo. The children in the placebo group also gained an average of two pounds more than kids in the Prozac group. Regarding this, the FDA said, “The clinical significance of this observation on long-term growth is unknown.”

As stamps of approval go, I find that one less than comforting. And it begs the question: If Prozac inhibits growth and weight gain, what is it doing to young brains as they grow and develop? No one knows the answer to that one.

What the studies DO show is that the side effects of Prozac are the same for children as they are for adults – including; dizziness, nausea, nervousness and difficulty concentrating. Of course, those last two are no problem. The pediatrician could always just write out a prescription for Ritalin to go along with the Prozac.

Sound absurd? What scares me is that it’s probably already going on.

A better first option

According to Dr. Donald L. Rosenblitt, the medical director of the Lucy Daniels Center for Early Childhood, it’s not unusual for physicians to prescribe Prozac, Zoloft or Paxil for children as young as 4 years old. As deplorable as that is, the real shame is that, beyond whatever environmental, social or personal circumstances might trigger depression, there are dietary factors that can and should be addressed long before any pediatrician offers the free “starter pack” of Prozac.

In an e-Alert I sent you last fall (“Omega Delta Blues” 10/28/02), I told you how those who experience mild to moderate depression often find relief with an increased intake of omega-3 fatty acids (in fish or fish oil supplements). People who are depressed are often deficient in magnesium, as well, which is found in whole grains, nuts and leafy green vegetables. Herbal supplements like valerian root, chamomile, black cohosh, and rosemary may also help manage depression. And the standout among the herbs for mild to moderate depression is, of course, St. John’s wort, which is sometimes called the “natural Prozac” for its apparent ability to help manage the proper functioning of seratonin in the brain.

High levels of B vitamins have also been shown to relieve symptoms of depression. In addition to supplements, good dietary sources of vitamin B are: tuna, salmon, avocados, bananas, mangoes, potatoes, broccoli, cauliflower, poultry and meat. Note that stress (which often goes hand in hand with depression) is believed to deplete the body’s store of B vitamins.

As pure as the Lilly white snow

In an Associated Press report last Friday, a spokesperson for Eli Lilly stated that the company “didn’t intend to market Prozac for children.” Right. I can’t help but wonder if this spokesperson used to work for Phillip Morris. You and I both know that the FDA approval will have an absolute effect on the way Lilly’s salespeople promote Prozac. With this new approval, doctors will feel more comfortable prescribing the drug for kids, and Lilly salespeople will certainly exploit the leverage of the FDA blessing.

If you’re the parent or grandparent of a child who’s struggling with depression, I urge you to explore the dietary and supplement options before you choose to medicate with a powerful drug whose long-term effects in children have not been adequately researched.

And if you have a friend or relative who is considering a pharmaceutical for their depressed child, I hope you’ll forward this e-mail to them. Then when they’re tempted by an easy answer and a “feel good” sales pitch (and they will be), they’ll also know that they have another, less dangerous course of action to try first.

To Your Good Health,

Jenny Thompson
Health Sciences Institute