Antidepressant for teenage depression -
Side-effects vary depending on the type of medication. More information on side-effects is included for each type of types of antidepressant. When starting medication treatment for depression, people may be at an increased risk of suicide. Most cases of increased risk of suicide were observed in adolescents and young people.
One possible explanation is that it may be related to the increase in energy that comes early in treatment, before improvement in mood. In other words, antidepressants may give some people the energy to act on their suicidal thoughts. Some antidepressants can also cause feelings of agitation, restlessness and detachment.
These feelings may resemble symptoms of anxiety and may add to, rather than relieve, feelings of hopelessness and despair.
Some people may become suicidal or violent. This reaction to antidepressants is thought to occur in about four per cent of people who take them, with the risk being highest in the first few weeks of treatment.
Before starting treatment , prepare for the possibility of feeling worse before you feel better. Know what supports are available to you and who you can call. When you begin treatment , monitor your thoughts and moods, and communicate any thoughts of hurting yourself or others with your doctor, a crisis line or the emergency department.
If you experience an increase in suicidal thinking or anxiety, your doctor can help you decide if you should stop taking the medication or if you should try to be patient and give the medication a chance to work.
There are several classes of antidepressants; within each class there are many individual medications. While all antidepressants work well overall, no drug or type of drug works equally well for everyone who takes it.
You may be advised to try more than one type of antidepressant or to use a combination of antidepressants to seek relief from your distress. The different types of antidepressants are listed in the order in which they are most commonly prescribed.
Medications are referred to in two ways: by their generic name and by their brand or trade names. Brand names available in Canada appear in brackets. This group of drugs, including fluoxetine Prozac , paroxetine Paxil , fluvoxamine Luvox , citalopram Celexa , escitalopram Cipralex and sertraline Zoloft , is usually the first choice for treatment of depression and anxiety disorders.
These medications are known to have milder side-effects than some other antidepressants. Buspirone Buspar is similar to SSRIs and has been found to help with anxiety but not depression.
Common side-effects include nausea, vomiting, diarrhea, weight gain, dry mouth, headaches, anxiety, sedation and a decrease in sexual desire and response. This group of drugs may also cause a jittery or restless feeling and sleep difficulties, such as problems falling asleep, waking in the night, vivid dreams or nightmares.
This class of medications includes venlafaxine Effexor , duloxetine Cymbalta , levomilnacipran Fetzima and desvenlafaxine Pristiq. These drugs are used to treat depression, anxiety problems and chronic pain.
Common side-effects include nausea, drowsiness, dizziness, nervousness or anxiety, fatigue, loss of appetite and sexual problems. In higher dosage, these medications may increase blood pressure. The medication available in this class is bupropion Wellbutrin, Zyban.
When used to treat depression, it is often given for its energizing effects, in combination with other antidepressants. Mirtazapine Remeron , the medication available in this class, is the one of the most sedating antidepressants, making it a good choice for people who have insomnia or who are very anxious.
This medication also helps to stimulate appetite. This older group includes amitriptyline Elavil , , imipramine Tofranil , desipramine Norpramin , nortriptyline Aventyl , trimipramine Surmontil and clomipramine Anafranil.
Because these drugs tend to have more side-effects than the newer drugs, they are not often a first choice for treatment.
However, when other drugs do not provide relief from severe depression, these drugs may help. Common side-effects include dry mouth, tremors, constipation, sedation, blurred vision, difficulty urinating, weight gain and dizziness.
Because cyclics may cause heart rhythm abnormalities, your doctor should order an electrocardiogram ECG before you take this medication. Monoamine oxidase inhibitors, or MAOIs, such as phenelzine Nardil and tranylcypromine Parnate were the first class of antidepressants.
MAOIs are effective, but they are not often used because people who take them must follow a special diet. A newer MAOI, moclobemide Manerix , can be used without dietary restrictions; however, it may not be as effective as other MAOIs. Common side-effects include a change of blood pressure when moving from a sitting to a standing position orthostatic hypotension , insomnia, swelling and weight gain.
When you start a new antidepressant, the first step is to decide whether you can tolerate the side-effects; this should become clear within a few weeks. The next step is to decide whether the drug helps with your depression or anxiety.
Improvements should be seen in two to four weeks. Full remission is seen at six to twelve weeks. If the medication does work for you, your doctor will advise you to continue taking it for at least six to nine months after you start to feel its beneficial effects. People who stop taking antidepressants too soon risk having the symptoms of their depression or anxiety problem return.
Most people who take antidepressants need to take them for at least a year. People who experience depression that keeps coming back may need to take them for a longer term.
Drugs that are addictive produce a feeling of euphoria, a strong desire to continue using the drug, and a need to increase the amount used to achieve the same effect. Antidepressants do not have these effects. Antidepressants do, however, have one thing in common with some addictive drugs—they can cause withdrawal effects when you stop taking them.
When you take antidepressants for months or years, your body adjusts to the presence of the drug. If you then stop using it, especially if you stop suddenly, you may experience withdrawal effects such as muscle aches, electric-shock-like sensations, dizziness, headache, nausea, chills and diarrhea.
These effects are most commonly reported with paroxetine Paxil and venlafaxine Effexor ; however, they can occur with any antidepressant. Some people find these effects distressing and have difficulty withdrawing from these drugs.
