Antidepressant Rx: Careful Monitoring Needed
Patients need close follow-up for treatment of clinical depression.
"Make sure the various doctors are talking to each other -- so they can see how the child is doing" he tells WebMD. He also says to make sure that the signs of side effects are dealt with right away.
5) Know symptoms of worsening depression.
Doctors will usually see patients at least monthly when they are starting or changing doses of antidepressants, says Thase. "But with the new FDA cautionary statement, follow-up should be more frequent." Telephone check-ins could be set up and may be sufficient.
However, "it's important for patients to know that if they take a turn for the worse, they can see the doctor quickly," he tells WebMD. "If patients notice they're not sleeping well, getting restless, having more negative thoughts, let the doctor know that, so the dosage can be changed. They should not suffer in silence."
Children should get careful monitoring, says Fassler. "Every child's depression is different, and parents have to work with the doctor to figure out what symptoms should be monitored -- whether the child's energy is improving, if they're less irritable, sleeping better, appetite better, doing more things with friends. If any child is expressing thoughts about hurting themselves or anyone else, obviously they need to be seen and re-evaluated."
Talk to the child's doctor about monitoring symptoms, Fassler advises. "During initial phases of treatment, children should be seen more frequently. If the child's behavior has not started to change after a couple of weeks, call the doctor, ask 'What should I do?'"
Some kids will tell their parents about thoughts of suicide, he says. "Some will tell a friend. Usually, if someone's thinking about suicide, they will tell somebody. That's why it's important that they see a doctor frequently, so they can talk about these things."
6) Learn the system.
Managed care companies now recognize the need for mental health treatment, Feinberg tells WebMD. "The number of visits may be limited, but I think managed care has done a good job in increasing access to treatment."
However, there may be some difficulty getting coverage for a psychiatrist's care, he adds. Patients may have to pay out of pocket, or sign up for a preferred provider organization (PPO) plan, to get coverage for a psychiatrist's care.