Antidepressants: Are They Safe for Children and Teens?

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In the last few years, concerns over whether or not antidepressants are safe for use by children and teens have gained the spotlight in the public consciousness. 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 is always some level of risk of negative side effects when using prescription medication, whether in children, teens, or adults. Because their body chemistry is different, children and teens have different reactions to prescription medication. Whenever children or teens take an antidepressant that was designed for adults, there are certain risks that parents and doctors should look out for.

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 this risk of suicidality in children and teens, it is important to remember that the risk is also a direct result of their major depressive disorder.

In the mid-90s, reports that the brand name antidepressant Paxil increased risk of suicidal ideation and suicide attempts in children and teens. The FDA states that Paxil specifically should be avoided for use in children and teens; the only antidepressant approved for use in cases of pediatric major depressive disorder is Prozac. 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 wild mood swings from depression to mania) should be especially careful when taking antidepressants. Antidepressants tend to send anyone with bipolar disorder into a 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, 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)

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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. For the best results, it is recommended that children and teens with major depressive disorder take Prozac, which has been approved for use in children and teens.

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.

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