Antidepressant medications are commonly used to treat depression in adolescents, just as they are in adults. However, it should be noted that many antidepressant medications have not been studied in adolescents and many have not been approved by the FDA for use in adolescents. Doctors often prescribed medications in ways not approved by the FDA and sometimes it is appropriate to do so. It’s important to understand, though, that the use of antidepressants in adolescents carries certain risks.
All medications have side effects and antidepressants are no exception. Not all patients experience all the possible side effects of a particular drug, of course. Potential side effects include things like fatigue, insomnia, weight gain, dry mouth, headache, nausea, constipation, dizziness, tremors, nervousness and sweating. Antidepressants can be discontinued if side effects are intolerable but patients should consider the risk of side effects before starting to take any medications. Adolescents may hesitate to take antidepressants or may not take them consistently if side effects trouble them.
Some antidepressants cause withdrawal symptoms if they are discontinued abruptly. Withdrawal symptoms may include increased depressed, anxiety, muscle pain, nausea, stomach pain, insomnia, muscle spasms and “electric shock” sensations. Some patients experience some withdrawal symptoms even if antidepressants are discontinued gradually and in some cases withdrawal symptoms are fairly severe. Some antidepressants, including Paxil and Effexor, are known to cause more severe withdrawal symptoms than others. Doctors should consider the risk of withdrawal symptoms when prescribing antidepressants to adolescents.
Increased Risk of Suicide
Some studies have found that the risk of suicide increases in young people taking antidepressants. In fact, the FDA requires many antidepressants to carry a warning on the package that states that they may increase the risk of suicidal thinking and behavior in people under the age of 25. Adolescents taking antidepressants should be carefully monitored, especially during the initial phase of treatment (the first four weeks).
One study, partially funded by the National Institute of Mental Health, concluded that the benefits of antidepressant use often outweigh the risks in adolescents. To be sure, depression is a very serious illness, sometimes deadly. It may be prudent to try treating depression with psychotherapy first, especially in mild or moderate cases of depression, but the potential benefits of antidepressants medications are probably worth the risks in severely depressed adolescents. When antidepressant therapy is initiated, adolescents need carefully monitoring and supervision to watch for an increase in suicidal thinking or behavior. Adolescents should be monitored for side effects and they should not discontinue taking their medication abruptly in order to prevent withdrawal symptoms.
Health Central. http://www.healthcentral.com/depression/c/7399/65465/antidepressants. Depression, Adolescents, and Antidepressants.
FDA. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2007/ucm108905.htm. FDA Proposes New Warnings About Suicidal Thinking, Behavior in Young Adults Who Take Antidepressant Medications.
National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/antidepressant-medications-for-children-and-adolescents-information-for-parents-and-caregivers.shtml. Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers.
Help Guide. http://helpguide.org/mental/medications_depression.htm. Antidepressants.