Depression is a complex mental health condition characterized by persistent low mood and sadness. It may be caused by a variety of factors, including chemical imbalances and certain health conditions. Selective Serotonin Reuptake Inhibitors are the primary treatment for depression in teens, but can cause suicidal thoughts and behaviors in rare instances. Understanding the risks and benefits of anti-depressants is vital for choosing a safe, effective remedy for depression in teens.
Types
Selective Serotonin Reuptake Inhibitors are the first-line treatment for most types of depression. According to the National Institutes of Health, fluoxetine and escitalopram are the only drugs approved to treat depression in adolescents and teens.
Tricyclic antidepressants such as clomipramine are sometimes prescribed off-label for teens with depression, as are atypical antidepressants such as Wellbutrin and Remeron. These drugs are not approved for use by people under age 18 and may be more likely to cause unforeseen side effects.
Effects
Patients taking fluoxetine and other Selective Serotonin Reuptake Inhibitors often report a general improvement in mood, energy and motivation, all of which can be negatively affected by depression. In most cases, these medications take between two to four weeks to produce their full effects.
Tricyclic antidepressants have similar positive effects on mood, but may be more likely to cause side effects, such as sedation and weight gain, that are severe enough to warrant quitting the medication.
Pharmacology
Serotonin is a neurotransmitter that regulates sleep cycles, mood and appetite. Low serotonin is associated with a number of mental disorders, including depression, anxiety and obsessive-compulsive disorder. Selective Serotonin Reuptake Inhibitors work by preventing the re-uptake of serotonin in the brain, resulting in improved transmission of nerve impulses.
Escitalopram is a relatively short-acting drug, while fluoxetine has the longest half-life of any medication in its class. Selective Serotonin Reuptake Inhibitors can take several weeks to produce effects, making consistent dosing vital to the success of treatment.
Side Effects/Risks
Antidepressants can cause a wide range of side effects in teenagers and adolescents. According to Discover Magazine, Selective Serotonin Reuptake Inhibitors may increase the risk of suicide by up to three times in children ages 7 to 18. While the exact cause isn't known, it is possible that these medications lift lethargy just enough to enable children to act on suicidal thoughts. Suicide risks are generally greatest in the first weeks of treatment and immediately after discontinuing the medication.
Additional side effects of fluoxetine and other escitalopram include headache, low libido, weight changes and nausea. In people with underlying bi-polar disorder, antidepressants may trigger a manic state and are therefore considered a poor choice for long-term treatment.
Warning
Children and teens taking antidepressants should be monitored closely by a doctor. Irritability, insomnia, nervousness and suicidal thoughts or behaviors can signal serious problems. Never attempt to quit taking antidepressants abruptly without a doctor's supervision, as this may increase the risk for adverse effects.
