Atypical antidepressants for depression in children and teens

Atypical antidepressants balance certain brain chemicals (neurotransmitters). When these brain chemicals are balanced, the symptoms of depression are relieved.

These medicines have not been approved for use in people younger than 18, but they may be effective and are sometimes used. Examples of atypical antidepressants sometimes used to treat children or teens include:

• Duloxetine (Cymbalta).
• Bupropion (Wellbutrin, Wellbutrin SR).
• Mirtazapine (Remeron).
• Trazodone (Desyrel).

They may be effective in treating depression in children and teens, but research is limited. These medicines are often tried if treatment with a selective serotonin reuptake inhibitor (SSRI) does not work or if side effects from other medicines are a problem.¹ Trazodone may be prescribed to help your child sleep or cope with anxiety. Sometimes a combination of medicines is the most effective treatment for depression.

FDA Advisories. The U.S. Food and Drug Administration (FDA) has issued advisories to patients, families, and health professionals to closely monitor adults and children taking antidepressants for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed. The FDA also advises that patients be observed for increases in anxiety, panic attacks, agitation, irritability, insomnia, impulsivity, hostility, and mania. It is most important to watch for these behaviors in children, who may be less able to control their impulsivity as much as adults and therefore may be at greater risk for suicidal impulses. The FDA has not recommended that people stop using antidepressants but simply to monitor those taking the medications and, if concerns arise, to contact a health professional.

Citations

1. Dulcan MK, et al. (2003). Mood disorders section of Adult disorders that may begin in childhood or adolescence. In Concise Guide to Child and Adolescent Psychiatry, 3rd ed., pp. 129–177. Washington, DC: American Psychiatric Publishing.