Deciding to put your teenager on antidepressants isn’t one made casually. In this PsychCentral article, Mindpath Health’s Julian Lagoy, MD, discusses why this is a joint decision between you, your teen, and their doctor after weighing the pros and cons.
For many people, including teens, antidepressants are invaluable to a mental health treatment plan.
But antidepressant use in youth has received mixed sentiments among the general public. Concerns about teen-specific side effects are always prevalent. But many caregivers also don’t “believe in” putting teens on medication because they don’t feel symptoms are related to mental health.
Safe antidepressants for teenagers
What makes an antidepressant safe isn’t the complete absence of adverse reactions.
“Safe” medications for teens have passed rigorous Food and Drug Administration (FDA) testing in the pediatric population. After proving efficacy and risk below a certain threshold, they’re granted permission to include pediatric use on their labels.
Common antidepressants FDA-approved for use in teens include:
- fluoxetine (Prozac)
- escitalopram (Lexapro)
- duloxetine (Cymbalta)
- sertraline (Zoloft)
- fluvoxamine (Luvox)
- clomipramine (Anafranil)
But FDA approval isn’t the only indicator of safety. According to Dr. Willough Jenkins, a pediatric psychiatrist, there are other antidepressants safely used off-label in teens.
Even among FDA-approved medications, some formulations are preferred to others.
Dr. Julian Lagoy, a mental health clinician from San Jose, California, indicates, “Numerous antidepressants are FDA-approved for teenagers, and in my opinion, the safest ones are Lexapro, Prozac, Zoloft, and Cymbalta.”
Which antidepressant is best for a teen?
There’s no one-size-fits-all antidepressant for teens. Different medications may work better than others, depending on the condition being treated.
According to a teen-focused 2020 systematic review, Prozac was the most helpful for major depressive disorder. In addition, Prozac and Zoloft were top-tier for obsessive-compulsive disorder (OCD).
You should consult a trusted medical professional to determine which medication best suits your teen’s needs.
Symptoms of depression in adolescents
As an adult looking back, it’s clear that life as a teenager isn’t easy. It’s challenging to juggle school, friends, activities, and physical changes.
It’s natural for all teenagers to have ups and downs as they figure out how they fit in with the world around them.
Because of this natural angst, the symptoms of depression in adolescents can be tough to spot. They’re often subtle and gradual and can include:
- persistent feelings of worthlessness or emptiness
- academic decline
- change in friend group
- lack of concentration
- sleep disturbances
- loss of interest in hobbies and enjoyable activities
- isolation/social withdrawal
- decline in hygiene
When should I put my teenager on antidepressants?
Antidepressants are intended to be utilized as a part of dynamic treatment, including psychotherapeutic interventions.
For caregivers, Lagoy says certain signs suggest antidepressants are a good option for teens, including:
- the presence of a co-existing mental health condition, like an eating disorder or ADHD
- a family history of mental health challenges
- psychotherapy hasn’t made enough of a difference
- a teen isn’t eating or sleeping well
- there’s a history of self-harm or suicide ideation
Jenkins adds that it’s important to communicate with your teen openly and honestly.
Pros and cons for antidepressants in teens
The benefit of antidepressants is relief from symptoms like major depressive disorder, generalized anxiety disorder (GAD), or OCD.
They can alleviate symptoms enough to help your teen take other actionable steps toward improving mental well-being.
Like all drugs, they do have potential side effects, including:
- gastrointestinal upset
- sleep disturbance
- sexual dysfunction
- increased bruising/bleeding
How to monitor your teen during antidepressant use
The FDA recommends close monitoring by caregivers and medical professionals during a teen’s antidepressant use, especially over the first several months.
This includes physical changes or changes in behaviors, thoughts, or function.
How to support a teen with depression
Jenkins indicates that small steps can go a long way in supporting a teen with depression. She recommends:
- understanding that failure to complete tasks isn’t from laziness
- avoiding dismissive statements like, “Just look on the bright side.”
- encouraging open, nonjudgmental conversation
- keeping your home a safe place without weapons, harmful substances, or situations of abuse
- being an example of healthy habits related to eating, exercising, and lifestyle
- educating yourself on your teen’s mental health diagnosis
- encouraging teens to continue with their interests, friends, and hobbies
- reaffirming you’re dedicated to helping them overcome their mental health challenge
- supporting the use of professional help
“Let your teenager know you love them and will do everything possible to help them,” says Lagoy. “Children and teenagers know that you care. Their family and loved ones will support them no matter what.”