In a way, it’s ironic that the very medication meant to manage depression in teens might cause suicide. Although this isn’t true for all teens, the risk of suicide appears to be present for some teens who take antidepressants.
Antidepressants work well because they adjust the chemicals in the brain. Antidepressants affect the levels of dopamine and serotonin, which influence mood stability. There are various forms of antidepressants that affect the brain in different ways. However, the group of antidepressants known as Selective Serotonin Re-uptake Inhibitors (SSRI’s) are considered to be an improvement over Monoamine Oxidase Inhibitors (MAOI’s) and Tricyclic Antidepressants (TCA’s).
In 1965, Joseph Schildkraut found that depression was connected to the absence of norepinephrine. Norepinephrine is both a neurotransmitter in the brain and a hormone that is released in the body during times of stress. As a neurotransmitter, it activates in the brain arousal and alertness. However, later researchers discovered serotonin playing a larger role in the presence of depression.
SSRI’s are used to increase the levels of serotonin, which can ease depressive symptoms. SSRI’s are incredibly effective, but they do come with risks. For teens in particular, it is essential to know that anti-depressants can cause suicidal thoughts and even attempts at suicide. For this reason, close communication with a psychiatrist as well as observation of your child is essential while he or she is using SSRI’s for the treatment of depression. However, SSRI’s have fewer and milder symptoms than other anti-depressants. When SSRI’s are taken with other drugs that increase serotonin levels, confusion, high blood pressure, tremors, and hyperactivity may be side effects.
Yet another advancement of antidepressant medication is the use of Selective Serotonin Re-uptake Inhibitors (SNRI’s). These anti-depressants are a newer class of anti-depressants. They differ from SSRI’s in that they increase levels of both serotonin and norepinephrine in the brain. They have similar side effects to SSRI’s as well.
In the past decade, there has been some concern that the use of antidepressant medications may induce suicidal behavior in youths. As a result, the U.S. Food and Drug Administration (FDA) reviewed all of the available published and unpublished material on antidepressants to determine the danger of the drug on children and teens. Finally, in October of 2004, the FDA issued a warning about the increased risk of suicidal thoughts or behavior (suicide attempts) in children and adolescents treated with SSRI antidepressant medications.
However, more recently, a comprehensive review of clinical trials through 2006 led to the following conclusion: the benefits for teens who take antidepressant medication outweigh the risks of suicidal thinking and behavior. For this reason, the field of psychology continues to approve the use of SSRI’s for children and adolescents with major depression and anxiety disorders.
Antidepressants are used to treat not only moderate to severe depression, but also other psychological disorders such as anxiety disorders, such as Generalized Anxiety Disorder (GAD), Obsessive-Compulsive Disorder (OCD), and Post Traumatic Stress Disorder (PTSD). Antidepressants can also address the painful mood states that some with personality disorders experience. Common forms of SSRI medication prescribed to teens include:
- fluoxetine (Prozac)
- sertraline (Zoloft)
- paroxetine (Paxil)
- citalopram (Celexa)
- escitalopram (Lexapro)
- fluvoxamine (Luvox)
Another antidepressant medication, venlafaxine (Effexor), is not an SSRI but is closely related.
Because of the danger of suicide discussed above, it’s important that teens and their parents stay in close communication with a psychiatrist. Furthermore, parents should remember to closely monitor their children while he or she is using this type of antidepressant medication. Although there are risks, this type of psychotropic medication has also been incredibly successful in treating depression and other types of teen mental illness. For this reason, it might be the best treatment choice for your teen. However, keep the risks in mind when you are communicating with your teen’s psychiatrist.