ANTIDEPRESSANTS
When it comes to antidepressants, in Child and Adolescent Psychiatry, we predominantly use Selective Serotonin Reuptake Inhibitors (SSRIs). These are a class of antidepressant medications commonly used to treat conditions such as major depressive disorder, anxiety disorders, and certain other mental health conditions. SSRIs work by increasing the levels of serotonin, a neurotransmitter in the brain, which can help improve mood and emotional well-being. We know through research that the Theory of a chemical imbalance in the brain, such as the insufficient Serotonin Theory is probably incorrect. However, these medications appear to be very helpful, despite this.
When it comes to using SSRIs in children, it's important to approach the topic with caution and under the guidance of a qualified healthcare professional. While SSRIs can be effective for treating certain mental health conditions in children and adolescents, there are also risks and potential side effects to consider.
The most likely antidepressants that are used in Young People are:
Sertraline
Fluoxetine
Citalopram
These type of medications should be used with caution due to the side effects associated with them. The main mode of treatment for Depression and Anxiety disorders is mainly through non-pharmacological methods, such as psychotherapy and Cognitive Behavioural Therapy (CBT). In more difficult cases, combination of medication with psychotherapy provides the best results. They are also used in young people who don’t respond to psychotherapy or don’t want to undertake psychotherapy.
Antidepressants don’t work immediately and take about 4 weeks to show any effectiveness, in the case of depression and in anxiety they can take upwards of 10 weeks. The effect of the medication if positive, is usually noticed by others before the patient notices themselves. Due to the time the medication takes to be effective, it is important that it is taken consistently without pauses.
There are also side effects associated with the medication. Initially it may cause agitation, stomach upset, diarrhoea and in very rare cases it may increase suicidal thoughts. This is the reason the medication requires close monitoring by a psychiatrist and by parents.
The medication should not be discontinued suddenly as it can lead to discontinuation syndrome. This can involve symptoms such as: flu-like symptoms, insomnia, nausea, imbalance, sensory disturbances, including “brain zaps” and hyperarousal. To avoid this if you are planning to stop an SSRI - always chat to your doctor first.
