The experience of depression in children and teens is somewhat different than that of adults. Depression in childhood is more likely to lead to the continuation of depression in adulthood, as well as other, more serious mental illnesses. When children are depressed, their symptoms may appear to be normal mood changes common to children and teens, such as irritability, school refusal, physical complaints and getting in trouble. The treatment of children and teens with depression often relies on a combination of psychotherapy and medication.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are the most commonly used antidepressants to treat depression. These medications are an improvement over older antidepressants, causing fewer side effects and safer if an overdose is taken. SSRIs include Prozac (fluoxetine), Zoloft (sertraline), Lexapro (escitalprolam), Paxil (paroxetine) and Celexa (citalopram). Currently, Prozac is the only antidepressant medication approved by the U.S. Food and Drug Administration to treat depression in children age 8 and above; however, physicians often prescribe other SSRIs as well. However, in 2003, the U.S. Food and Drug Administration issued a statement that Paxil was not to be used in treating children with depression. In addition, a warning was issued by the U.S. Food and Drug Administration for the use of all antidepressants, indicating an increased risk of suicidal thoughts and behavior in patients who took these medications.
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
SNRIs are similar to SSRIs in their function and are also a newer class of antidepressant medication. They act on both serotonin and norepinephrine in the brain, as opposed to only serotonin, as in SSRIs. SNRIs include Effexor (venlafaxine) and Cymbalta (duloxetine). Although not approved for use in children, Effexor has been used to treat depression for this population.
Tricyclics
Tricyclics are an older form of antidepressant medication that includes Elavil (amitriptyline) and Tofranil (imipramine). These are still in use and may be the most effective treatment for some individuals; however, they are not commonly used to treat children.
Monoamine Oxidase Inhibitors (MAOIs)
MAOIs are another type of antidepressant medication; they act by preventing the breakdown of neurotransmitters in the brain. One difficulty with MAOIs is the need for a strict diet while taking the medication. Foods containing tyramine, a chemical often found in cheese and wine as well as certain medications, must be avoided. The combination of these foods and an MAOI can lead to a spike in blood pressure and eventual stroke. The significant harmful effects of this type of medication make physicians cautious in their use, particularly with children. Although rarely used in children, this type of antidepressant is an alternative to the more common SSRIs.
