My Teen Has Been Prescribed Antidepressants
You probably noticed your teen acting and behaving differently than was typical. Maybe they were sleeping too much, or not enough. Grades were suffering and your teen seemed to have lost some of their sparks, so you took them to the doctor. After a full evaluation and some tough questions, your teen has been diagnosed with depression and given medication. Now what? Whether you or someone you know has been on antidepressants before the concerns for teens on antidepressants are different and the challenges are new. Knowing what to do, how to do it, and when to be concerned can go a long way towards making a peaceful transition to the new routine.
Finding the right balance
Starting a new medication can be a big boost in confidence that a depressed teen is lacking, recovery and returning to normal was once seen as hopeless by many people suffering from depression, but with a new plan and a daily task of taking a pill, recovery might seem more possible or even guaranteed. However, there is no magic pill. What works for one person may not work for another and finding the right medication can be a long process.
There are a few basic types of antidepressants on the market, each one with varying brands that are a little different. The four main types are SSRI, atypical antidepressants, TCAs, and MAOIs.
Selective serotonin reuptake inhibitors (SSRIs): These medications work by increasing the serotonin levels in the brain. Serotonin is a chemical in the brain that helps regulate mood. Doctors and scientists have found evidence that low serotonin can be associated with depression, although they are still not sure if low serotonin is the cause for depression or if depression itself causes the body to make less of it. The answer is still being worked on, but in the meantime there is strong evidence that correcting a low serotonin level can help people regulate their mood, avoiding some of the lowest of the lows. Serotonin reuptake inhibitors work by blocking the brain from reabsorbing serotonin making it more abundant in the brain itself. SSRI medications are often the first attempt at treating depression with medication as the side effects are mild and mostly manageable. There are many different brands of SSRI and while they all work the same, you may find that one brand over another is more preferable due to side effect differences or other factors.
Atypical antidepressants: Atypical antidepressants are often the next step after a good trial of SSRI type have not worked or are not well tolerated. However, your doctor may start out with this type as they have fewer side effects than many other types. Atypical antidepressants block the reabsorption of dopamine, serotonin, and norepinephrine. This bonus dopamine may help boost moods while other lifestyle changes are being made.
Tricyclic antidepressants (TCAs): Tricyclic or Cyclic antidepressants work by preventing the reabsorption of both Serotonin and Norepinephrine. Norepinephrine is another chemical in the brain that can affect mood levels. It is associated with both depression and ADHD, and while this type of medication isn’t the first choice for most doctors, it can be useful if your child has other issues that may be treated by taking a TCA.
Monoamine oxidase inhibitors (MAOIs): These were some of the first antidepressants and are considered “old school” by many doctors. It is unlikely that this will be a first line treatment for a teen but if you’ve tried many other paths and none are working, this is another option. Like SSRIs, these medications affect the amount of serotonin in the brain, but the difference is these block the enzyme that breaks serotonin down. MAOI medication is not considered until others have not worked well due to their side effects and their interaction with other medications.
It can take a while to find the right medication and dosage, some medications require a titration or ramp up, starting at a small dose and increasing it regularly until you are in a therapeutic range, and all antidepressants will need a step-down and time to clear the system before a new one is started. This can make each experiment take weeks, but it is worthwhile to keep trying until you find a medication that helps. It is often dangerous to stop medication after you have started so make sure you talk to your teen’s doctor before making any changes to the medication routine.
Keeping an eye out for trouble
All antidepressants have a black box label on them for children and teens. This is the most stringent of warnings that are available to pharmaceuticals. The reason being that many of these medications have not been specifically tested on children and teens, however, most evidence points to them being safe as long as the teen is monitored by a doctor.
Anyone taking antidepressants is going to be at risk for suicide or worsening depression, it is hard to know if their condition was going to worsen on its own or if the medication is helping it along. Make sure to keep open lines of communication between you and your teen about side effects and if their thought patterns are tending to be darker. Remember that you can always switch up medication if it’s not working well, but you’ll want to consult your doctor to make sure you do so in a safe way.
Antidepressants can take up to 8 weeks to start to have an effect on depression and those first few weeks can be a bit of a struggle to keep on routine, taking your medication at the same time every day, and making sure that you’re being realistic about the treatment plan. If side effects are too bothersome or your teen starts to act very differently it’s time to call the doctor.
Antidepressants alone cannot cure depression, they can merely help your teen get out of the lowest points. Lifestyle changes and therapy along with medication have been the most successful treatment plan for many. Make sure your teen has adequate nutrition, is getting good sleep, and is making changes in their life to lower stress. Depression can be a tricky disorder, and you may find your teen doing great for a while only to relapse. Keep working on changes until you find the right balance of medication, lifestyle, and ask your doctor if they have advice for making transitions easier.