In recent years, concerns over whether or not antidepressants are safe for use by children and teens have been raised. These concerns are mainly tied to reports that certain antidepressants increase the risk of suicidal thinking and suicide attempts in some children and teens. What are the real risks when using antidepressants in children and teens?
There are always risks of negative side effects when using prescription medications, whether in children, teens, or adults. Because their body chemistry is different, children and teens have different reactions to prescription drugs. Whenever children or teens take an antidepressant that was designed for adults, there are certain risks that parents and doctors should be aware of.
The Risk of Suicide
When a child or teen is depressed and their depression goes untreated, they are at risk of experiencing suicidal ideation (thinking about suicide), attempting, or committing suicide. About 2 in every 100 depressed children are suicidal when not using any form of antidepressant. While antidepressants might increase the risk of suicide in children and teens, it is important to remember that the risk can also be a direct result of their major depressive disorder as well.
In the mid 1990s, reports that the brand name antidepressant Paxil increased risk of suicidal ideation and suicide attempts in children and teens emerged. The FDA states that Paxil specifically should be avoided for use in children and teens. If your child is suffering with major depressive disorder, it’s important to know which antidepressants are best for use in children and teens.
The risk of suicidality doubles when children and teens are using certain antidepressants. This means that the risk goes from 2% to 4%, with 4 out of every 100 children using an antidepressant experiencing suicidal thoughts or attempting suicide. Whether or not a child is using an antidepressant, parents should always closely monitor their child’s behavior to look for the warning signs of suicidality, especially if their child has been diagnosed with major depressive disorder.
Certain Factors Increase Risk
If your child is dealing with major depressive disorder, there are certain risk factors that increase their likelihood of experiencing suicidality when given antidepressants. These risk factors include:
- Bipolar disorder
- Family history of bipolar disorder
- Family history of attempting or committing suicide, or a personal history of attempting suicide
When discussing your child’s depressive disorder with a doctor, make sure to inform him or her of your family history, any suicidal behavior in your child, and any family history of bipolar disorder. Children and teens with bipolar disorder (a specific type of depressive disorder that causes extreme mood swings from depression to mania) should be especially careful when taking antidepressants. Antidepressants tend to send anyone with bipolar disorder into full-blown mania, which can increase the risk of suicide.
Important Information for Parents
If your child or teen is prescribed an antidepressant or is suffering with major depressive disorder, it is recommended that you monitor them closely for any adverse reaction. Once the child has started treatment, they should see their healthcare provider once a week for the first 4 weeks. This will help the doctor determine the effectiveness of the antidepressant, make adjustments to dosage, and check for negative side effects. After the first 4 weeks, the child should see the doctor every 2 weeks for a month, once at 12 weeks, and, after 12 weeks, or as regularly as recommended by the doctor. If you observe any problems or major changes in your child’s behavior, you will want to see your child’s healthcare provider to determine the problem and find a solution.
Even if your child is not using an antidepressant, there are certain warning signs you should look for if you fear that they might experience suicidality for any reason. Those warning signs are:
- Aggressive or violent behavior, or intense anger
- Marked and extreme increase in talking and activity
- Sleep difficulty such as insomnia
- Noticeable increase in irritability
- Panic attacks
- Extreme restlessness or agitation
- Acting on impulse without thought to the negative or dangerous consequences
- Heightened anxiety
- Heightened depression
- Vocalizing suicidal thoughts
- Attempts at suicide or self-harm (cutting)
If your child or teen exhibits any or all of these behaviors, speak with their doctor immediately. If they are taking an antidepressant, do not discontinue use until they’ve seen their doctor. Many antidepressants have negative withdrawal effects, and the doctor will be better able to determine the source of the problem.
Other Risks and Benefits
As with any prescription medication, antidepressants can have negative side effects. Generally speaking, these side effects are mild and only occur in rare cases.
There are benefits as well. Depression seriously effects and interrupts your child’s ability to live a happy and productive life, and, if their depression worsens, it can lead to suicide and extreme behavioral disruptions. Antidepressants can help alleviate the symptoms of depression in children and teens, and, in most cases, the benefits far outweigh the risks.