Warning Signs Should You Watch for When Your Child is Taking Antidepressants.
Antidepressant Use in Children, picture from dailymail.co.uk
What antidepressants can children take?
Fluoxetine FDA approved
Your child’s doctor or qualified mental health professional can prescribe any antidepressant on the market. However, the FDA has officially approved only one antidepressant for the treatment of depression in children fluoxetine (Prozac). In addition to Prozac, escitalopram (Lexapro) is approved for the treatment of depression in adolescents age 12 and older.
Critics fear that physicians are adopting chemical solutions to the emotional problems of children because of pressure from insurers and health maintenance organizations. Most psychiatric drugs have not been adequately tested in children, and some drug combinations occasionally prescribed for children particularly stimulants and antidepressants have not been fully tested even in adults. A child’s development could be detoured by a misapplication of drugs.
Children’s adverse reactions are inadequately monitored in everyday practice. Researchers who study side effects in children sometimes ask the wrong questions, or not enough questions. The American Academy of Child and Adolescent Psychiatry has established a Pediatric Psychopharmacology Initiative. A group of educators, child psychiatrists, developmental psychologists, and pharmaceutical company representatives will monitor controlled trials, set consistent standards, and promulgate guidelines for researchers and prescribing physicians.
Meanwhile, the rule is caution in prescribing antidepressants for children. For children with both attention deficit disorder and depression, experts recommend trying a stimulant first, because its effects can be observed immediately. Children can continue to take the drug if it seems to be helping, but they should be watched closely for side effects.
What warning signs should you watch for when your child is taking antidepressants?
Sometimes the signs and symptoms of suicidal thoughts or self-harm are difficult to see. They’re not always obvious, and your child may not directly tell you that he or she is having such thoughts. Here are some signs and symptoms that your child’s condition may be worsening or that he or she may be at risk of self-harm:
- Thoughts about suicide or dying
- Attempts to commit suicide
- Self-injury
- Feeling very agitated or restless
- Panic attacks
- Sleeping problems
- Increasing sadness
- An extreme increase in talking or activity
- Aggression, violence or hostility
- New or worsening anxiety
- Social or academic problems at school
- Spending more time alone
Contact your child’s health care professional right away if any of these signs and symptoms occur, if they get worse, or if they worry you, your child, a teacher or other caregiver.
List of Antidepressant Drugs
| Anafranil (clomipramine) | fluvoxamine maleate | Paxil (paroxetine HCl) |
| Asendin (amoxapine) | Lexapro (escitalopram oxalate) | Pexeva (paroxetine mesylate) |
| Aventyl (nortriptyline) | Limbitrol (chlordiazepoxide/amitriptyline) | Prozac (fluoxetine HCl) |
| Celexa (citalopram hydrobromide) | Ludiomil (maprotiline) | Remeron (mirtazapine) |
| Cymbalta (duloxetine) | Marplan (isocarboxazid) | Sarafem (fluoxetine HCl) |
| Desyrel (trazodone HCl) | Nardil (phenelzine sulfate) | Seroquel (quetiapine) |
| Elavil (amitriptyline) | nefazodone HCl | Sinequan (doxepin) |
| Effexor (venlafaxine HCl) | Norpramin (desipramine HCl) | Surmontil (trimipramine) |
| Emsam (selegiline) | Pamelor (nortriptyline) | Symbyax (olanzapine/fluoxetine) |
| Etrafon (perphenazine/amitriptyline) | Parnate (tranylcypromine sulfate) | Tofranil (imipramine) |
| Tofranil-PM (imipramine pamoate) | Triavil (perphenazine/amitriptyline) | Vivactil (protriptyline) |
| Wellbutrin (bupropion HCl) | Zoloft (sertraline HCl) | Zyban (bupropion HCl) |
References :
- Kutcher S, ed.Practical Child and Adolescent Psychopharmacology. Cambridge University Press, 2002.
- Bridge JA, Iyengar S, Salary CB, Barbe RP, Birmaher B, Pincus HA, Ren L, Brent DA, MD. Clinical Response and Risk for Reported Suicidal Ideation and Suicide Attempts in Pediatric Antidepressant Treatment: A Meta-analysis of Randomized Controlled Trials. JAMA. 2007;297:1683-1696.
- Wagner KD, et al. “Efficacy of Sertraline in the Treatment of Children and Adolescents with Major Depressive Disorder: Two Randomized Clinical Trials,†JAMA (August 27, 2003): Vol. 290, No. 8, pp. 1033–41.
- Treatment for Adolescents with Depression Study (TADS) Team. Fluoxetine, cognitive-behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents with Depression Study (TADS) randomized controlled trial. Journal of the American Medical Association, 2004 Aug 18; 292(7):807-20.
- Varley CK. “Psychopharmacological Treatment of Major Depressive Disorder in Children and Adolescents,†JAMA ( August 27, 2003): Vol. 290, No. 8, pp. 1091–93.
- Olfson M, Marcus SC, Shaffer D. Antidepressant Drug Therapy and Suicide in Severely Depressed Children and Adults. Archives of General Psychiatry. 2006 Aug. 63:865-72
- DeBar LL, et al. “Use of Psychotropic Agents in Preschool Children: Associated Symptoms, Diagnoses, and Health Care Services in a Health Maintenance Organization,†Archives of Pediatrics and Adolescent Medicine (February 2003): Vol. 157, No. 2, pp. 150–57.
- Simon GE, Savarino J, Operskalski B, Wang P. Suicide Risk During Antidepressant Treatment. American Journal of Psychiatry. 2006. 163 (1): 41-47.
- Gibbons RD, Hur K, Bhaumik DK, Mann JJ. The relationships between antidepressant prescription rates and rate of early adolescent suicide. American Journal of Psychiatry 2006. 163 (11): 1898-1904
- National Institute of Mental Health, Antidepressant Medications for Children and Adolescents: Information for Parents and Caregivers. Last updated June 2008