According to the National Institute of Mental Health, approximately 5 percent of adolescents experience major depressive disorder. Medication intervention is one option for treating teen depression, though the U.S. Food and Drug Administration has strict warnings about the safety of using antidepressant medications in teens. In fact, there is only one FDA approved antidepressant medication for use in children over the age of 8 years old. All other antidepressants prescribed must be done at the discretion of the physician, in low doses, with close monitoring due to the risk of serious side effects such as increased suicidal thoughts and behaviors.
Fluoxetine
Fluoxetine is a selective serotonin reuptake inhibitor, or SSRI, used to treat depression in children over 8 years old. This class of medication works by increasing the amount of serotonin, a naturally occurring chemical in the brain, to restore mood and emotional balance. The Mayo Clinic explains that this is the only FDA approved depression medication for teens. Clinical trials by the FDA concluded that the risk of suicidal thoughts or behavior was lower with this medication than the other antidepressants studied. However, careful physician and caregiver monitoring of teens on fluoxetine is necessary to evaluate the potential for serious side effects.
Sertraline
Sertraline is an antidepressant in the SSRI class of medications used in the treatment of depression and for symptoms of obsessive-compulsive disorder, or OCD, in teens. This medication is not approved by the FDA for use in treating those with depression under the age of 18 years old, however it is used off label in low doses, according to the Mayo Clinic. Pfizer Inc. manufactures the brand name for sertraline and further warns that this medication is only approved for use in children ages 6 to 17 years old to treat OCD. However, Pfizer reports comparison studies of children taking sertraline for depressive disorder verses OCD, and they did not find a significant difference in suicidal thoughts or behaviors when using sertraline in low doses to treat the differing disorders. Regardless, physician monitoring while using this medication is essential in maintaining teen mental wellness.
Escitalopram, Citalopram and Venlafaxine
According to MedlinePlus, escitalopram is used in teens ages 12 to 17 for major depressive episodes, but it is noted that ongoing studies for side effects of using this medication in teens is inconclusive regarding the suicide risk. The Mayo Clinic indicates an additional problem with toxicity from using a similar medication called citalopram, which warrants further physician exploration prior to use. The National Institute of Mental Health mentions venlafaxine, a selective norepinephrine reuptake inhibitor, or SNRI, which is a relative of SSRIs but works on an additional chemical structure. This medication may also be used off label by physicians in treating teen depression. As with all antidepressants that are not approved by the FDA for use in teens, these medications should be chosen with caution, and if prescribed, the teen should be closely monitored for serious side effects and suicidal behaviors.
