My 5 yr old daughter has been diagnosed w/ sm. She was held back in pre-k to give her more time to adjust to a school environment. She not only does not talk in social settings; but also gets overwhelmed by loud noises & large groups. We have thus far only tried reward therapy & currently are trying audio therapy (which has been somewhat successful). I have read that the reason meds are used is for seratonin replacement. I have been taking a drug called Sarafem (fluoxetine hydrochloride) for that exact same thing due to a “hormone deficiency”. I only recently started this medication; but I already can say that my anxiety level has decreased. I have always had anxiety problems; but have never had any problems talking. My question is…is this seratonin deficiency inherited? Honestly, my husband & I have always said that we would never give our daughter drugs to help her; but after my experience on Sarafem, I may have changed my mind.


Please, take one step at a time with your child. You should not jump right to medication without fully exhausting other possible treatment modalities. From what you asked me in your question you really need to take time to educate yourself to SM and anxiety disorders. Please go through our site and especially read the other “Ask the Doc” questions and answers. Many of the questions will clearly help you understand the relationship between serotonin and anxiety.

As you probably know SM is indeed an anxiety disorder and anxiety disorders are correlated with LOW serotonin levels. So by replacing serotonin levels will usually help alleviate anxiety symptoms such as SM symptoms.

In addition, although this is not too prevalent in the literature, I have seen a strong correlation with SM (anxiety!) and sensory integration issues such as what you described when you said your child is sensitive to loud noises and large groups. In fact; I plan on doing an upcoming study on just this topic! My ‘professional’ theory is that low levels of serotonin correlate with sensory problems in some children. I believe that many of our SM children are not able to adequately ‘block out’ sensory input due to their low serotonin levels. By replacing serotonin we can often treat their SM and sensory issues. I see this happen often! I recommend having your child evaluated by an occupational therapist to further access whether your child does indeed have a sensory integration disorder.

You will need to have your child fully evaluated by a trained professional to give you the best treatment plan to help your child with SM and other symptoms she may be having.

Dr. Elisa Shipon-Blum