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    Antidepressant Rx: Careful Monitoring Needed

    Patients need close follow-up for treatment of clinical depression.


    2) Do your homework.

    For a short-term episode of clinical depression -- what doctors call mild or moderate depression -- treatment with either medication or therapy alone will usually work, explains Michael Thase, MD, professor of psychiatry at the University of Pittsburgh School of Medicine and author of the book, Beating the Blues.

    Both antidepressants and therapy change brain chemistry, which relieves depression and stabilizes mood, research shows. But before making a decision, do some research, advises Feinberg.

    "If you're talking about an antidepressant, read everything you can find about it," he says. "Don't allow your child to take an antidepressant that has not been tested and found safe for children."

    For most children, antidepressants are prescribed for short-term treatment, although some will need to continue much longer, says Fassler. "Some kids, particularly those with recurrent episodes of depression, may take medications for many years and into adulthood."

    3) Discuss the merits of therapy.

    Research has shown that a combination treatment -- both medications and therapy -- can prevent recurrences of depression for many years after drug treatment ends. When people take antidepressants alone, they are more vulnerable to depression once they stop the drug.

    Therapy helps people understand the roots of their depression, change negative thought patterns, and learn better coping skills, Fassler explains.

    Therapy can also help fix emotional problems caused by the depression itself, he says. "By the time patients get help, there are lots of secondary emotional ramifications -- self-esteem problems, guilt about their depression, they feel different, have trouble at school, home, friends. Medication isn't going to fix those problems."

    If kids are reluctant to take antidepressants, therapy can provide the encouragement they need, Fassler tells WebMD. "It's a struggle. But if kids really understand what the illness is about, and see how medicine helps them live more normal and healthy lives, they are more likely to take it."

    4) Make sure doctors communicate with each other.

    If multiple doctors are treating you or your child, make sure they share treatment information, says Fassler.

    "Across the country, we're seeing more and more prescriptions for antidepressant medications written by pediatricians and primary care physicians," says Fassler, who is also a spokesman for the American Academy of Child and Adolescent Psychiatry.

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