My 8 year old son has both SM and OCD and has been treated fairly successfully over the last 2 years with Prozac eventually getting up to 40mg/day by one of the Columbia researchers who did the clinical trials on Prozac. He talks to most children he is familiar with, few adults and the OCD has improved except for his eating. He will only eat a few foods, no meat vegetables, fruit or milk. He is hypersensitive to food textures, smells, etc. I have been told that this is common in these children. He is small for his age and will often not eat lunch in school nor even drink all day and says he can’t stomach watching other children eat with their mouths open. I think it is also having others watch him eat. We have tried desensitization, rewards, etc. with no success. I have been told that the only appetite stimulant will counteract the effects of Prozac. Can you suggest anything? Would Paxil be more effective?

Answer

This is a difficult question for me to answer. Because I do not know your child and whether or not there are any nutritional issues to be concerned about. If your child is at his ideal weight, and eats well, then I do not think any additional calories are needed. We really do not recommend ‘appetite stimulants’ to children unless there is a nutrition issue at hand. If weight loss is a concern you can always supplement with the various liquid nutrition that are available in your local pharmacy. For example, Pediasure by Abbot Labs provides complete nutrition for children 1-10 years of age. We will often recommend a well balanced diet and supplement with 1-3 cans a day for children with nutritional deficits or poor weight gain. My advice to you would be to speak with your pediatrician about his or her recommendations.

Dr. Elisa Shipon-Blum