My daughter, who will be 5 years old in June, has SM. My question is about medication. We are currently seeing a psychologist 1x/week who is trying to help us by getting my daughter comfortable enough with her, so that eventually she will speak to the psychologist. The idea being that the psychologist will then be able to help her in school in September when she starts Kindergarten. But it is obvious she will need medication to help her along. Her suggestion is Paxil. My main concern is that we don’t know the long-term effects on children of this med. I worry that years down the line a study may find some dangerous side effects. When a child is still developing, how dangerous is a medication like Paxil?? Also, I have read that sometimes medication can “jump-start” the brain to start producing seratonin on its own. Is there any truth to this statement? Thank you for any information you can give me.


P .., your concern over medication is a very common concern among most parents. Try and read over the previous questions and answers, I think you will see that many other parents have asked similar questions. As I have mentioned in previous questions, there are NO long term studies to prove the overall safety of these types of medications. BUT, all of the preliminary studies indicate the medications are safe for children. The reason there are no long-term studies is simply because the medications have only been a round since 1988… there is no way to really know what will happen in 30 years from now. I have to say though, you must considera few things. What are the long-term effects of being SM or socially phobic? They could be horrendous, right? Well, this is one reason why many parents have chosen the medication route.

Many physicians are using Paxil more and more now; it is the only SSRI drug approved for social phobia, and since SM is primarily thought to be an anxiety disorder due to social phobia, Paxil is being used. Prozac, Paxil, Luvox, Celexa, and Zoloft are all similar acting drugs…the differences are subtle and can often be used for the same disorders. My concern about Paxil is the very short half life. Because of this, withdrawal reactions when you decide to discontinue the medication can be quite bothersome….If a dose is missed, you can start feeling ‘withdrawal’ as soon as 24 hours after a missed dose. Prozac, on the other hand, does not have much of a withdrawal reaction; it lasts for days, and if a dose is missed, no effects are usually seen. This is the main reason why I prefer Prozac. Plus, we have had a lot of success with this drug in children.

You asked about the drug helping the body to produce seratonin on its own…the mechanism isn’t known, but studies indicate that many people can successfully discontinue the medication after approximately 9 months.Good luck!

Dr. Elisa Shipon-Blum