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Is there an average dosage of medication for a child of 4?
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My daughter is almost 4 1/2 yrs. We sought therapy for her this summer; she has been diagnosed with social phobia and SM. She began medication approximated 2 weeks ago. She was prescribed Prozac (1 ml of 20 mg Prozac). We are seeing subtle changes in her, as well a more relaxed demeanor with new situations. She is now participating more with other children in small group settings. Our psychiatrist is pleased with these results, as we are. His plan is to keep her at this level of medication until she "plateaus", and we no longer see new improvements. We will visit him again in 6 weeks and will adjust the dosage if necessary. Given your experience, is this an average dosage of medication for a child of 4? In reading your website, I have seen dosages defined in mg (e.g., 10 mg of Prozac), and am not certain how our one ml of liquid compares. Our doctor is conservative, and I agree with the philosophy of not wanting to overmedicate. However, I was curious if increasing the dosage in smaller increments over time might get her talking? Our psychiatrist feels that the speaking will come if her anxiety is reduced and she becomes more comfortable in social situations. I guess I am overly eager to see results; she currently speaks only to my husband and myself and her paternal grandparents. Thank you for any insights to medication that you can give me.
Answer
It sounds like your daughter is making some nice progress. I hope you are also involved in behavioral therapy as well. Meds without any therapy is not going to be nearly as effective. Plus, you want your child to build coping skills, and behavioral therapy helps with that. You asked about dosage of Paxil. I assume you are giving your daughter 20 mg per teaspoon (5 ml); Therefore, 10 mg would be 2.5 ml, 5 mg would be 1.25 ml. If you are giving your daughter 1 ml, then she is getting about 4 mg of Paxil.
Like your doctor, I am conservative and base dosages on the child's response, although I usually try to end at about 10 mg. That is the dosage I feel works well with minimal side effects in the majority of kids. Starting very low, as your doctor did, and moving slow is important in order to prevent side effects.
Dr. Elisa Shipon-Blum
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