Kids with learning and attention issues may be at greater risk for depression than other kids. That’s especially true for kids with ADHD.
If your child has been diagnosed with depression, you may wonder about treatment. There are different types of therapy that can help, such as cognitive behavioral therapy. Antidepressant medication is another option. Medication can also be helpful when combined with psychotherapy.
Learn about antidepressant medications available for children, and possible side effects.
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs are usually the first type of drugs doctors prescribe for children with depression. These drugs are taken once a day and cause few side effects. They work by increasing the level of a chemical called serotonin in the brain. Low levels of serotonin have been linked to depression.
Examples of SSRIs include:
- Fluoxetine (Prozac): Approved by the Food and Drug Administration (FDA) for kids age 8 and older
- Escitalopram (Lexapro): Approved by the FDA for kids age 12 and older
Other SSRIs may be prescribed for “off-label” use in children. Medications that are “off-label” may be safe and effective, even though they haven’t earned FDA approval to treat depression in children. Off-label antidepressants include:
- Sertraline (Zoloft)
- Paroxetine (Paxil)
- Citalopram (Celexa)
If a child doesn’t respond to SSRIs, her doctor may prescribe a different class of drugs called atypical antidepressants. They adjust levels of brain chemicals, which in turn boosts mood.
Examples of atypical antidepressants are:
- Venlafaxine (Effexor)
- Desvenlafaxine (Pristiq)
- Duloxetine (Cymbalta)
- Mirtazapine (Remeron)
- Bupropion (Wellbutrin)
Another category of drugs is tricyclic antidepressants. Like other antidepressants, they adjust levels of brain chemicals, which boosts mood. Tricyclic antidepressants may cause more side effects than other types of antidepressants. For that reason, SSRIs and atypical antidepressants are usually tried first. Examples of tricyclic antidepressants are:
- Imipramine (Tofranil)
- Amitriptyline (Elavil)
- Desipramine (Norpramin)
- Nortriptyline (Pamelor)
- Clomipramine (Anafranil)
Side Effects of Antidepressant Medications
Antidepressant medications are usually well-tolerated. Be sure to discuss side effects with the doctor before your child starts taking these drugs.
SSRI medications often have fewer side effects than other antidepressants. Common side effects include changes in sleep (drowsiness or trouble sleeping) and digestive upset (such as nausea or diarrhea). However, there is some risk of manic behavior and increased suicidal thinking in kids taking SSRI medication (see below for more information).
Several atypical and tricyclic antidepressants have possible side effects that must be closely monitored by the doctor.
No matter what medication the doctor prescribes for your child, you can play it safe by following these tips:
- Make sure your child takes the medication only as directed. Antidepressant medications can be dangerous, even deadly, if taken in overdose.
- Always read the package insert that comes with your child’s prescription medication.
- Talk with the doctor or pharmacist about possible interaction with other medications, including over-the-counter cold and cough medicine.
Most side effects aren’t serious and go away in the first few months of starting a drug. Even so, you should report any side effects to your child’s doctor. If your child develops rare side effects—such as fever or a rash—contact your child’s doctor immediately.
It’s also important to talk to your child’s doctor before stopping the medication. Some antidepressants (such as SSRIs) need to be decreased slowly, rather than stopped suddenly.
Keep in mind that it can take four to six weeks for medication to begin to relieve a child’s depression symptoms. If you don’t see results by then, check with the doctor. He may want to increase the dose or try another medication.
Antidepressants and the Risk of Suicide
An FDA review of research studies on SSRI medications found that there were no suicides among nearly 2,200 children treated with SSRI medications. However, 4 percent of the children had suicidal thoughts or even attempted suicide. That’s double the rate of those not taking antidepressants.
Due to the increased risk of suicide, the FDA has given SSRI antidepressants a “black box” label warning, the most serious type of warning for prescription drugs. The warning says children and adolescents taking SSRI medications should be closely monitored, especially during the first four to six weeks of treatment or whenever the dose is increased. This warning is clear in the medication package inserts given to patients.
Helping Your Child With Depression
It can be painful to see your child struggle with depression. Fortunately, therapy and medication can often help. If your child doesn’t respond to treatment, or if he recovers but the depression returns, be sure to consult his doctor and therapist.
Explore a list of behavior changes that can be signs of depression. And read about what to do if you think your child is depressed.
For more information on treating depression in children, visit our founding partner, the Child Mind Institute.
Understood is not affiliated with any pharmaceutical company.