Children and Antidepressants

During the past few years, much has been discussed and written about the use of antidepressants among children.  Opinions vary to the extremes, but the majority of medical and pharmaceutical professionals agree that there is cause for some alarm when it comes to prescribing these medications to children and teens.

In 2004, the Food and Drug Administration (FDA) decided that there was indeed a reason to issue warnings about the increased risk of suicidal tendencies among patients under the age of 17 who were taking the drug Paxil.  Since that time, they’ve chosen to include warnings for all antidepressants in regards to their use by children.

  The drugs carry a “black box” warning, the most serious issued by the FDA.  Great Britain has gone so far as to ban the use of all antidepressants by children, a step which the FDA has refused to take. 

Many doctors began prescribing these drugs to children in the mid 1990s, with the emergence of drugs known as selective serotonin reuptake inhibitors (SSRI).  Though Prozac is the only SSRI approved for children (2003), others are routinely prescribed, a practice known as “off-label use” among those in the medical community.

Theories as to why and, indeed, if, these SSRI drugs cause increased risk of suicide vary.  Some suggest that it’s because the increased level of serotonin in the drugs produce new brain cells in the constantly developing brain of a child, confusing the brain.

Others heartily disagree and believe that the underlying depression may be the cause for the increased suicide levels.  Many argue that suicide is prevalent among adolescents and teens regardless of their intake of such drugs. 

Proponents of the ban, however, believe that some of the side effects of antidepressants, such as agitation and anxiety, may lead to increased thoughts of suicide and the tendency to carry it out.  All agree that children with bi-polar disorders should steer clear of serotonin-producing drugs as they may cause manic episodes which result in the child’s attempts at risky behaviors or self-harm.

Children who are taking antidepressants should never stop them cold turkey.  Kids must be weaned from the medication, if desired.  Much of the medical community and even plenty of parents, however, will argue that the benefits of the drugs far outweigh the risks.  Nonetheless, children taking antidepressants should always be carefully monitored and any changes in behavior should be investigated immediately.