Is It Right to Prescribe Antidepressants for Teens?

According to Mental Health America, depression and other psychiatric disorders in youth are real and growing problems. Many of the troubling trends in teen mental health, including depression in childhood, are accelerated by the pandemic and its ripple effects. 

Being a teen is already a difficult time. Young people go through significant changes, physically, emotionally, socially, and psychologically. Unrealistic expectations can compound challenges teens face, and they’re constantly receiving conflicting messages from social media, their friends, family, and society.

Teens often have a difficult time understanding the physical and emotional changes they’re experiencing. Mood swings occur as a result. 

There are times when these mood shifts are more than just being a teen and may indicate a mental illness. 

When a teen’s emotional or mental health starts affecting their daily functionality, it could be a more significant problem, such as depression or anxiety. As a parent, you may know you need to do something to help your teen, but there is controversy surrounding the use of antidepressants for teens.

Below, we go into what parents, caregivers, teachers, and anyone with a teen should know about mental health and the use of antidepressants for teens or antidepressants for children. 

Symptoms of Depression in Teens

Research shows that as many as one in five teens suffers from depression. The number may be even higher, particularly now. In teens, it’s difficult to diagnose the different types of depression because we associate moodiness or a slightly depressed mood with the adolescent years. 

Teens also tend to have a hard time identifying and expressing their feelings. This difficulty can make it less likely a teen will seek help for their symptoms.

Mental health professionals who specialize in working with teens can help discern normal adolescent behaviors from actual depression. 

Some of the possible depressive symptoms or indicators of depressive episodes in teens can include:

• Poor school performance
• Withdrawing from friends and activities
• Hopelessness or sadness
• A lack of motivation, energy, or enthusiasm
• Poor self-esteem
• Feelings of guilt or worthlessness
• A significant change in sleeping or eating patterns
• Substance abuse
• Physical symptoms like weight loss or weight gain
• Problems with authority
• Anger or aggression
• Suicidal thoughts or behaviors or a history of suicide attempts 

Treating Depression in Teens

If you suspect your teen is struggling with adolescent depression or other mental disorders such as bipolar disorder or anxiety, prompt diagnosis and treatment are critical. These conditions tend to get worse, not better, over time.

When depression goes untreated, it can become life-threatening.

One of the best ways to treat depression in teens or the disorder in children is therapy. Psychotherapy or talk therapy helps teens understand more about how they’re feeling and work through events. Teens can also learn healthy coping skills through therapy.

Cognitive-behavioral therapy is one of the most common forms of talk therapy. Cognitive behavior therapy helps teens identify their negative thought patterns, change their behavior, and see improvements in depression symptoms. 

Some teens might benefit from family therapy, too, to improve relationships with their parents and loved ones.

Medication such as antidepressants can treat teen depression, but we’re learning more about the possible risks of antidepressants for teens. Treating depression with medication isn’t always the right option. 

What Are Antidepressants?

Antidepressant drugs are a class of medications that help with not only depression symptoms but other mental health symptoms, including social anxiety disorder, other anxiety disorders, and seasonal affective disorder. Along with therapy, these are first-line treatments for depression. 

An antidepressant medication corrects neurotransmitter imbalances in the brain. Doctors believe the neurotransmitters that antidepressants target are responsible for behavioral and mood changes.

There are five subtypes of antidepressants, but selective serotonin reuptake inhibitors (SSRIs) are the most common antidepressant prescribed. This class of antidepressant is practical and tend to have lower side effects than other types of antidepressants. Tricyclic antidepressants are another option, but they aren’t prescribed nearly as often, despite being effective treatments. 

Some of the common side effects of antidepressants include:

• Nausea
• Insomnia
• Headache
• Dry mouth
• Dizziness
• Diarrhea
• Weight gain
• Sexual side effects

For most people, the side effects of antidepressants are temporary and mild. Antidepressant medicines don’t start working right away. It takes anywhere from four to six weeks to feel the full benefits and effects of these medications. It may take nearly two months of treatment for some to see the full impact, particularly in instances of severe depression. 

There are certain drugs with approval for the treatment of depression in children and adolescents with depression. Healthcare providers might prescribe:

• Cymbalta is for generalized anxiety disorder and is for children seven and older
• Lexapro is for major depressive disorder and has approval for children 12 and older
• Prozac can treat OCD and major depression and is approved in children seven and older
• Zoloft can help in the treatment of children with OCD and is for ages six and above

Are Antidepressants for Teens Safe?

While antidepressants for older people with depression are considered a reasonably safe treatment option, that may not be the case for teens because of a possible risk of suicide. 

The U.S. Food and Drug Administration warns that young adults between 18 and 24 taking an antidepressant may increase the risk of suicidal actions and thoughts. The trouble is typically most serious when teens start taking the medications and in the first few months of treatment.

The FDA requires pharmaceutical companies to indicate the risk and adverse effects of antidepressant treatment on the package insert, a black box warning.

If a teen begins taking an antidepressant medication, their parents and caregivers should be mindful of this potential side effect and watch for increased suicidal thinking or behavior. More clinical trials are likely needed to learn about the potential for suicidal ideation in teens. 

Things to Watch For

The FDA provides warning signs that could indicate a teen is experiencing suicidal thoughts, including:

• New or persistent thoughts of suicide
• Depression that’s worsening
• Agitation
• Anxiety
• Restlessness
• Panic attacks
• Insomnia
• Irritability
• Aggressive behavior or hostility 
• Impulsivity
• Mania or hypomania
• Changes in behavior

If your teen is taking an antidepressant and you notice symptoms you think are unusual, speak to your teen’s health care provider right away.

It’s important to note that we don’t necessarily know for there’s a causal link between the use of antidepressants and suicides in teens and young people. It’s an issue drug companies are exploring further to learn more about. 

Should Teens Take Antidepressants?

If a health care provider believes your child and adolescent should take an antidepressant, they should go over the risks versus the benefits with you. They should talk about potential side effects and discontinuation symptoms so that you have a complete evidence-based understanding before making a decision.

For many teens and children, taking antidepressants works and can help them function well and live a fulfilling life. Before a child or teen takes a mental health medication, they should undergo a thorough psychiatric evaluation.

There can be benefits of getting off antidepressants after some time, but it can be dangerous if you stop cold turkey without medical guidance. Suddenly stopping antidepressants can lead to antidepressant discontinuation syndrome or severe withdrawal symptoms. Withdrawal symptoms may include the return of rebound depression symptoms, anxiety, and flu-like symptoms. Your doctor may recommend a treatment program consisting of smaller doses when discontinuing antidepressants. 

Whether or not it’s right to prescribe antidepressants for teens is based on your child’s health care provider’s recommendations and your child’s situation. You can look at this article to see what you can do to help someone with depression.

There isn’t one correct answer for everyone, but for some children and teens, the benefits of the medications outweigh any possible side effects. Again, untreated depression can in itself become life-threatening, so call (858) 258-9883 to talk with a health professional at The Mental Health Center of San Diego about concerns you might have as far as drugs for depression and your teen.