Cautions About the Use of SSRIs and Other Antidepressants in Teenagers

Depressed teenage girl covering face while sitting on the ground
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When a teen has depression, counseling and antidepressants are often offered as options for treatment, especially if the depression is considered moderate or severe.

If your teen is prescribed an antidepressant, like a selective serotonin reuptake inhibitor (SSRI), it's normal to have questions about its effectiveness and safety. This is why it's important for you and your teenager (and others in the family) to be educated about the antidepressant's effects, including its benefits and potential adverse effects (and how to monitor those).

Effectiveness in Teens

Antidepressants are there to help with the uncomfortable, disturbing, and even disabling symptoms of depression. Antidepressants can help to improve your teen's mood, appetite, ability to sleep, ability to focus, and can relieve the aches and pains that sometimes come with depression.

They can also help with related anxiety symptoms. Most importantly, because depression can lead to suicide, it is extremely important to effectively treat teens with depression and thoughts of suicide.

Antidepressants are best used when the teen is also seeing a mental health professional like a therapist or psychiatrist.

During counseling, your teen can learn coping skills to help deal with life's stressors. Your teen can also explore possible causes of depression and talk about issues they may not feel comfortable disclosing to friends or family.

A mental health professional can be a wonderful ally for a parent of a teen with depression and can be a wealth of information about the disorder and how to treat it.

Potential Adverse Effects

All medications have side effects. If your physician or psychiatrist suggests an antidepressant, ask about the common side effects.

One most commonly prescribed classes of antidepressants are the selective serotonin reuptake inhibitors (SSRIs). SSRIs can cause:

  • Nausea
  • Diarrhea
  • Insomnia
  • Sedation
  • Headaches
  • Dry mouth
  • Dizziness
  • Weight gain
  • Sexual side effects

For many antidepressants, these physical side effects are temporary and are not severe. Knowing what the side effects are, and if they will go away in time, are important to know when making this decision.

Although not necessarily a drawback, it is important for parents and teens to know that the medications do not work instantly. It can take six to eight weeks for someone to feel the full effect of an SSRI.

Just like it takes time for the side effects to go away, it takes some time for the medication to fully work. If you and your teen know that ahead of time, you won't be disappointed when the depression isn't relieved immediately.

Suicide Risk

The Food and Drug Administration (FDA) released a report which stated that, when young adults (ages 18 to 24) begin taking an antidepressant, the rates of suicidal thoughts and actions increased in some of those being treated. This was noted during the beginning of treatment, in some cases within the first month or two.

More study on this subject is obviously needed, as there is no clear-cut understanding of the link between the use of antidepressants and an increase in teen suicides. In other words, no causal relationship has been found.

Teens, parents, and doctors are encouraged to watch for a potential increase in suicidal thinking and behavior when taking antidepressants.

What to Watch For

Your teen is an individual, and it is impossible to know how an antidepressant will affect them.

The FDA recommends looking for the following warning signs that your teen may be considering suicide or deteriorating psychologically. Becoming familiar with these signs and staying involved and alert is especially important during the first couple of months of treatment and when changes are made such as an increase or decrease in dose, addition of new medications, discontinuation of medications, or a change in medication:

  • Expression of new or persistent thoughts of suicide
  • Worsening depression
  • Anxiety
  • Agitation 
  • Feelings of restlessness (akathisia)
  • Panic attacks
  • Insomnia
  • New or worsening irritability
  • Aggressive behavior
  • Hostility or impulsivity
  • Unusual changes in behavior
  • Hypomania or mania

If you notice any of these, or your teen brings any of them to your attention, it is imperative that you contact your teen's physician, psychiatrist, or counselor immediately.

If your teen is threatening suicide or has made an attempt, call 911 or your local emergency or crisis number for help. You can reach the National Suicide Prevention Hotline at 1-800-273-8255.

Next Steps

If your teen has depression, it is important for you, your teen, and your teen's physician to sit down and discuss these pros and cons of antidepressant use.

If prescribed, SSRIs must be taken daily to be effective. Teens should always take their antidepressants exactly as prescribed. Tell your teen's doctor if your teen is taking any other medications or supplements, as they may cause drug interactions.

Additionally, these medications should not be stopped abruptly. Suddenly stopping an antidepressant can lead to symptoms of withdrawal, so you should talk to your teen's doctor about switching medications and tapering off their antidepressant gradually.

A Word From Verywell

Teens with depression can be very disabled by their condition. Depression can cause many problems, such as difficulty sleeping, problems eating, and issues at school or with friends. It's understandable that you want to help your child in the best way possible. When making a choice about treatment for a disorder, it is important to weigh the benefits and drawbacks of the therapy so that the decision is an informed one.

Depression is a serious issue that can have serious and deadly side effects if not handled quickly and appropriately. Together, antidepressants and counseling can make a big difference in the life of a depressed teen.

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