Whether you want to cut down your dose or stop taking a medication, the same rule applies: go slowly. Sudden changes in your dose can greatly increase your risk of having another mood episode or having withdrawal effects.
The first step is to ask yourself if this is the right time. Are you feeling well? Is the level of stress in your life manageable? Do you feel supported by your family and friends?
If you are not satisfied with his or her reasons, you may want to see another doctor for a second opinion. If your doctor does agree, he or she will advise you not to skip doses but to reduce your dose gradually—usually by about 10 per cent at a time—with at least two to three weeks between each reduction.
This process of cutting back will take several months. Using a pill cutter can help you to cut your dose down in small amounts. If you want to stop taking more than one medication, your doctor will usually suggest that you lower the dose of one drug at a time.
As you cut down, if you start to feel unwell, let your doctor know. He or she can help you determine whether you are experiencing withdrawal effects or signs that symptoms are returning.
Find the dose that works best for you. Antidepressants may interact with some other types of medication, even over-the-counter medications, such as cold or allergy tablets or cough syrups, and some herbal remedies, such as St.
Always ask your doctor, dentist or pharmacist about potential drug interactions with the medication you are taking before you take other medications.
Drinking alcohol can worsen symptoms of depression or anxiety. Alcohol can also worsen some side-effects of antidepressants, making you more sleepy, dizzy and lightheaded. However, if you have been taking antidepressants for more than a few weeks, and you are feeling well, having a drink or two on occasion should be okay—but remember that one drink could have the effect of two or even three drinks.
The caffeine in coffee and other beverages can cause problems if you struggle with depression or anxiety. Depression disrupts sleep, and caffeine, a stimulant, can make the problem worse.
It is better to drink decaffeinated coffee and beverages or to decrease the amount you drink. You want to feel well.
While street drugs such as marijuana or cocaine may have some effects that seem to make you feel better for a while, mixing the effects of these drugs may make your situation worse.
Street drugs may also interact with your medication, for example, by interfering with its effectiveness or by worsening side-effects.
Depression itself can lead to fatigue and concentration problems, affecting your ability to drive. Antidepressant medications may also cause drowsiness, especially in the early stages of treatment, before your body has adjusted to the medication.
If you feel drowsy, do not drive a car or operate machinery. Alcohol, sedatives and antihistamines cold and hay fever medication will worsen the problem. Antidepressants, especially those that increase serotonin activity, can also negatively affect sexual function.
Sexual side-effects of antidepressants can include delayed ejaculation and the inability to experience an orgasm. Many factors affect your sexuality. When antidepressants bring relief from the distress of depression or anxiety, this may help you to focus more on your partner and to feel more desire.
If you think your medication affects your sexual function, your doctor may be able to help by changing your dose, switching medication or adding other medications. For any pregnant woman with a history of depression, the question of whether to take antidepressants during pregnancy usually comes down to a risk-benefit analysis.
When treatment with an antidepressant helps to avoid a relapse or to reduce distress, the benefits of continuing the medication may outweigh the risks. Antidepressants are relatively safe to use during pregnancy. When they are used close to delivery, newborns may be restless and irritable, and may have sleeping, feeding and breathing difficulties.
Learning about depression is an important component of depression treatment. Family education is also important before decisions are made about a treatment plan.
Understanding how depression affects the child or teen's mood, thoughts, body, and behavior can help the patient and his or her family in several ways:.
For example, the need to limit access to certain items, such as prescription medications and weapons, should be discussed. A person can have mild, moderate, or severe major depression.
People with major depression of mild severity have fewer and less intense symptoms compared with people with moderate or severe major depression. Children and adolescents with mild depression are usually treated with psychotherapy alone. If the depressive symptoms do not begin to improve within six to eight weeks, or if symptoms worsen, an antidepressant medication may be recommended.
Children and adolescents with moderate to severe depression generally require psychotherapy and one or more medications. Compared with adults, there are fewer high quality studies of treatment of depression in children and adolescents [ ].
Current practice guidelines for treating younger patients are based upon a combination of data from studies of depressed adolescents, adult depression research, and practical experience.
Many pediatricians diagnose and treat depression in children and adolescents, but they often work closely with mental health specialists including psychiatrists, psychologists, social workers, and counselors to provide care as a team.
A psychiatrist is a medical doctor with specialized training in the treatment of mental health illnesses and problems. A psychiatrist working with young patients should ideally have training and experience in child and adolescent psychiatry or, if the person has adult-only training, he or she should have experience treating teenagers.
This includes how to deal with low mood, engage in productive behaviors, manage relationships, and develop effective problem solving strategies for life stressors associated with depression. Therapy sessions are usually conducted in the therapist's office or virtually with a secure and private telehealth platform, once per week for 30 to 60 minutes.
The patient, parents, and therapist should work together to determine the optimal schedule. During therapy sessions, children and teens talk about their feelings, thoughts, behaviors, and relationships with the therapist. The patient and therapist can discuss alternate ways of thinking or taking action, which often helps the child or teen to cope more effectively with depressive symptoms, improve social and problem solving skills, and increase self-confidence.
There are two specific types of psychotherapy that have been shown to be effective:. Interpersonal therapy for adolescents is adapted from a similar type of therapy used for adults with depression, but tailored to address issues relevant to adolescents such as autonomy, romantic and sexual relationships, peer pressure, and conflict with parents.
