Drugs to Prevent Teen Depression & Suicide

There are several different types of medications used to treat depression and suicide risk in adolescents. Meeting with a physician will help parents understand the differences between the many types of medications available to treat depression. Psychiatrists, medical doctors who specialize in mental health diagnoses and treatments, will be the most helpful in determining the appropriate medication for a teenager. A comprehensive medical, social and psychological history should be obtained prior to starting a medication for depression. Consistent follow-up with a physician is necessary for appropriate monitoring of the condition. Supportive psychotherapy is often recommended as well along with medication to provide the patient with the most comprehensive and effective treatment plan.

Selective Serotonin Inhibitors

• The newest and most common antidepressants are selective serotonin inhibitors or SSRI's. Medications such as Celexa, Lexapro, Prozac, Luvox, Paxil and Zoloft are catergorized as SSRI's. SSRI's work to stablize levels of serotonin in the brain. Serotonin is a neurotransmitter that is thought to be at lower levels than normal in individuals who are depressed. With SSRI's, there is a disclaimer on the drug label warning that suicidal thoughts may result from the use of these medications in adolescents. This is an important detail to discuss with the physician prescribing the medication. It is important to consider the risk/benefit of using any medication, and to remember that treating depression does effectively reduce the risk of suicide.

Other Antidepressants

• Typically, a second-tier choice for the treatment of depression in teenagers are other medications such as Wellbutrin, Cymbalta, Remeron, Serzone, Desyrel and Effexor. These medications are different from each other but all are antidepressants that activate both serotonin and norepinephrine neurotransmitters. These medications may be recommended if the SSRI's are ineffective in the treatment of depression, or the side effects of SSRI's are not well tolerated. Older antidepressants that are less commonly used are categorized as tricyclic antidepressants or monoamine oxidase inhibitors (MAOI's). These medications are used if the newer types have not been effective. Uncomfortable side effects and special diet considerations are drawbacks of these older types of medications.

Mood Stabilizers

• Mood stabilizers such as Tegretol, Depakote, Lamictal, Trileptal, Topamax and lithium can be prescribed if a patient has an adverse reaction to antidepressants. An adverse reaction to antidepressants might include symptoms of mania that can actually put an adolescent at more risk for suicide or destructive behavior. If mania is experienced with the use antidepressant medication, this signals that a patient may have a bipolar mood disorder as opposed to unipolar depression. Mood stabilizers are effective for bipolar disorder and can prevent mood swings, including depression. Mood stabilizers typically require frequent monitoring and possible blood work to keep the medication at a therapeutic level.

Antipsychotic Medication

• Antipsychotic medication can be used as an adjunct to help to manage severe depression and suicidal thoughts in adolescents if other medications have not been fully effective. Atypical agents on the market are newer than the traditional antipsychotic. Common atypical antipsychotic medications are Abilify, Zyprexa, Invega, Seroquel, Risperdal or Geodon. The patient does not necessarily need to have psychotic symptoms (such as hearing voices or seeing things) to be prescribed this type of medication. Several physicians use this medication to boost an antidepressant or mood stabilizer.

Antianxiety Meidcation

• At times, antianxiety medication may be used if the teenager is severely anxious and the other medications are not fully effective. One class of medications for anxiety are benzodiazepines. These include Xanax, Klonopin, Valium and Ativan. These medications have the potential for abuse and can be lethal in an overdose. Therefore, they require supervision and very close monitoring. Other anxiety medications more commonly used with teenagers are BuSpar, Benadryl or Vistaril. These medications do not have the "street value" of the benzodiazepines and have less potential for harm.