Selective serotonin reuptake inhibitors (SSRIs) for depression in children and teens

Examples

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Brand Name	Chemical Name
Celexa	citalopram

Brand Name	Chemical Name
Lexapro	escitalopram oxalate

Brand Name	Chemical Name
Prozac	fluoxetine

Brand Name	Chemical Name
Luvox	fluvoxamine

Brand Name	Chemical Name
Zoloft	sertraline

How It Works

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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

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

How Well It Works

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The U.S. Food and Drug Administration (FDA) has approved fluoxetine to treat childhood and adolescent depression. Recent studies indicate that fluoxetine is well-tolerated and effective for childhood depression.¹ Although other SSRIs are not approved for the treatment of children, they may also be used.

Side Effects

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Side effects of SSRIs include:

• Nausea, loss of appetite, or diarrhea.
• Anxiety or irritability.
• Agitation or overactivity.
• Problems sleeping or drowsiness.
• Loss of sexual desire or ability.
• Headaches or dizziness.

These side effects often become less severe or go away altogether after several weeks.

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 the antidepressants Paxil and Paxil CR and birth defects. Taking these medicines in the first 12 weeks of pregnancy may increase your chance of having a baby with a birth defect.
• A warning about taking triptans, used for migraines, with SSRIs (selective serotonin reuptake inhibitors) or SNRIs (selective serotonin/norepinephrine reuptake inhibitors). Taking these medicines together can cause a serious condition called serotonin syndrome.

What To Think About

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Although fluoxetine is the only selective serotonin reuptake inhibitor (SSRI) approved for the treatment of symptoms of depression in children, 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.

If fluoxetine or 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.

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

References

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Citations

1. Emslie GJ, et al. (2002). Fluoxetine for acute treatment of depression in children and adolescents: A placebo-controlled, randomized clinical trial. Journal of the American Academy of Child and Adolescent Psychiatry, 41(10): 1205–1215.

Credits

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Author	Jeannette Curtis
Author	Lila Havens
Editor	Susan Van Houten, RN, BSN, MBA
Associate Editor	Michele Cronen
Associate Editor	Pat Truman
Primary Medical Reviewer	Michael J. Sexton, MD - Pediatrics
Specialist Medical Reviewer	Gisele Ferguson, MD, FRCPC - Psychiatry, Child and Youth Psychiatry
Last Updated	April 25, 2007