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Should My Teen Take an Antidepressant?

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Updated April 22, 2009

When a teen has depression, counseling and antidepressants are often offered as options for treatment. Should your teen take an antidepressant?

Teens with depression can be very disabled by their condition. Depression can cause many problems, such as difficulty sleeping, problems eating, and issues at school or with friends. It's understandable that you want to help your child in the best way possible. When making a choice about treatment for a disorder, it is important to weigh benefits and drawbacks of the therapy so that the decision is an informed one.

Drawbacks of Antidepressant Use in Teens

All medications have side effects. If your physician or psychiatrist suggests an antidepressant, ask about the common side effects. One main class of antidepressants is the SSRI group of drugs (selective serotonin reuptake inhibitors). SSRIs can cause gastrointestinal symptoms like nausea or diarrhea, insomnia or sedation, headaches, dry mouth and sexual side effects. For many antidepressants, these physical side effects are temporary and are not severe. Knowing what the side effects are, and if they will go away in time, are important to know when making this decision.

SSRIs can lead to an increased risk of bleeding. Your doctor might tell your teen to avoid other medications that will increase the risk of bleeding, such as NSAIDs (aspirin, ibuprofen, naproxen) or COX-2 inhibitors (Celebrex) when taking an SSRI. If your teen is on an anticoagulant like warfarin, SSRIs might not be an option for your teen. Only your physician can advise you and your teen about what the best treatment options are.

Although not necessarily a drawback, it is important for parents and teens to know that the medications do not work instantly. It can take six to eight weeks for someone to feel the full effect of an SSRI. Just like it takes time for the side effects to go away, it takes some time for the medication to fully work. If you and your teen know that ahead of time, you won't be disappointed when the depression isn't relieved immediately.

Benefits of Antidepressant Use in Teens

Antidepressants are there to help with the uncomfortable, disturbing and even disabling signs and symptoms of depression. Antidepressants can help to improve your teen's mood, appetite, ability to sleep, ability to focus, and can relieve the aches and pains that sometimes come with depression. They can also help with related anxiety symptoms. Most importantly, because depression can lead to suicide, it is extremely important to effectively treat teens with depression and thoughts of suicide.

Antidepressants are best used when the teen is also seeing a counselor or therapist. During counseling, your teen can learn coping skills to help deal with life's stressors. Your teen can also explore possible causes of the depression and talk about issues he or she may not feel comfortable disclosing to friends or family. The counselor can be a wonderful ally for a parent of a teen with depression, and can be a wealth of information about the disorder and how to treat it.

Do Antidepressants Increase Suicide in Teens?

The U.S. Food and Drug Administration (FDA) released a report in 2004 which stated that, when teens begin treatment, the rates of suicidal thoughts and actions increased in some of those being treated. The same report stated that a large study (that looked at 24 smaller studies) found that the rates of suicidal thoughts increased, but there were no completed suicides.

In 2005, the Journal of the American Medical Association (JAMA) released a report looking at teen suicide rates. The JAMA study found that between 2001 and 2003, more teens were being treated with antidepressants, but suicide rates did not increase. A more recent study from the American Journal of Psychiatry found that after the FDA released its report, the number of antidepressants prescribed for teens dropped. The study also found that suicides actually increased during that time period.

More study on this subject is obviously needed, as there is no clear-cut link between the use of antidepressants and an increase in teen suicides just yet.

Your teen is an individual, and it is impossible to know how an antidepressant will affect him or her.

The FDA recommends looking for these signs and symptoms that might be a sign your teen is considering suicide and might be deteriorating psychologically:

  • expression of new or persistent thoughts of suicide
  • suicide attempts
  • new or worsening depression
  • new or worsening anxiety
  • increased agitation or feelings of restlessness
  • panic attacks
  • insomnia
  • new or worsening irritability
  • aggressive behavior; acting on dangerous impulses; hyperactivity or other changes of behavior
If you notice any of these, or your teen brings any of them to your attention, it is imperative that you contact your teen's physician, psychiatrist or counselor immediately. If your teen is threatening suicide or has made an attempt, call 911 or your local emergency or crisis number for help. You can reach the National Suicide Prevention Hotline at 1-800-784-2433.

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