Is Fluoxetine Effective for Treating Pediatric Body Dysmorphic Disorder?

Body dysmorphic disorder or BDD, usually starts in childhood or adolescence, but treating it within the pediatric population has not been studied. Recent research suggests adults with body dysmorphic disorder could respond positively to serotonin reuptake inhibitor medications such as fluoxetine (Prozac). The preliminary results of this study reports that these medications may also be beneficial in treating the disorder in children and adolescents.

Little Known Relative of Obsessive Compulsive
Disorder

BDD commonly shares features of obsessive compulsive disorder or OCD. The hallmark of the disorder is having a preoccupation with an imaginary or slight abnormality or defect in appearance. Body dysmorphic disorder often shows up during childhood or adolescence, but until currently, no studies for drug therapy treatments has been done.

Recently a study was performed by Dr. Eric Hollander of the Montefiore Medical Center, Albert Einstein College of Medicine, researchers looked at the effectiveness of fluoxetine for treating BDD.

The Study

Dr. Hollander and his team looked at 44 Caucasian children who were aged 18 and younger. The children had a clinical diagnosis of BDD and received no previous treatment with fluoxetine and no concurrent psychotherapy.

Hollander stated, “ The mean age of the study population was just under 15 years, the age of onset was around puberty, age 12 or 13, when their bodies are rapidly changing and they are very concerned about fitting in with their peers.”

The illness was quite severe within this age group and it had an impact on the child’s academic and social function. “Some children refused to go to school, some became homebound,” he noted.

After 7 days of a single-blind placebo, children who did not significantly improve were randomly assigned to a twelve week regimen of fluoxetine. (Dosages were weight based with a maximum of 60 mg per day.)
It turns out fluoxetine was well tolerated and Dr. Holland noted, “We didn’t see any suicidal thoughts or behaviors with fluoxetine in the pediatric population with BDD.”

It is very important that treatment options for pediatric BDD continue being studied because the symptoms a young child faces can be chronic and debilitating.

The research team discovered that pediatric-onset body dysmorphic disorder interfered with developmental tasks of childhood and adolescence. It also has a more malignant course of illness than that seen in adults and when untreated, it can be persistent and cause severe morbidity throughout one’s lifespan.

Conclusion of the Study

Subjects of the study who received the fluoxetine had a greater reduction in BDD symptoms than the ones who received the placebo. Dr. Scott L. Rauch, MD and the president and chief psychiatrist at McLean Hospital in Belmont, Massachusetts who was not involved in the study was quoted as telling the Medscape Medical News, “Though on average subjects who received SSRI treatment had greater reduction in symptoms than those who received placebo, this difference was modest in magnitude and did not reach statistical significance. But it would be premature to conclude that SSRIs are not efficacious in treating BDD in adolescence.”

More research is needed in order to determine the effectiveness of fluoxetine in treating childhood/adolescence body dysmorphic disorder and further studies can improve the lives of many who currently suffer from the disease.