Other psychotherapies may also be helpful for depressed children and adolescents, particularly those who present with self-harm. These include family therapy and dialectical behavior therapy a form of CBT. The reason for this is that all patients have a right to privacy and may be reluctant to openly discuss important topics when parents are present.
The initial therapy sessions often focus on trying to identify the factors that are contributing to and maintaining depression. Therapy often includes changing unproductive behavior patterns that are common during episodes of depression. Although psychotherapy can lessen depression within several weeks, the greatest benefit of therapy may not be seen for eight to 10 weeks or longer.
Psychotherapy can be provided by a range of healthcare professionals with appropriate training, including psychiatrists, psychologists, clinical social workers, and clinical nurse specialists. It is also important to consider the therapist's willingness to incorporate family members in the therapy.
If so, how? Children and teens with severe depression and those at risk for suicide are often hospitalized in a psychiatric facility. During the hospitalization, the patient usually has a group of clinicians psychiatrist, psychologist, social worker, etc. who comprise the treatment team. Treatment with an antidepressant medication helps to reestablish the normal balance of chemicals in the brain.
In most cases, the preferred antidepressant is a selective serotonin reuptake inhibitor SSRI ; however, there are other options as well. If a healthcare provider recommends an antidepressant medication for a child or adolescent's depression, the following issues should be discussed before treatment begins:.
An information sheet for parents about antidepressants in children and adolescents is provided in a table table 1. Selective serotonin reuptake inhibitors SSRIs — Medications called selective serotonin reuptake inhibitors SSRIs are generally the first-line medication for depression in children and adolescents because most people have only mild or no side effects, and the medication is generally taken once per day.
SSRIs that have been studied and used in children and adolescents with unipolar major depression include fluoxetine brand name: Prozac , citalopram brand name: Celexa , escitalopram brand name: Lexapro , fluvoxamine brand name: Luvox , paroxetine brand name: Paxil , and sertraline brand name: Zoloft.
Fluoxetine has been more widely studied than other SSRIs in children and adolescents. Questions or concerns about any antidepressant should be discussed with the individual clinician. A more serious potential side effect of SSRIs is serotonin syndrome. Symptoms of serotonin syndrome can include agitation, confusion, and overheating hyperthermia.
This can occur with high doses of an SSRI or if an SSRI is taken in combination with other medications that affect serotonin, such as a class of migraine medications called triptans.
Research indicates that around half of depressed youth who do not respond to a first SSRI will respond to a second one. Atypical antidepressants — Atypical antidepressants may be considered if SSRIs are not effective or cannot be tolerated. Available options include venlafaxine brand name: Effexor , desvenlafaxine brand name: Pristiq , duloxetine brand name: Cymbalta , mirtazapine brand name: Remeron , and bupropion brand name: Wellbutrin.
Venlafaxine appears to be effective for depression in adolescents, and works about as well as SSRIs, although it has more side effects. However, other than venlafaxine, these medications have not been well studied in children and adolescents.
Tricyclic antidepressants — Another group of antidepressants that are rarely used in children or adolescents are called tricyclic antidepressants TCAs. Drugs in this class include imipramine brand name: Tofranil , amitriptyline brand name: Elavil , desipramine brand name: Norpramin , nortriptyline brand name: Pamelor , and clomipramine brand name: Anafranil.
TCAs do not appear to be effective in children and younger adolescents. In addition, TCAs can cause numerous side effects, so healthcare providers rely first on alternatives such as SSRIs.
But if SSRIs and alternatives do not adequately treat the depression, TCAs may be an option. The side effects of TCAs may include dry mouth, blurred vision, constipation, nausea, difficulty urinating, drowsiness, weight gain, and rapid heartbeat.
However, some parents are concerned that treatment with antidepressants can actually increase the risk of suicide. While there appears to be a very small increased risk of suicidal thoughts and behavior in people under the age of 25 who are in the initial stages of antidepressant treatment, many more patients benefit from antidepressants than will experience suicidal thoughts.
In considering whether or not to use medication to treat depression, the parent s and prescriber must balance the small increased risk of suicidal thoughts against the very real risk of suicide if the child or teen's depression is not adequately treated.
Any mention of suicidal thoughts or feelings in a depressed child or adolescent should be taken seriously. Parents who are concerned that their child is considering suicide should seek care as soon as possible.
A depressed child or adolescent who is at risk of attempting suicide will be provided with emergency treatment for depression; this may include hospitalization, antidepressant medication, and intensive therapy.
Treatment of depression can decrease the risk of suicide, but does not eliminate the risk. For this reason, most experts recommend that the parents and healthcare providers eg, therapist, psychiatrist, pediatrician closely monitor the child or adolescent for evidence of suicidal thoughts or behaviors for at least the first 12 weeks of depression treatment and if the antidepressant medication dose is changed.
If suicidal thoughts or behaviors develop during treatment with an antidepressant, the dose may be adjusted, an alternative antidepressant may be tried, or the medication may be discontinued.
Time required for a response — Some people respond to antidepressant medication after about two weeks, but for most, the full effect is not seen until four to six weeks or longer.
During the first few weeks, the dose is usually increased gradually. The patient typically sees the prescribing clinician more frequently at the start of treatment every one to four weeks for first several months. As the patient stabilizes, follow-up progressively shifts to once every three months.
