New warnings on antidepressants for children and adolescents highlight the need for appropriate treatments for depression

Sep 29 2004

New warnings on antidepressants for children and adolescents highlight the need for appropriate treatments for depression, says a national psychiatric drug expert at The Menninger Clinic.

“Taking an antidepressant comes with risks. When deciding whether an antidepressant is right for a son or daughter, parents should discuss with the physician the possible alternatives, including psychotherapy. Research by the National Institute of Mental Health shows that combining talk therapy and an antidepressant is the most effective treatment for teens battling depression,” said Joyce Davidson, M.D., staff psychiatrist at The Menninger Clinic and assistant professor in the Menninger Department of Psychiatry & Behavioral Sciences at Baylor College of Medicine.

“At The Menninger Clinic, we carefully evaluate youth and use only the necessary treatments that are likely to benefit a particular adolescent. If we believe an antidepressant is warranted, we provide a written fact sheet and discuss why the medication would be beneficial, the side effects and the importance of vigilant monitoring of the teenager’s response to medication. The patient and family make the choice.”

The FDA hearings in October 2003 and earlier in September confirmed that depression among children and adolescents is a serious mental health issue in America. It is estimated that 11 million young Americans took antidepressants in 2002. Equally important is the risk of suicide. Studies show that half of teens with depression will attempt suicide; 7 percent will die by suicide.

Dr. Davidson explains that adolescents with severe depression are prone to suicide because they tend to act impulsively and lack the lessons and perspective of life experiences to cope with romantic breakups and other difficulties. Substance abuse also raises the risk of suicide in adolescents.

Early intervention can increase recovery from depression and substance abuse, decreasing the risk of suicide. Dr. Davidson urges parents to become familiar with the symptoms of depression and to seek treatment for their son or daughter when they are concerned.

“Depression is a greater risk to teens than taking an antidepressant for treatment,” she said. “The important element to add to treatment is close monitoring from the physician or psychiatrist in charge. Here in our hospital, our patients have severe symptoms of depression and other psychiatric disorders. Our staff can observe, support, educate and provide a safe environment for these youth as they progress in treatment over a number of weeks.”

For youth who are currently taking an antidepressant, Dr. Davidson said they should not stop taking the medication without the involvement of their physician or psychiatrist.

Signs of depressive disorders in children & adolescents

Depression is more than kids getting moody. Depression can affect thoughts, feelings, behavior and overall health. Seek a professional evaluation from a physician or mental health professional if five or more of the following symptoms last for more than two weeks.

1. Feeling sad or negative or crying a lot
2. Feeling guilty for no reason or experiencing loss of confidence
3. Feeling that life seems meaningless or that nothing good will ever happen again
4. No longer enjoying favorite sports, activities or friends and family
5. Failing in school
6. Trouble concentrating, remembering or making a decision
7. Quick to lose temper or get irritated
8. Change in sleeping or eating
9. Feeling tired or restless most of the time
10. Thinking about death or dying or that a parent may die

In the case of bipolar disorder (manic depression) in adolescents, signs of mania include:

1. Feeling high as a kite or on top of the world
2. Racing thoughts and talking fast
3. Always on the go
4. Taking risks with driving, spending, sex, etc.
5. Getting by on little sleep
6. Trouble getting along with friends, at home or at school

The Menninger Clinic is a national specialty psychiatric hospital for adolescents and adults in Houston and is affiliated with Baylor College of Medicine and The Methodist Hospital at the Texas Medical Center. Menninger is consistently named among the leading psychiatric hospitals in U.S. News & World Report’s annual rankings of America’s Best Hospitals. Menninger was founded in 1925 in Topeka, Kansas, by Drs. C.F., Karl and Will Menninger and relocated to Houston in 2003.