title: Emergence of self-destructive phenomena in children and adolescents during fluoxetine treatment.
abstract: Self-injurious ideation or behavior appeared de novo or intensified during fluoxetine treatment of obsessive-compulsive disorder in six patients, age 10 to 17 years old, who were among 42 young patients receiving fluoxetine for obsessive-compulsive disorder at a university clinical research center. These symptoms required the hospitalization of four patients. Before receiving fluoxetine, four patients had major risk factors for self-destructive behavior including depression or prior suicidal ideation or self-injury. Three hypotheses concerning the apparent association between fluoxetine and these self-injurious phenomena are discussed: (1) coincidence; (2) disorganization of vulnerable individuals secondary to drug-induced activation; and (3) a specific serotonergic-mediated effect on the regulation of aggression.
authors.affiliation: Yale Child Study Center, Yale University School of Medicine, New Haven, CT 06510-8009.
authors.forename: R A
authors.initials: RA
authors.lastname: King
authors.forename: M A
authors.initials: MA
authors.lastname: Riddle
authors.forename: P B
authors.initials: PB
authors.lastname: Chappell
authors.forename: M T
authors.initials: MT
authors.lastname: Hardin
authors.forename: G M
authors.initials: GM
authors.lastname: Anderson
authors.forename: P
authors.initials: P
authors.lastname: Lombroso
authors.forename: L
authors.initials: L
authors.lastname: Scahill
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy* / Q000523:psychology; D010919:Placebos; D012652:Self Mutilation / Q000139:chemically induced*; D013405:Suicide / Q000523:psychology*
chemical_list: D010919:Placebos; D005473:Fluoxetine