Medication for Children with Depression

Children can experience depression just as adults can; the difference is the suitable child depression medication as the age of a depressed patient is a major factor for physicians when prescribing antidepressant medications.

Why Can't Children Take the Same Antidepressants as Adults

One reason there lies a difference in the prescribing of antidepressant medication for children is not only because of their weight and brain development, but also because research has shown that for unknown reasons, the percentage of children on certain antidepressant medications or SSRIs (Selective Serotonin Re-uptake Inhibitors) have the potential of causing increased suicidal thoughts and behaviors in children and adolescents. It should be taken into account, however, that children with depression, especially Major Depression Disorder, are also at risk of having suicidal thoughts and behaviors. It is up to the caregiver and the physician to weigh the risk vs. benefit when it comes to prescribing child depression medication.

The FDA's Approval of Child Depression Medication & the Doctors Choice for Child Antidepressant Medication

The FDA has only approved one antidepressant medication with SSRI for the treatment of depression, including Major Depression Disorder, for children ages eight and up. Fluoxetine, better known as Prozac, is currently the only FDA approved medication for children with depression. However, physicians have the right to order other FDA approved medications for children on an "off-the-label" basis. This simply means that the doctor prescribes the depressed child or adolescent with an FDA approved medication, but prescribes it to help the patient although the particular medication is not approved for the mental disorder or the approved age for the child. The physician decides what is best, with the approval of the caregiver, that the "off-the-label" could be beneficial for the depressive symptoms the child is suffering.

The Reason Some Children Need Antidepressant Medication

There are various medications that will help a child with Major Depression Disorder and unspecified depression. The goal of each antidepressant is to of course reduce the feelings of depression such as sadness, hopelessness, agitation, easily irritated, poor performance at school due to depression, poor self esteem, lack of enthusiasm, withdrawal from friends, family, and activities the child once enjoyed, among a variety of other depression symptoms. These, SSRI antidepressant medications are meant to reduce the effects of depression on a child and increase the child's quality of life by improving their overall mental well being and allowing them to lead a happier childhood with the use of child depression medication.

Potential Danger of Child Depression Medication

It should be noted that a black box warning is applied to all antidepressant medication that is prescribed to children and young adults up to the age of 25. A black box warning is the most serious drug label warning for any medication. The reason the warning is there is due to the increased risk of suicidal thoughts and behaviors that could be induced by taking the antidepressant medication.

It is unknown why this is a side effect to these medications and studies have revealed that the percentage rate of children actually experiencing any if all of these symptoms is low. Sometimes leaving the depression untreated by medication could lead to suicidal thoughts and behaviors as well; as revealed in various studies by not only the FDA but by NIMH, doctors, and other mental health specialists. It is up to the doctor and the caregiver to decide the risk vs. benefit of the treatment.

What Parents Should Know and Do if their Child Takes Antidepressant Medication

The child should be monitored closely by the caregiver and doctor for the first full month of being on the antidepressant drug therapy. If the child starts to show signs of suicidal thoughts, behaviors, or continuous thoughts of death-the caregiver should notify the doctor immediately and the doctor will discontinue this medication carefully. The caregiver should also notify the physician if they notice that the child, after starting the child depression medication treatment, begins to have increased depression symptoms. This means, they are acting and feeling worse than before. The doctor will be able to handle this situation as well and possibly prescribe a different medication or suggest hospitalization or various other methods of treating the depression that include psychotherapy and cognitive behavioral therapy.

The Most Common Child Depression Medications

The types of SSRI antidepressant medications that are most prescribed to children with Major Depression Disorder include:

Fluoxetine (PROZAC)

Sertaline (ZOLOFT)

Citalopram (Celexa)

Escitalopram (Lexapro)

Fluoxamine (LUVOX)

The above listed medications, besides the Prozac, are what some doctors prescribe to children with a mental disorder such as MDD or other types of depression but prescribe them "off-the-label". Success rates for each of these medications have been good and their ability to help with childhood depression varies from child to child. This is why the doctor may prescribe a medication that is FDA approved for adults, but not children.

If Prozac does not work effectively for the child's depression, the doctor will then consider another child depression medication such as Zoloft, Celexa, Lexapro, or Luvox. A doctor will never prescribe Paxil to a child with depression due to its increase risk over the others for suicidal thoughts and behaviors.

Depression, whether suffered by an adult or a child is not always due to daily stresses, traumatic events, or various other pressures. Clinical depression is one of the most common causes for depression among old and young alike. Clinical depression is causes by a mental illness in the brain and is out of the control of the child. This reason is why child depression medication is prescribed overall. The physician will choose the antidepressant medication that is the most suitable for the child to reduce the depression and improve the quality of the child's life.

Sources:
http://www.nami.org/helpline/depression-child.html

http://www.nimh.nih.gov/health/topics/child-and-adolescent-mental-health/antidepressant-medications-for-children-and-adolescents-information-for-parents-and-caregivers.shtml

http://www.nimh.nih.gov/health/publications/mental-health-medications/complete-index.shtml