Depression can be treated with medications, therapy and lifestyle changes, depending on your child's needs and their healthcare provider's recommendations. This page describes the medications that are most commonly prescribed to treat depression.
What type of medication is usually prescribed for depression?
If your child needs medication to treat depression, they will most likely be prescribed a class of medications called selective serotonin reuptake inhibitors (SSRIs).
A large volume of evidence supports the use of SSRIs in children and teens. They are especially useful when depression significantly disrupts a child's routine, such as difficulty with attendance at school, poor sleep patterns and reduced appetite.
Examples of SSRI medications include fluoxetine, fluvoxamine, sertraline, citalopram and escitalopram. They are available only with a prescription.
How SSRIs treat depression
SSRIs work by increasing levels of the chemical serotonin in the brain. This chemical is involved with feelings of general wellbeing and happiness. A person with depression typically has lower levels of serotonin than someone without these disorders.
SSRIs can reduce symptoms of depression. They can sometimes provide a faster and additional benefit to psychotherapy.
How long do SSRIs take to start working?
SSRIs typically take two to four weeks to start working. Sometimes they can take up to six weeks.
Of the range of SSRIs that exist, fluoxetine has the most evidence for effectiveness in children and teens with depression and anxiety. Citalopram, escitalopram and sertraline also have studies showing benefits over not taking medication at all.
Because people can have different responses to different SSRIs, your child may need to try more than one medication before achieving the desired effect. Children and teens usually start on very low dose of SSRIs, so they may also need to increase their dose over time.
How long might my child need to take an SSRI?
It is usually recommended that a person continue taking an SSRI until they are feeling well for six to 12 months.
What are the side effects of SSRIs?
Like other medications, SSRIs have side effects. Some of these effects, such as nausea, headaches, dizziness and restlessness, resolve within one to two weeks. Your child or teen's doctor will monitor your child closely to watch for these effects.
Most teens tolerate SSRIs well, without any side effects. However, some teens on higher doses can experience lower interest in sexual activity and reduced sexual responsiveness as well as other side effects. These can be addressed by adjusting the medication.
Some children and teens may find that an SSRI will make them feel worse in some ways at first, but it is important to be patient and give the medication a chance to work.
Rare but serious side effects include an increase in suicidal thoughts. This occurs in up to 2 per cent of teens treated with SSRIs, usually when treatment starts or the dose is increased.
Further information
For more information on depression, please see the following pages:
Depression: Signs and symptoms
Depression: Treatment with psychotherapy and lifestyle changes
Resources
Emslie, G., et al (2006). Treatment for Adolescents with Depression Study (TADS): safety results. Journal of the American Academy of Child & Adolescent Psychiatry. 45(12):1440-1455. doi:10.1097/01.chi.0000240840.63737.1d
Bridge, J.A., et al (2007). Clinical response and risk for reported suicidal ideation and suicide attempts in pediatric antidepressant treatment: a meta-analysis of randomized controlled trials. Journal of the American Medical Association. 297(15):1683-1696. doi:10.1001/jama.297.15.1683