Antidepressant Drug Use in Children

Depression can be a debilitating disease that robs kids of a normal carefree childhood and prevents them from engaging in typical fun activities. According to the Mayo Clinic, antidepressant medications can effectively treat depression and other mental disorders in children and teens. But they do come with risks of harmful side effects and complications.

Diagnosing Depression

• Before taking antidepressants, children should undergo a physical exam as well as a psychiatric evaluation to determine potential risk factors for self-harm, assessment of other mental illnesses and family history of mental illness and suicide. This evaluation can be performed by a pediatrician, psychiatrist or family doctor.

Medication Options

• If your child's doctor decides that he needs medication, any antidepressant can be prescribed, but only fluoxetine (Prozac) has been approved by the FDA for the treatment of depression in children. According to the Mayo Clinic, many doctors choose other medications, such as sertraline (Zoloft), fluvoxamine (Luvox) and clomipramine (Anafranil). These drugs also are approved to treat obsessive-compulsive disorder in children.

Increased Suicidal Thoughts

• Clinical trials have showed that antidepressants may cause or worsen suicidal thinking in kids and teens, and therefore they are required by the FDA to carry strong warnings about this on their labels. In these studies, children taking antidepressants had about a 4 percent chance of harboring suicidal thoughts, compared with a 2 percent increase in kids taking a placebo. According to the Mayo Clinic, doctors believe that children who have increased suicidal thoughts while on antidepressants also may have bipolar disorder, and that treating these children with antidepressants could cause episodes of mania that leads to impulsive behavior and possibly self-harm. In some children, antidepressants can cause increased anxiety, hostility, restlessness and impulsivity.

Effective Treatment for Most Patients

• The Mayo Clinic reports that these side effects don't mean that children can't be treated successfully with antidepressants. In most kids, antidepressant treatments improve symptoms of depression, obsessive-compulsive disorder and other mental health conditions. If these disorders aren't treated, children's lives can suffer greatly and chances of suicide in untreated patients are certainly possible as well. According to the University of Michigan Depression Center, children with untreated depression are 30 times more likely to commit suicide than average children.

Careful Monitoring

• Parents of children who take antidepressants should be aware of the warnings and watch closely to evaluate their child's state of mind as well as communicate with their child to intervene if suicidal thoughts are present. The Mayo Clinic recommends that children on these drugs visit their doctor often during treatment, even if symptoms appear to get better. The highest risks of suicidal thinking and behavior usually occur within the first few months of treatment or when dosage is increased or decreased. Also, suddenly stopping antidepressant medication can cause serious withdrawal-type symptoms which can be harmful, so parents should never discontinue drug treatment without consulting a doctor.

Alternatives to Medication

• According to the Mayo Clinic, there are other effective methods for treating depression in children, including a variety of counseling techniques. These include: psychotherapy, cognitive behavior therapy and family therapy. Many doctors recommend a combination of medication and counseling. Parents of children with depression should speak to their pediatrician and a mental health professional to find what treatment options are best for them.