If problems develop at any point, more frequent visits are resumed. By six to eight weeks after starting an antidepressant medication, it is usually possible to determine if the medication is effective.
If symptoms have improved somewhat during this time, the dose of the medication may be increased. If there has been no improvement in symptoms, an alternate antidepressant medication may be recommended; psychotherapy may also be added if it was not already part of the treatment plan.
Duration — In most cases, the antidepressant medication is continued for at least 6 to 12 months after the symptoms of depression improve. This recommendation varies greatly depending upon the individual's situation. The decision to stop antidepressant medication should be shared among the child or adolescent, parent s , and the clinician.
Ideally, discontinuation occurs during a lower stress time for the patient eg, at the beginning of summer vacation. When most antidepressants are stopped, they should be tapered slowly over two to four weeks to minimize the potential side effects associated with abruptly stopping medication.
One exception is fluoxetine , which takes a long time to be cleared from the body, and can be stopped without a taper. Side effects associated with stopping antidepressant medication quickly can include jitteriness, dizziness, nausea, fatigue, muscle aches, chills, anxiety, and irritability.
Although these symptoms are not dangerous and usually improve over one to two weeks, they can be quite distressing and uncomfortable. A relapse in depression is relatively common after stopping antidepressant medications; in some cases, longer-term treatment is recommended. See 'Maintenance drug therapy' below.
Maintenance drug therapy — Maintenance drug therapy long-term antidepressant therapy may be appropriate for children and adolescents who are at high risk for a relapse of depression. Relapse often occurs in pediatric patients who stop their antidepressants soon after their depressive syndromes improve [ ].
Maintenance therapy may last from one year to indefinitely, depending upon the individual's situation and personal history of depression. Therapy with other medications — For some people, depression is accompanied by other psychiatric conditions, such as panic attacks, obsessive-compulsive disorder, or mania.
Treatment with more than one medication, including an antidepressant and an antipsychotic, antianxiety, mood-stabilizing eg, lithium , or anticonvulsant medication may be recommended in these situations.
Alternative treatments — Some alternative methods for treating depression have been studied, including omega-3 fatty acids found in fish oil and St. So far, the research on these and other alternative treatments has been inconclusive, so we do not recommend their use.
But those who interested in the efficacy of such options can learn more at the National Center for Complementary and Alternative Medicine, a branch of the National Institutes of Health www. Electroconvulsive therapy ECT — During electroconvulsive therapy ECT , an electrical current is passed through the brain, which in turn causes chemical changes that can relieve severe depression.
While scientists do not yet fully understand exactly how ECT does this, they know it causes helpful changes to the molecules and cells of the brains of people with depression.
ECT is especially effective for people with depression who also have delusions powerful, irrational beliefs and for people who have severe depression that has not responded to other treatments.
The parent s , patient, and psychiatrist must all agree to a trial of ECT before it is considered; state and local guidelines may also apply. See "Medical evaluation for electroconvulsive therapy".
Patients who undergo ECT are given general anesthesia to induce sleep and prevent discomfort. The patient is monitored carefully before, during, and after the treatment.
Side effects of this therapy include brief confusion and memory loss. Although ECT has often been negatively portrayed in the media, it often provides rapid and dramatic relief of depression and has few side effects.
Most people who undergo ECT find it a helpful treatment for their depression. See "Patient education: Depression treatment options for adults Beyond the Basics ", section on 'Depression and pregnancy'. This article will be updated as needed on our web site www.
Related topics for patients, as well as selected articles written for healthcare professionals, are also available.
Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials. The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition.
These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Patient education: Depression in children and teens The Basics Patient education: Depression in adults The Basics Patient education: Medicines for depression The Basics Patient education: Electroconvulsive therapy ECT The Basics Patient education: Post-traumatic stress disorder The Basics Patient education: When you have depression and another health problem The Basics.
Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.
Patient education: Depression in children and adolescents Beyond the Basics Patient education: Depression in adults Beyond the Basics Patient education: Depression treatment options for adults Beyond the Basics. Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings.
These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based.
Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.
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For many children and teens, antidepressants are an effective way to treat depression, anxiety, obsessive-compulsive disorder or other mental health conditions. If these conditions aren't treated effectively, your child may not be able to lead a satisfying, fulfilled life or do everyday activities.
It's important that your child have a thorough evaluation before starting to take an antidepressant. A mental health evaluation by a psychiatrist — or a pediatrician or family physician who is experienced in the treatment of child and adolescent mood disorders — should include:.
Talk with your doctor about treatment options, treatment goals and the expected results of any recommended treatment. The FDA has approved certain antidepressants for use in children and teenagers for different types of diagnoses.
Antidepressants come with a medication guide that advises parents and caregivers about risks and precautions. Be sure to carefully read the medication guide and package insert, and discuss any questions with the prescribing physician and your pharmacist.
Antidepressants can also be used for other conditions. The antidepressant imipramine is approved by the FDA to treat daytime or nighttime involuntary urination childhood enuresis in children 6 years of age and older. Physicians may use their medical judgment to prescribe other antidepressants for children for what's called off-label use.
This is a clinically common practice for many types of medications for both children and adults. The FDA advises that doctors prescribe the smallest quantity of pills possible to help reduce the risk of deliberate or accidental overdose.
