Rosh Pediatrics Practice Exam

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What potential side effect should be discussed with an 18-year-old patient starting fluoxetine for depression?

ACardiac toxicity
BPanic attacks
CSuicidal ideation
DXerostomia

The correct answer is: CSuicidal ideation

When discussing the potential side effects of fluoxetine with an 18-year-old patient starting treatment for depression, it's crucial to highlight the risk of suicidal ideation. This particular concern is important, especially in young adults and adolescents. The FDA has issued warnings regarding an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults taking antidepressants, including fluoxetine. Patients in this age group may experience an initial worsening of depression or emergence of suicidal thoughts, particularly during the first few weeks of treatment or when the dosage is adjusted. Therefore, it’s essential for healthcare providers to closely monitor these patients during the early stages of treatment and to encourage open communication with family and caregivers about any changes in mood or behavior. While cardiac toxicity, panic attacks, and xerostomia might be relevant considerations when prescribing medications, they are not as prominently indicated in the context of fluoxetine compared to the concern of suicidal ideation in young individuals.