Antidepressant Effectiveness and Safety in Teenagers

Close Monitoring and a Team Approach is Critical

When a teen has depression, counseling and antidepressants are often offered as options for treatment, especially if the depression is considered moderate or severe.

If your teen is prescribed an antidepressant, like a selective serotonin reuptake inhibitor or SSRI, it is normal to have questions about its effectiveness and safety. This is why it's important for you and your teenager (and others in the family) to be educated about antidepressant effects, including its benefits and potential adverse effects (and how to monitor those).

Effectiveness 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, an 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 mental health professional like a therapist or psychiatrist. 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.

A mental health professional 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.

Potential Adverse Effects 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 and common 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, dizziness, weight gain, 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.

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 a 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.

Do Antidepressants Increase Suicide in Teens?

The U.S. Food and Drug Administration (FDA) released a report which stated that, when young adults (ages 18 to 24) begin taking an antidepressant, the rates of suicidal thoughts and actions increased in some of those being treated.

This was noted during the beginning of treatment, like within the first month or two.

More study on this subject is obviously needed, as there is no clear-cut understanding of the link between the use of antidepressants and an increase in teen suicides. In other words, no causal relationship has been found. 

What To Watch Out For In Your Teen

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. This is especially important during the first couple months of treatment and when a dose of the medicine is changed, like increased or decreased. 

  • expression of new or persistent thoughts of suicide
  • worsening depression
  • anxiety
  • agitation  
  • feelings of restlessness (akathisia)
  • panic attacks
  • insomnia
  • new or worsening irritability
  • aggressive behavior
  • hostility or impulsivity
  • unusual changes of behavior
  • hypomania or mania

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.

Making a Decision About Treatment

If your teen has depression, it is important for you, your teen and your physician to sit down and discuss these pros and cons of antidepressant use. If prescribed, SSRIs must be taken daily to be effective. Additionally, these medications should not be stopped abruptly.

A Word From Verywell

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.

Depression is a serious issue that can have serious and deadly side effects if not handled quickly and appropriately. Together, antidepressants and counseling can make a big difference in the life of a depressed teen.

Sources:

Oberlander TF, Miller AR.  Antidepressant use in children and adolescents: Practice touch points to guide paediatriciansPaediatr Child Health. 2011 Nov; 16(9):549-53.

U.S. Food and Drug Administration. (April 2016). Antidepressant Use in Children, Adolescents, and Adults

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