Locking up all pills in the home is one measure families can take to reduce the risk of suicide. Careful monitoring by parents, caregivers and health care professionals is important for any child or teenager taking an antidepressant for depression or any other condition. Parents and caregivers should closely observe the child on a daily basis during these transition periods and watch for worrisome changes for the whole time the child takes antidepressants.
The FDA also recommends that your child receive close monitoring by a health care professional during the first few months of treatment, and ongoing monitoring throughout treatment.
Frequency of contact with doctors or mental health professionals depends on your child's needs. Make sure you stick to your child's recommended appointment schedule.
Sometimes the signs and symptoms of suicidal thoughts or self-harm are difficult to see, and your child may not directly tell you about such thoughts.
Here are some signs that your child's condition may be worsening or that he or she may be at risk of self-harm:. Contact your child's health care professional right away if any of these signs occur, if they get worse, or if you, your child, a teacher or other caregiver has concerns.
Make sure your child doesn't stop antidepressant treatment without the guidance of the prescribing doctor. Suddenly stopping an antidepressant may cause flu-like symptoms, an increase in anxiety and other side effects referred to as discontinuation syndrome.
Stopping too suddenly may also result in the return of depression symptoms. Most children who take antidepressants for depression will improve with medication.
However, combining medication with talk therapy psychotherapy is likely to be even more effective. Many types of psychotherapy may be helpful, but cognitive behavioral therapy and interpersonal therapy have been scientifically studied and shown to be effective for treating depression.
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By Mayo Clinic Staff. Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. Show references Dwyer JB, et al. Antidepressants for pediatric patients. Current Psychiatry. Suicidality in children and adolescents being treated with antidepressant medications.
Food and Drug Administration. Accessed May 12, Antidepressants — Pediatric dosing chart. Centers for Medicare and Medicaid Services. Depression: Parents' medication guide. American Academy of Child and Adolescent Psychiatry. Boaden K, et al. Antidepressants in children and adolescents: Meta-review of efficacy, tolerability and suicidality in acute treatment.
Frontiers in Psychiatry. Teen depression. National Institute of Mental Health. Accessed May 15, Spielmans GI, et al. Duty to warn: Antidepressant black box suicidality warning is empirically justified. Kaminski JA, et al. Antidepressants and suicidality: A re-analysis of the re-analysis.
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: Antidepressant for teenage depression| Cautions About the Use of Zoloft (sertraline) and Other Antidepressants in Teens | Please select a newsletter. Concerns about teen-specific side-effects are always prevalent. Encourage your teen not to give up. Practice preparation, identification, assessment, and initial management. Antidepressants can take up to several weeks to be fully effective. In most cases, side-effects lessen as treatment continues. It is vital young people receive the help they need as early as possible to prevent lasting mental health difficulties. |
| Depression in Children and Teens | HealthLink BC | Eating disorder and depressive symptoms in urban high school girls from different ethnic backgrounds. J Dev Behav Pediatr. Pabayo R, Dias J, Hemenway D, et al. Sweetened beverage consumption is a risk factor for depressive symptoms among adolescents living in Boston, Massachusetts, USA. Public Health Nutr. Kullik A, Petermann F. Attachment to parents and peers as a risk factor for adolescent depressive disorders: the mediating role of emotion regulation. Child Psychiatry Hum Dev. Torres-Rodríguez A, Griffiths MD, Carbonell X, et al. Internet gaming disorder in adolescence: psychological characteristics of a clinical sample. J Behav Addict. Brunborg GS, Mentzoni RA, Frøyland LR. Is video gaming, or video game addiction, associated with depression, academic achievement, heavy episodic drinking, or conduct problems?. Orth U, Robins RW, Widaman KF, et al. Is low self-esteem a risk factor for depression? Findings from a longitudinal study of Mexican-origin youth. Dev Psychol. Muris P, van den Broek M, Otgaar H, et al. Good and bad sides of self-compassion: a face validity check of the self-compassion scale and an investigation of its relations to coping and emotional symptoms in non-clinical adolescents. J Child Fam Stud. Orchard F, Reynolds S. The combined influence of cognitions in adolescent depression: biases of interpretation, self-evaluation, and memory. Br J Clin Psychol. Rawal A, Rice F. Examining overgeneral autobiographical memory as a risk factor for adolescent depression. J Am Acad Child Adolesc Psychiatry. Marino C, Gini G, Vieno A, et al. The associations between problematic Facebook use, psychological distress and well-being among adolescents and young adults: a systematic review and meta-analysis. J Affect Disord. Kodish T, Herres J, Shearer A, et al. Bullying, depression, and suicide risk in a pediatric primary care sample [published correction appears in Crisis. Hamm MP, Newton AS, Chisholm A, et al. Prevalence and effect of cyberbullying on children and young people: a scoping review of social media studies. JAMA Pediatr. Adams J, Mrug S, Knight DC. Characteristics of child physical and sexual abuse as predictors of psychopathology. Child Abuse Negl. Cohen JR, McNeil SL, Shorey RC, et al. Maltreatment subtypes, depressed mood, and anhedonia: a longitudinal study with adolescents [published online December 27, ]. Psychol Trauma. Lai BS, La Greca AM, Auslander BA, et al. Children's symptoms of post-traumatic stress and depression after a natural disaster: comorbidity and risk factors. Tang B, Liu X, Liu Y, et al. A meta-analysis of risk factors for depression in adults and children after natural disasters. BMC Public Health. Kremer P, Elshaug C, Leslie E, et al. Physical activity, leisure-time screen use and depression among children and young adolescents. J Sci Med