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Fluoxetine exposures: are they safe for children?

  • S.David Baker
    Correspondence
    Address reprint requests to S. David Baker, Central Ohio Poison Center, Children’s Hospital, 700 Children’s Dr, Columbus, OH 43205 USA
    Affiliations
    Central Texas Poison Center, Texas Poison Center Network, Scott & White Memorial Hospital and Clinic, Texas A&M University System Health Science Center College of Medicine, Temple, Texas, USA
    Search for articles by this author
  • D.L Morgan
    Affiliations
    Central Texas Poison Center, Texas Poison Center Network, Scott & White Memorial Hospital and Clinic, Texas A&M University System Health Science Center College of Medicine, Temple, Texas, USA
    Search for articles by this author

      Abstract

      Although it is generally believed that unintentional ingestions of fluoxetine by children are relatively safe, there are no large published studies supporting this concept. The goal of this retrospective study is to determine the signs and symptoms of these children. Inclusion criteria included fluoxetine exposures from six certified regional poison centers: <6 years old, known amount, single substance, 20 mg or more ingested, and follow up done to determine outcome. One hundred twenty cases met all inclusion criteria. Average age was 25 months ± 12 months. Median amount ingested was 20 mg. Mild signs and symptoms were noted in 3.3%, and no major signs or symptoms were reported. In 48 cases, a milligram per kilogram dose was calculated, and the median dose ingested was 2.26 mg/kg. In 92% of the cases, the amount ingested was 60 mg or below. These children will have no adverse effects or only minimal effects and require no emergency treatment or gastric decontamination.

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      References

        • Litovitz T.L
        • Klein-Schwartz W
        • Caravati E.M
        • et al.
        1998 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System.
        Am J Emerg Med. 1999; 17: 435-487
        • Litovitz T.L
        • Klein-Schwartz W
        • White S
        • et al.
        1999 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System.
        Am J Emerg Med. 2000; 18: 517-574
        • Litovitz T.L
        • Klein-Schwartz W
        • White S
        • et al.
        2000 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System.
        Am J Emerg Med. 2001; 19: 337-395
        • Litovitz T.L
        • Klein-Schwartz W
        • Rogers G
        • et al.
        2001 Annual Report of the American Association of Poison Control Centers Toxic Exposure Surveillance System.
        Am J Emerg Med. 2002; 20: 391-452
        • Rushton J.L
        • Whitmire J.T
        Pediatric stimulant and selective serotonin reuptake inhibitor prescription trends—1992 to 1998.
        Arch Pediatr Adolesc Med. 2001; 155: 560-565
      1. Indianapolis Star, Library Archives. 2000 (Available at: http://www.indystar.comu/ulibrary/ufactfilesu/ubusinessu/companiesu/ulilly/lilly.html. Accessed October 10, 2000)
      2. Top 200 Drugs Dispensed in the United States for the Year 1998. 2001 (Available at: http://rxlist.com/98top.htm. Accessed March 20, 2001)
      3. Top 200 Drugs Dispensed in the United States for the Year 1999. 2001 (Available at: http://rxlist.com/99top.htm. Accessed March 20, 2001)
      4. Top 200 Drugs Dispensed in the United States for the Year 2000. 2001 (Available at: http://rxlist.com/00top.htm. Accessed March 20, 2001)
      5. Top 200 Drugs Dispensed in the United States for the Year 2001. 2002 (Available at: http://rxlist.com/200top.htm. Accessed August 12, 2002)
        • Ellenhorn M.J
        • Schonwald S
        • Ordog G
        • Wasserberger J
        Antidepressant agents.
        in: Ellenhorn M.J Schonwald S Ordog G Wasserberger J Ellenhorn’s Medical Toxicology. Diagnosis and Treatment of Human Poisoning. 2nd ed. Williams and Wilkins, Baltimore1997: 615-623
        • DeJonghe F
        • Swinkels J.A
        The safety of antidepressants.
        Drugs. 1992; 43: 40-47
        • Haddad L.M
        • Shannon M.W
        • Winchester J.F
        Centrally active agents.
        in: Haddad L.M Shannon M.W Winchester J.F Clinical Management of Poisoning and Drug Overdose. 3rd ed. WB Saunders Co, Philadelphia1998: 437-451
        • Swinkels J.A
        • DeJonghe F
        Safety of Antidepressants.
        Int Clin Psychopharmacol. 1995; 9: 19-25
        • Rushton J.L
        • Clark S.J
        • Freed G.L
        Pediatrician and family physician prescription of selective serotonin reuptake inhibitors.
        Pediatrics. 2000; 105: e82
        • Barbey J.T
        • Roose S.P
        SSRI safety in overdose.
        J Clin Psychiatry. 1998; 59: 42-48
        • Borys D.J
        • Setzer S.C
        • Ling L.J
        • et al.
        Acute fluoxetine overdose.
        Am J Emerg Med. 1992; 10: 115-120
        • Borys D.J
        • Setzer S.C
        • Ling L.J
        • et al.
        The effects of fluoxetine in the overdose patient.
        J Toxicol Clin Toxicol. 1990; 28: 331-340