6 year old on prozac safe?

Fluoxetine (Prozac) is unlikely to damage your daughter's liver, or cause other physical harm. The SSRI class antidepressants are relatively benign even in overdose and are being increasingly prescribed in pregnancy.

However, as with many medications,  if taken long term there can be withdrawal affects when it is discontinued which may require a gradual weaning, though fluoxetine is a long acting (long half-life) antidepressant so is much less likely to produce this than other SSRIs. This is not addiction but the body adapting to the presence of the medication, and a rebound when it is no longer in the system. This can occur with many drugs including antibiotics, heart medications, even to a limited extent with some vitamins - vitamin C, for example.

Unfortunately, there are limited treatment options. The only non drug treatment with a proven track record is Cognitive Behavior Therapy (CBT). At 6yo your daughter may just be at the intellectual level required to benefit. However, it will require a therapist experienced in treating Selective Mutism, and importantly, a willingness by your daughter's teacher(s)/school to work with the therapist. Your national SM association may be able to recommend a therapist in your area, or suggest alternatives if none are available.

Best wishes

Ian


NOTE: I am not a doctor, and more importantly, I'm not your daughter's doctor so the above advice is necessarily of a general nature which may or may not apply to her. Always consult your health provider before acting on anything you've read here.