Treatment of Childhood Depression
AntidepressantsWhile several types of depression medications (antidepressants) can be effective at treating adults with depression, these medications may not be as effective at treating childhood depression. Care must be used in prescribing and monitoring all medication. Therefore, a child or adolescent with depression should be carefully and thoroughly evaluated by a healthcare provider to determine if medication is appropriate.
The medications most widely prescribed for childhood depression belong to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). There are several different types of SSRIs, including:
- Citalopram (Celexa®)
- Escitalopram (Lexapro®)
- Fluoxetine (Prozac®)
- Fluvoxamine (Luvox®)
- Paroxetine (Paxil®)
- Sertraline (Zoloft®).
Prozac is the only SSRI approved for the treatment of childhood depression in children ages eight and older. The other SSRI medications and the SSRI-related antidepressant venlafaxine have not been approved for treatment of depression in children or adolescents; but doctors still sometimes prescribe them to children on an "off-label" basis. In June 2003, however, the FDA recommended that paroxetine not be used in children and adolescents for treating depression.
Those who are prescribed an SSRI medication should receive ongoing medical monitoring. Children already taking an SSRI medication should remain on the medication if it has been helpful, but should be carefully monitored by a doctor for side effects. Parents should promptly seek medical advice and evaluation if their child or adolescent experiences suicidal thinking or behavior, nervousness, agitation, irritability, mood instability, or sleeplessness that either emerges or worsens during treatment with SSRI medications.
Once started, treatment with these depression medicines should not be abruptly stopped. Although they are not habit-forming or addictive, abruptly ending an antidepressant can cause withdrawal symptoms or lead to a relapse. Families should not discontinue treatment without consulting their healthcare provider.
All treatments can be associated with side effects. Families and doctors should carefully weigh the risks and benefits, and maintain appropriate follow-up and monitoring to help control for the risks.
(Click Antidepressants in Children for more information about using depression medications in children.)