Medication Guide About Using Antidepressants in Teenagers What is the most important information I should know if my student is being prescribed an antidepressant?
Parents need to think about 4 important things when
their student is prescribed an antidepressant:
1. There is a risk of suicidal thoughts or actions
2. How to try to prevent suicidal thoughts or actions in your student
3. You should watch for certain signs if your student is taking an antidepressant
4. There are benefits and risks when using antidepressants
1. There is a Risk of Suicidal Thoughts or Actions
Teenagers sometimes think about suicide, and many report trying to kill themselves. Antidepressants increase suicidal thoughts and actions in some teenagers. But suicidal thoughts and actions can also be caused by depression, a serious medical condition that is commonly
treated with antidepressants. Thinking about killing yourself or trying to kill yourself is called suicidality or being suicidal.
A large study combined the results of 24 different studies of children and teenagers with depression or
other illnesses. In these studies, patients took either a placebo (sugar pill) or an antidepressant for 1 to 4 months. No one committed suicide in these studies, but some patients became suicidal. On sugar
pills, 2 out of every 100 became suicidal. On the antidepressants, 4 out of every 100 patients became suicidal. For some teenagers, the risks of suicidal actions may be especially high. These include patients
• Bipolar illness (sometimes called manic-depressive illness)• A family history of bipolar illness
• A personal or family history of attempting suicide
If any of these are present, make sure you tell your healthcare provider before your student takes an antidepressant. 2. How to Try to Prevent Suicidal Thoughts and Actions
To try to prevent suicidal thoughts and actions in your student, pay close attention to changes in her or his moods or actions, especially if the changes occur suddenly. Other important people in your student's
life can help by paying attention as well (e.g., siblings, roommates, friends, and other important people). The changes to look out for are listed in Section 3. Whenever an antidepressant is started or its dose is
changed, pay close attention to your student.
After starting an antidepressant, your student should generally see his or her healthcare provider:
• Every 2 weeks for the next 4 weeks• After taking the antidepressant for 12 weeks
• After 12 weeks, follow your healthcare provider's advice about how often to come back• More often if problems or questions arise (see Section 3)
Your student should call his/her healthcare provider between visits if needed. 3. You Should Watch for Certain Signs If Your Student is Taking an Antidepressant
Your student should contact his/her healthcare provider right away if he/she exhibits any of the following
signs for the first time, or if they seem worse, or worry you, or him/her:
• Thoughts about suicide or dying• Attempts to commit suicide
• New or worse depression• New or worse anxiety
• Feeling very agitated or restless• Panic attacks• Difficulty sleeping (insomnia)
• New or worse irritability• Acting aggressive, being angry, or violent
• Acting on dangerous impulses• An extreme increase in activity and talking
• Other unusual changes in behavior or mood
Never let your student stop taking an antidepressant without first talking to his or her healthcare provider. Stopping an antidepressant suddenly can cause other symptoms. 4. There are Benefits and Risks When Using Antidepressants
Antidepressants are used to treat depression and other illnesses. Depression and other illnesses can lead to suicide. In some teenagers, treatment with an antidepressant increases suicidal thinking or actions. It is
important to discuss all the risks of treating depression and also the risks of not treating it. You and your
student should discuss all treatment choices with your healthcare provider, not just the use of antidepressants.
Other side effects can occur with antidepressants.
Of all the antidepressants, only fluoxetine (Prozac) has been FDA approved to treat pediatricdepression.
For obsessive compulsive disorder in teenagers, FDA has approved only fluoxetine (Prozac), sertraline
(Zoloft), fluvoxamine, and clomipramine (Anafranil) to be of proven benefit to teens.
Your healthcare provider may suggest other antidepressants based on the past experience of your student. Is this all I need to know if my child is being prescribed an antidepressant?
No. This is a warning about the risk for suicidality. Other side effects can occur with antidepressants.
Be sure to ask your healthcare provider to explain all the side effects of the particular drug he or she is
prescribing. Also ask about drugs to avoid when taking an antidepressant. Ask your healthcareprovider or pharmacist where to find more information.
For more information, see link to read FDA Guide (Medication Guide: About Using Antidepressants in
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Medication Guide About Using Antidepressants in Teenagers