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What Should You Do for a Child With Depression?
• Major depression in children and adolescents is a serious condition that should be adequately treated, which includes careful follow-up and monitoring.
• Each child should be carefully and thoroughly evaluated by a physician to determine if medication is appropriate. Those who are prescribed an SSRI medication should receive ongoing medical monitoring, with particular care paid in the first four weeks of taking the drug.
• Psychotherapy is often used as an initial treatment for milder forms of depression. Many times, psychotherapy accompanied by an early follow-up appointment may help to establish the persistence of depression before a decision is made to try antidepressant medications. Psychotherapies include "cognitive behavioral therapy" and "interpersonal therapy." For moderate to severe forms of depression, especially if persistent, the current evidence supports the use of fluoxetine alone or in combination with cognitive-behavioral therapy (CBT). See results for the recently completed Treatment for Adolescents with Depression Study (TADS).
• Should suicidal thinking or behavior, nervousness, agitation, irritability, mood instability, or sleeplessness emerge or worsen during treatment with SSRI medications, parents should obtain a prompt evaluation by a clinician with expertise in these medications.
• Children already on any of the SSRI medications should remain on the drug if it has been helpful but they should also be carefully monitored by a physician for evidence of side effects. Once started, treatment with these medications should not be abruptly stopped, because of potential side effects. Families should not discontinue treatment without consulting with their physician.
• All treatments can be associated with side effects. A careful weighing of risks and benefits, with appropriate follow-up to help reduce risks, is the best that can be currently recommended.
Antidepressant Medications for Children and Adolescents
Information for Parents and CaregiversDepression is a serious disorder that can cause significant problems in mood, thinking, and behavior at home, in school, and with peers. It is estimated that major depressive disorder (MDD) affects about 5 percent of adolescents, who have more frequent suicidal thinking and behavior and greater likelihood of substance abuse than youth in general.
Research has shown that, as in adults, depression in children and adolescents can be treated. In particular, antidepressant medications — called selective serotonin reuptake inhibitors (SSRIs) because they specifically target the neurotransmitter serotonin — have been shown to be of benefit to children and adolescents with major depressive disorder. Certain types of psychological therapies have also been shown to be beneficial. In those with moderate to severe depression they are especially useful when combined with medication. Our knowledge of antidepressant treatments in youth, though growing substantially, remains limited when compared with what we know about treatment of depression in adults.
Recently, concerns have been raised that the use of antidepressant medications themselves may induce suicidal behavior in youths. In fact, following a thorough and comprehensive review of all the available published and unpublished controlled clinical trials of antidepressants in children and adolescents, the FDA has warned the public about an increased risk of suicidal thoughts or behavior ("suicidality") in children and adolescents treated with SSRI antidepressant medications.
Studies show that there are substantial benefits from medication treatment for adolescents with moderate and severe depression, including many with suicidal ideation.
Source: National Institute of Mental Health—February 2, 2005
Link: Find a Therapist
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