Medications for Depression

Medications for Depression and How they work

The development of newer antidepressant medications and mood-stabilizing drugs for depression has improved the treatment of depression. Medications can relieve symptoms of depression and have become the first line of treatment for most types of the disorder.

Medications used to treat childhood depression include:

Selective serotonin reuptake inhibitors (called SSRIs), such as fluoxetine (Prozac). SSRIs are the medications most often used for childhood or teen depression. Fluoxetine is currently the only SSRI approved by the U.S. Food and Drug Administration (FDA) for use in children, although other SSRIs are sometimes used.
Atypical antidepressant medications, such as venlafaxine (Effexor) or bupropion (for example, Wellbutrin) In some cases, these may be used to treat childhood or teen depression.
Monoamine oxidase inhibitors (MAOIs), such as phenelzine (Nardil). MAOIs are rarely given due to potentially serious side effects and dietary restrictions.
Tricyclic antidepressants such as amitriptyline (Elavil, for example). Tricyclic antidepressants have been used in the past for childhood depression, but recent studies have found limited evidence that these medications are effective. Tricyclics also carry the risk of overdose and other serious consequences, such as heart problems.
Stimulants, such as methylphenidate (Ritalin, Concerta), dextroamphetamine (Dexedrine, Dextrostat) or modafinil (Provigil) if you can't take antidepressants because they're contraindicated due to another medical condition. These medications are also sometimes given in conjunction with antidepressants.
Lithium and mood-stabilizing medications,(Eskalith, Lithobid), valproic acid (Depakene), divalproex (Depakote) and carbamazepine (Tegretol, Carbatrol) to treat bipolar depression. Medications called atypical antipsychotics such as olanzapine (Zyprexa), risperidone (Risperdal) and quetiapine (Seroquel) were initially developed for treatment of psychotic disorders. Doctors sometimes also use them to treat bipolar disorder.

Most antidepressants have a similar level of effectiveness. But a medication that works for someone else might not work for others. Doctors choose antidepressants based on your family history and the match between your symptoms and the medication's side effects. For example, if a teen has insomnia, a sedating antidepressant may help them. But if they're lethargic, then a more energizing antidepressant may be more helpful.

It can take up to eight to 12 weeks before the full effects of an antidepressant are felt, though you some changes may be felt earlier. If the response to medication hasn't resulted in satisfactory progress after that time, your doctor may suggest either adding another antidepressant or replacing the first medication with another drug from a different chemical family.

As with any medication, side effects are possible. The side effects mqay be noticed before the drug begins to ease the depression. Most of the side effects from antidepressant are temporary and will disappear as the body gets used to the medication. Let your doctor know about any side effects that interfere with daily functioning, or if they're especially bothersome.

SSRIs. Side effects that may occur with SSRIs and other new antidepressants include headache, nausea, insomnia, agitation or a jittery feeling, and sexual difficulties.
Tricyclic antidepressants. Older medications, such as tricyclics, may cause dry mouth, constipation, sexual difficulties, blurred vision, dizziness, bladder problems and daytime drowsiness.
MAOIs. These drugs can cause a significant increase in blood pressure if you eat foods high in tyramine, such as wine, cheese or pickles, or if you take certain drugs, such as decongestants, while taking an MAOI. Ask your doctor or pharmacist for a list of foods and drugs to avoid.

Although experts believe that, for many children with depression, the benefits of medication outweigh the risks, research on antidepressant medication in children is limited. The long-term effects and safety of medications used to treat depression in children and teens are still unknown.

Your child may have to try several medications before the most effective treatment is discovered. Once the right medication is found, your child may need to continue taking the medication for several months or longer after the symptoms of depression have subsided to prevent depression from occurring again.

In children and teenagers, there's some concern that the use of antidepressants to treat major depression may lead to an increased risk of suicide - from about 2 percent for children not taking these medications to 4 percent for children taking an antidepressant for major depression.

Physicians, parents and children need to weigh the benefits of these medications against the potential risks. Because of the increased risk, the Food and Drug Administration (FDA) directed manufacturers of antidepressants to include a warning on the medication that explains the risk and recommends that children be closely observed by their families, caregivers and physicians while on these medications.

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