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Selective Serotonin Reuptake Inhibitors (SSRIs) for Depression in Children and Teens

Examples

Generic Name Brand Name
citalopram Celexa
escitalopram Lexapro
fluoxetine Prozac
fluvoxamine Luvox
sertraline Zoloft

How It Works

Selective serotonin reuptake inhibitors (SSRIs) can restore the balance of certain brain chemicals (neurotransmitters) that regulate mood. When these brain chemicals are in proper balance, the symptoms of depression may be relieved.

Why It Is Used

Selective serotonin reuptake inhibitors are used to treat depression and anxiety.

How Well It Works

Fluoxetine can improve depression symptoms and prevent relapse in children and teens.1 Studies have also shown other SSRIs work for children and teens, such as citalopram and sertraline.2

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine your child takes. Side effects are also listed in the information that comes with the medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after your child takes the medicine for a while.
  • If side effects still bother your child and you wonder if he or she should keep taking the medicine, call your doctor. Your doctor may be able to lower your child's dose or change the medicine. Your child should not suddenly quit taking the medicine.

Call 911 or other emergency services right away if your child has:

  • Trouble breathing.
  • Swelling of the face, lips, tongue, or throat.

Call your doctor if your child has:

  • Hives.
  • Thoughts of suicide.
  • Agitation and restlessness.
  • Seizures.
  • Fast heartbeat.
  • Nausea and vomiting.

Common side effects of this medicine include:

  • Nausea, loss of appetite, or diarrhea.
  • Irritability.
  • Trouble sleeping or drowsiness.
  • Headache.
  • Changes in appetite.

SSRIs can trigger a manic episode if the child actually has bipolar disorder and not major depression.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

FDA advisories. The U.S. Food and Drug Administration (FDA) has issued:

  • An advisory on antidepressant medicines and the risk of suicide. The FDA does not recommend that people stop using these medicines. Instead, a person taking antidepressants should be watched for warning signs of suicide. This is especially important at the beginning of treatment or when doses are changed.
  • A warning about taking triptans, used for headaches, with SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective serotonin/norepinephrine reuptake inhibitors). Taking these medicines together can cause a very rare but serious condition called serotonin syndrome.

What To Think About

Although fluoxetine and escitalopram are often the first selective serotonin reuptake inhibitors (SSRI) used for the treatment of symptoms of depression in children and teens, doctors also prescribe others. People respond to medicines differently.

For some children or teens, another SSRI for treatment of symptoms of depression may be more effective than fluoxetine or escitalopram. If another SSRI is not effective, sometimes doctors may use another type of antidepressant to treat depression in children and teens.

Your child may start to feel better within 1 to 3 weeks of taking an SSRI. But it can take as many as 6 to 8 weeks to see more improvement. If you have questions or concerns about the medicine, or if you do not notice any improvement by 3 weeks, talk to your child's doctor.

Do not suddenly stop taking antidepressants. The use of antidepressants should be tapered off slowly and only under the supervision of a doctor. Abruptly stopping antidepressant medicines can cause negative side effects or a relapse into another depression episode.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. If your child takes medicine as your doctor suggests, it will improve your child's health and may prevent future problems. If your child doesn't take the medicines properly, his or her health may be at risk.

There are many reasons why people have trouble taking their medicines. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If your teen is pregnant or breast-feeding, do not use any medicines unless her doctor tells you to. Some medicines can harm the baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all of your teen's doctors know that she is pregnant or breast-feeding.

Checkups

Follow-up care is a key part of your child's treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It's also a good idea to know your child's test results and keep a list of the medicines your child takes.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Hazell P (2009). Depression in children and adolescents, search date April 2008. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.
  2. Wagner KD, Brent DA (2009). Depressive disorders and suicide. In BJ Sadock et al., eds., Kaplan and Sadock’s Comprehensive Textbook of Psychiatry, 9th ed., vol. 2, pp. 3652–3663. Philadelphia: Lippincott Williams and Wilkins.

Credits

By Healthwise Staff
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Lisa S. Weinstock, MD - Psychiatry
Last Revised May 14, 2012

Last Revised: May 14, 2012

Author: Healthwise Staff

Medical Review: Kathleen Romito, MD - Family Medicine & Lisa S. Weinstock, MD - Psychiatry

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