Sport. Korczak DJ, Madigan S, Colasanto M. Children's physical activity and depression: a meta-analysis. Uddin M, Jansen S, Telzer EH. Adolescent depression linked to socioeconomic status? Molecular approaches for revealing premorbid risk factors. Shanahan L, Copeland WE, Costello EJ, et al. Child-, adolescent- and young adult-onset depressions: differential risk factors in development?. Douglas J, Scott J. A systematic review of gender-specific rates of uni-polar and bipolar disorders in community studies of pre-pubertal children. Bipolar Disord. Preventive Services Task Force. Depression in children and adolescents: screening. February Accessed August 12, American Academy of Family Physicians. Adolescent health clinical recommendations and guidelines. Depression — clinical preventive service recommendation. Accessed August 12, Zuckerbrot RA, Cheung A, Jensen PS, et al. Guidelines for adolescent depression in primary care GLAD-PC : part I. Practice preparation, identification, assessment, and initial management. The Reach Institute. Adolescent Depression in Primary Care GLAD-PC Toolkit. Patient Health Questionnaire PHQ screeners. PHQ Modified for Teens. Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association; Gunlicks-Stoessel M, Mufson L, Bernstein G, et al. Critical decision points for augmenting interpersonal psychotherapy for depressed adolescents: a pilot sequential multiple assignment randomized trial. Ballard ED, Cwik M, Van Eck K, et al. Identification of at-risk youth by suicide screening in a pediatric emergency department. Prev Sci. Suicide risk screening tool. Weihs KL, Murphy W, Abbas R, et al. Desvenlafaxine versus placebo in a fluoxetine-referenced study of children and adolescents with major depressive disorder. J Child Adolesc Psychopharmacol. Kennard B, Silva S, Vitiello B, et al. Remission and residual symptoms after short-term treatment in the Treatment of Adolescents with Depression Study TADS. Clarke GN, Rohde P, Lewinsohn PM, et al. Cognitive-behavioral treatment of adolescent depression: efficacy of acute group treatment and booster sessions. Wagner KD, Jonas J, Findling RL, et al. A double-blind, randomized, placebo-controlled trial of escitalopram in the treatment of pediatric depression. Cheung AH, Zuckerbrot RA, Jensen PS, et al. Guidelines for adolescent depression in primary care GLAD-PC : part II. treatment and ongoing management. Food and Drug Administration. Suicidality in children and adolescents being treated with antidepressant medications. Ignaszewski MJ, Waslick B. Update on randomized placebo-controlled trials in the past decade for treatment of major depressive disorder in child and adolescent patients: a systematic review [published online July 31, ]. Cipriani A, Zhou X, Del Giovane C, et al. Comparative efficacy and tolerability of antidepressants for major depressive disorder in children and adolescents. Forman-Hoffman VL, McClure E, McKeeman J, et al. Screening for major depressive disorder among children and adolescents: a systematic review for the U. Ann Intern Med. Clarke G, DeBar LL, Pearson JA, et al. Cognitive behavioral therapy in primary care for youth declining antidepressants: a randomized trial. Oud M, de Winter L, Vermeulen-Smit E, et al. Effectiveness of CBT for children and adolescents with depression: a systematic review and meta-regression analysis. Eur Psychiatry. March JS, Silva S, Petrycki S, et al. The Treatment for Adolescents With Depression Study TADS : long-term effectiveness and safety outcomes [published correction appears in Arch Gen Psychiatry. Arch Gen Psychiatry. Emslie GJ, Kennard BD, Mayes TL, et al. Continued effectiveness of relapse prevention cognitive-behavioral therapy following fluoxetine treatment in youth with major depressive disorder. Foster S, Mohler-Kuo M. Treating a broader range of depressed adolescents with combined therapy. Clark MS, Jansen KL, Cloy JA. Treatment of childhood and adolescent depression. Am Fam Physician. Bhatia SK, Bhatia SC. Childhood and adolescent depression. Son SE, Kirchner JT. Depression in children and adolescents. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. search close. PREV Nov 15, NEXT. Risk Factors. Screening for Depression. To use the PHQ-9 as a diagnostic aid for major depressive disorder: Question 1 or 2 needs to be endorsed as a 2 or 3. To use the PHQ-9 to obtain a total score and assess depressive severity: Add up the numbers endorsed for questions 1 to 9 and obtain a total score. See the chart below. Total score Depression severity 0 to 4 No or minimal depression 5 to 9 Mild depression 10 to 14 Moderate depression 15 to 19 Moderately severe depression 20 to 27 Severe depression. But listen without judging and try to put yourself in your teen's position. Help build your teen's self-esteem by recognizing small successes and offering praise about competence. It's a good idea to be well prepared for your appointment. Here's some information to help you and your teenager get ready, and what to expect from the doctor. To the extent possible, involve your teenager in preparing for the appointment. Then make a list of:. Your teen's doctor or mental health professional will likely ask your teen a number of questions, including:. The doctor or mental health professional will ask additional questions based on your teen's responses, symptoms and needs. Preparing and anticipating questions will help make the most of your appointment time. Teen depression care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version. This content does not have an Arabic version. Diagnosis When teen depression is suspected, the doctor will typically do these exams and tests. Physical exam. The doctor may do a physical exam and ask in-depth questions about your teenager's health to determine what may be causing depression. In some cases, depression may be linked to an underlying physical health problem. Lab tests. For example, your teen's doctor may do a blood test called a complete blood count or test your teen's thyroid to make sure it's functioning properly. Psychological evaluation. A doctor or mental health professional can talk with your teen about thoughts, feelings and behavior, and may include a questionnaire. These will help pinpoint a diagnosis and check for related complications. Care at Mayo Clinic Our caring team of Mayo Clinic experts can help you with your teen depression-related