Although experts believe that, for many children with depression, the benefits of medicine outweigh the risks, research on antidepressant medicine in children is limited. The long-term effects and safety of medicines used to treat depression in children and teens are still unknown.
You may have heard about concerns regarding a possible connection between antidepressant medicines and suicidal behavior. The U.S. Food and Drug Administration (FDA) has issued advisories about this issue.
Especially during the first few weeks of treatment with an antidepressant, there is a possible increase in suicidal feelings or behavior. A child beginning antidepressant treatment should be watched closely. But children with untreated depression are also at an increased risk for suicide. So it is important to carefully weigh all of the risks and benefits of antidepressant medicine.
Medicine choices include:
What to think about
Antidepressant medicines such as fluoxetine (Prozac, for example) can be effective in treating depression, but it may take 1 to 3 weeks before your child starts to feel better. It can take as many as 6 to 8 weeks to see more improvement. Make sure your child takes antidepressant medicines as prescribed and keeps taking them so they have time to work. If you have any questions or concerns about the medicine, or if you do not notice any improvement by 3 weeks, talk to your child's doctor.
SSRIs may also be effective in treating other conditions such as anxiety.
Your child may have to try several medicines or different dosages before the most effective treatment is discovered. After the right medicine and dosage is found, your child may need to continue taking the medicine for several months or longer after the symptoms of depression have subsided, to prevent depression from occurring again.
Some children who are first diagnosed with depression are later diagnosed with bipolar disorder, which has symptoms that cycle from depression to mania (very high energy, often with euphoria, agitation, irritability, risk-taking behavior, or impulsiveness). If your child or teen has bipolar disorder, a first episode of mania can happen spontaneously. But it can also be triggered by certain medicines such as stimulants or antidepressants. That is why it is very important to tell your child's doctor about any family history of bipolar disorder and to watch your child closely for signs of manic behavior. For more information about bipolar disorder in young people, see the topic Bipolar Disorder in Children and Teens.
The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. These signs may include talking about death or suicide and giving away belongings. This is especially important at the beginning of treatment or when doses are changed.