Emergence of self-destructive phenomena in children and adolescents during fluoxetine treatment.
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.
King
R A
RA
Yale Child Study Center, Yale University School of Medicine, New Haven, CT 06510-8009.
Riddle
M A
MA
Chappell
P B
PB
Hardin
M T
MT
Anderson
G M
GM
Lombroso
P
P
Scahill
L
L
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*
D010919:Placebos; D005473:Fluoxetine