health concerns Start Here. More Information Teen depression care at Mayo Clinic Antidepressants for children and teens Acupuncture Cognitive behavioral therapy Psychotherapy Show more related information. Request an appointment. By Mayo Clinic Staff. Show references Depressive disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM American Psychiatric Association; Accessed May 4, Bipolar and related disorders. Brown AY. Allscripts EPSi. Mayo Clinic. April 9, Teen depression. National Institute of Mental Health. Accessed March 30, Depression in children and teens. American Academy of Child and Adolescent Psychiatry. Psychotherapy for children and adolescents: Different types. Suicidality in children and adolescents being treated with antidepressant medications. Food and Drug Administration. Depression medicines. Building your resilience. American Psychological Association. Accessed May 5, Weersing VR, et al. Evidence-base update of psychosocial treatments for child and adolescent depression. Journal of Clinical Child and Adolescent Psychology. Zuckerbrot RA, et al. Guidelines for adolescent depression in primary care GLAD-PC : Part I. Practice preparation, identification, assessment, and initial management. Cheung AH, et al. Guidelines for adolescent depression in primary care GLAD-PC : Part II. Treatment and ongoing management. Resilience guide for parents and teachers. Rice F, et al. Adolescent and adult differences in major depression symptoms profiles. Journal of Affective Disorders. Haller H, et al. Complementary therapies for clinical depression: An overview of systemic reviews. BMJ Open. Ng JY, et al. Complementary and alternative medicine recommendations for depression: A systematic review and assessment of clinical practice guidelines. BMC Complementary Medicine and Therapeutics. American College of Obstetricians and Gynecologists. Practice Bulletin No. Reaffirmed Neavin DR, et al. Treatment of major depressive disorder in pediatric populations. Vande Voort JL expert opinion. June 29, Safe Place: TXT 4 HELP. Related Antidepressants for children and teens. Associated Procedures Acupuncture Cognitive behavioral therapy Psychotherapy. News from Mayo Clinic Mayo Clinic Minute: Know the difference between adult and teen depression April 15, , p. CDT Mayo Clinic researchers use AI to predict antidepressant outcomes in youth March 16, , p. Mayo Clinic in Rochester, Minnesota, has been recognized as one of the top Psychiatry hospitals in the nation for by U. |
| Add a comment | Most trials included in the reviews did not include children and teenagers at risk of suicide. Excluding this group from studies weakens their conclusions about antidepressants. Patients, carers and clinicians should continue to balance carefully the potential benefits of treatments with how acceptable they are, and the possible risk of suicide in a young person with depression. Psychological therapies, as recommended in guidance, remain an important part of any treatment approach. OCD is usually considered to be an anxiety disorder but is considered separately in the reviews and in this Collection. People with OCD have unwanted thoughts or urges obsessions and may use repetitive behaviours compulsions to relieve the unpleasant feelings. Fluvoxamine Faverin was consistently found to be more effective than placebo a dummy pill for treating anxiety disorders. Other SSRIs fluoxetine, sertraline and paroxetine were more effective than placebo by some but not all measures of anxiety depending on the specific assessment tool used. Sertraline Lustral consistently reduced the risk of suicidal thoughts and behaviours in young people more than placebo. Paroxetine Seroxat increased them. Sertraline and fluoxetine Prozac were consistently found to be more effective than placebo for treating OCD. The combination of sertraline and CBT was also effective according to one review. NICE guidelines do not cover the full range of anxiety disorders. Currently, there are guidelines for children and teenagers for social anxiety disorder , post-traumatic stress disorder and OCD. All recommend specific psychological therapies as first treatment. Only the guideline for OCD published in and due to be updated recommends antidepressants. When prescribed, NICE states an SSRI antidepressant should be combined with CBT. The reviews in this Collection broadly support this approach for OCD: sertraline and fluoxetine are both SSRIs. No antidepressants are licensed in the UK for anxiety in children and teenagers under 18 years except for OCD. Yet both specialists and GPs prescribe them. The reviews in this Collection indicate that certain antidepressants are effective and may be safe. Up to date guidelines are needed for the full range of anxiety disorders in children and teenagers. Uncertainty remains about the safety of antidepressants in young people with anxiety, especially over the long-term. More research is needed. The limited evidence about suicidal thoughts and behaviours highlights the importance of careful monitoring of children and teenagers taking antidepressants. Thousands of children and teenagers in the UK are taking antidepressants for depression and anxiety. The numbers continue to rise and many have not seen a specialist. This Collection brings together recent NIHR evidence showing that some antidepressants are effective and may be safe for children and teenagers. It also highlights uncertainties that remain. Very few of the studies included in major reviews looked at long-term treatment. Treatment was usually for between 2 and 16 weeks. More research is therefore needed into the effectiveness and safety of long-term antidepressant use in young people. Clinical guidelines stress the need to involve child and adolescent psychiatrists in decisions to use antidepressants in children and teenagers. We know this often does not happen. Limited access to mental health services and a lack of child and adolescent psychiatrists seem to prevent it. Some GPs start prescribing to help young people in urgent need, which may be life saving if they are very depressed. Depression and anxiety can profoundly affect the lives of children and teenagers and all of those around them. Evidence-based treatments, including psychological therapies and antidepressants, can help. But young people must be able to access mental health services they need. In the NHS Long Term Plan , the Government commits to expanding mental health services for children and young people and reducing unnecessary delays. This should improve the support available. How to cite this Collection : NIHR Evidence; Antidepressants for children and teenagers: what works for anxiety and depression? Disclaimer: This publication is not a substitute for professional healthcare advice. It provides information about research which is funded or supported by the NIHR. Please note that views expressed are those of the author s and reviewer s at the time of publication. They do not necessarily reflect the views of the NHS, the NIHR or the Department of Health and Social Care. Antidepressants for children and teenagers: what works for anxiety and depression? Mental Health View commentaries on this research Read below to discover what research tells us about how antidepressants are being prescribed for children and teenagers and which antidepressants are effective for depression and anxiety. Mental health care for children and teenagers: introduction More and more children and teenagers have poor mental health. Podcast: How to help young people with depression In this podcast , we discuss the help available for young people with depression, and the times when antidepressants could be the right choice. This website uses cookies to enhance your experience. Click 'Accept cookies' if you agree to the use of cookies. NIHR cookie settings Accept cookies. Close Privacy Overview This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience. Necessary Necessary. Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. Getting psychiatric treatment at a hospital can help keep your teen calm and safe until coping skills are learned and a safety plan is developed. Day treatment programs also may help. These programs provide the support and counseling needed while your teen gets depression symptoms under control. Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Make sure that you and your teenager understand the risks as well as possible benefits if your teen pursues alternative or complementary therapy. Don't replace conventional medical treatment or psychotherapy with alternative medicine. When it comes to depression, alternative treatments aren't a good substitute for medical care. Relying solely on these methods is generally not enough to treat depression. But they may be helpful when used in addition to medication and psychotherapy. You are your teenager's best advocate to help him or her succeed. In addition to professional treatment, here are some steps you and your teen can take that may help:. Showing interest and the desire to understand your teenager's feelings lets him or her know you care. You may not understand why your teen feels hopeless or has a sense of loss or failure. But listen without judging and try to put yourself in your teen's position. Help build your teen's self-esteem by recognizing small successes and offering praise about competence. It's a good idea to be well prepared for your appointment. Here's some information to help you and your teenager get ready, and what to expect from the doctor. To the extent possible, involve your teenager in preparing for the appointment. Then make a list of:. Your teen's doctor or mental health professional will likely ask your teen a number of questions, including:. The doctor or mental health professional will ask additional questions based on your teen's responses, symptoms and needs. Preparing and anticipating questions will help make the most of your appointment time. Teen depression care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version. This content does not have an Arabic version. Diagnosis When teen depression is suspected, the doctor will typically do these exams and tests. Physical exam. The doctor may do a physical exam and ask in-depth questions about your teenager's health to determine what may be causing depression. In some cases, depression may be linked to an underlying physical health problem. Lab tests. For example, your teen's doctor may do a blood test called a complete blood count or test your teen's thyroid to make sure it's functioning properly. Psychological evaluation. A doctor or mental health professional can talk with your teen about thoughts, feelings and behavior, and may include a questionnaire. These will help pinpoint a diagnosis and check for related complications. Care at Mayo Clinic Our caring team of Mayo Clinic experts can help you with your teen depression-related health concerns Start Here. More Information Teen depression care at Mayo Clinic Antidepressants for children and teens Acupuncture Cognitive behavioral therapy Psychotherapy Show more related information. Request an appointment. By Mayo Clinic Staff. Show references Depressive disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM American Psychiatric Association; Accessed May 4, Bipolar and related disorders. Brown AY. Allscripts EPSi. Mayo Clinic. April 9, Teen depression. National Institute of Mental Health. Accessed March 30, Depression in children and teens. American Academy of Child and Adolescent Psychiatry. Psychotherapy for children and adolescents: Different types. Suicidality in children and adolescents being treated with antidepressant medications. Food and Drug Administration. Depression medicines. Building your resilience. American Psychological Association. Accessed May 5, Weersing VR, et al. Evidence-base update of psychosocial treatments for child and adolescent depression. Journal of Clinical Child and Adolescent Psychology. Zuckerbrot RA, et al. Guidelines for adolescent depression in primary care GLAD-PC : Part I. Practice preparation, identification, assessment, and initial management. Cheung AH, et al. Guidelines for adolescent depression in primary care GLAD-PC : Part II. Treatment and ongoing management. Resilience guide for parents and teachers. Rice F, et al. Adolescent and adult differences in major depression symptoms profiles. Journal of Affective Disorders. Haller H, et al. Complementary therapies for clinical depression: An overview of systemic reviews. BMJ Open. Ng JY, et al. Complementary and alternative medicine recommendations for depression: A systematic review and assessment of clinical practice guidelines. BMC Complementary Medicine and Therapeutics. |
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