Cautions About the Use of Zoloft (sertraline) and Other Antidepressants in Teens

Table of ContentsView AllTable of ContentsEffectiveness in TeensPotential Adverse EffectsSuicide RiskWhat to Watch ForNext Steps

Table of ContentsView All

View All

Table of Contents

Effectiveness in Teens

Potential Adverse Effects

Suicide Risk

What to Watch For

Next Steps

When a teen has depression, counseling and antidepressants are often offered as options for treatment, especially if the depression is considered moderate or severe.If your teen is prescribed an antidepressant such as a selective serotonin reuptake inhibitor (SSRI), it’s normal to have questions about how it works and whether it’s safe. It’s important for you and your family to be educated about an antidepressant so you can help your teen understand the benefits and potential adverse effects (and how to manage them).An Overview of Teen DepressionEffectiveness in TeensAntidepressants are there to help with the uncomfortable, disturbing, and even disablingsymptoms of depression. Antidepressants can improve your teen’s mood, appetite, sleep, ability to focus, and may even relieve the physicalaches and painsthat sometimes come with depression. These medications also help treatanxiety symptoms.Most importantly, because depression can lead to suicide, it is extremely important to effectively treat teens with depression who are experiencing suicidal thoughts.Antidepressants may be most effective if your teen is also working with a therapist or psychiatrist.During counseling, your teen will learn coping skills to help deal with life’s stressors. Your teen will also explore the possible causes of depression and talk about issues they may not feel comfortable disclosing to friends or family.A mental health professional can be a wonderful ally for the parents of a teen with depression. These professionals have a wealth of information and resources about the disorder and can provide invaluable insight into the best way to treat it.The Dangers of Untreated Depression in TeensPotential Adverse EffectsAll medications have side effects. If your physician or psychiatrist suggests an antidepressant, you’ll walk to ask about the specific drug’scommon side effects.One of the most commonly prescribedclasses of antidepressantsfor adolescent depression is selective serotonin reuptake inhibitors (SSRIs).While these medications can be safe and effective, they can have side effects:NauseaDiarrheaInsomniaSedationHeadachesDry mouthDizzinessWeight gainSexual side effectsWith many antidepressants, the side effects are mild and temporary.When your teen is first starting a medication, it’s important for them to know that the physical discomfort is likely to get better soon.Although not necessarily a drawback, it is important for parents and teens to know that the medicationsdo not work instantly. It can take, on average, four to six weeks for the full effect of antidepressants to be felt.Just like it takes time for the side effects to improve, it also takes some time for the medication to fully work. Discussing how antidepressants work with your teen ahead of time will help you both avoid disappointment when your child’s depression doesn’t immediately get better.Suicide RiskThe Food and Drug Administration (FDA) cautions that young adults between the ages of 18 to 24 who are taking an antidepressant may be at risk for an increase in suicidal thoughts and actions.The risk has been noted at the beginning and through the first few months of treatment.The agency requested that drug manufacturers indicate this risk with a warning on the package inserts for the medications they make (called a black box warning).Parents, caregivers, and professionals need to watch for a potential increase in suicidal thinking and behavior in children and teens taking antidepressants.If your child is having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.The Pros and Cons of AntidepressantsWhat to Watch ForYour teen is an individual in many ways—from their sense of style to personality to hobbies. They are also unique in how they will respond to an antidepressant. While many teens do not experience an increase in suicidal thoughts, it is possible.The FDA recommends looking for the following warning signs which may indicate your teen is considering suicide or deteriorating psychologically:Expression of new or persistent thoughts of suicideWorsening depressionAnxietyAgitationFeelings of restlessness (akathisia)Panic attacksInsomniaNew or worsening irritabilityAggressive behaviorHostility or impulsivityUnusual changes in behaviorHypomania or maniaBecoming familiar with these signs and staying involved and alert is especially important during the first few months of treatment, as well as when changes are made to your teen’s treatment plan (such as an increase or decrease in dose, addition of new medications, discontinuation of medications, or a change in medication).If you notice these signs or your teen brings any of them to your attention, it is imperative that you contact your teen’s physician, psychiatrist, or counselor immediately.Next StepsIf your teen has depression, it is important for you and your teen to discuss the pros and cons of antidepressant use with your teen’s physician.Teens need to take their antidepressants exactly as their doctor prescribes them, usually daily. Tell your teen’s doctor if your child is taking any other medications or supplements, as they may interact with antidepressants.You and your teen should also know that antidepressant medications should never be stopped abruptly. If your teen suddenly stops taking their antidepressant, they may experiencesymptoms of withdrawal.If you or your teen think it’s time to change medications or alter the dose, talk to your teen’s doctor about tapering off the medication gradually.A Word From VerywellTeens with depression may have difficulty sleeping, issues related to eating, and problems at school or with friends. For some teens, antidepressant medications may be able to help. When making a choice about treatment, you and your family need to become familiar with the benefits and drawbacks of these medications so you can make an informed decision.Depression can have serious, even deadly, consequences—but early recognition, intervention, and treatment can help your whole family recovery. Antidepressants and counseling can make a big difference to a teen who is depressed, as well as offer your family with information and strategies for coping.How to Help Your Depressed Teenager

When a teen has depression, counseling and antidepressants are often offered as options for treatment, especially if the depression is considered moderate or severe.

If your teen is prescribed an antidepressant such as a selective serotonin reuptake inhibitor (SSRI), it’s normal to have questions about how it works and whether it’s safe. It’s important for you and your family to be educated about an antidepressant so you can help your teen understand the benefits and potential adverse effects (and how to manage them).

An Overview of Teen Depression

Antidepressants are there to help with the uncomfortable, disturbing, and even disablingsymptoms of depression. Antidepressants can improve your teen’s mood, appetite, sleep, ability to focus, and may even relieve the physicalaches and painsthat sometimes come with depression. These medications also help treatanxiety symptoms.

Most importantly, because depression can lead to suicide, it is extremely important to effectively treat teens with depression who are experiencing suicidal thoughts.

Antidepressants may be most effective if your teen is also working with a therapist or psychiatrist.

During counseling, your teen will learn coping skills to help deal with life’s stressors. Your teen will also explore the possible causes of depression and talk about issues they may not feel comfortable disclosing to friends or family.

A mental health professional can be a wonderful ally for the parents of a teen with depression. These professionals have a wealth of information and resources about the disorder and can provide invaluable insight into the best way to treat it.

The Dangers of Untreated Depression in Teens

All medications have side effects. If your physician or psychiatrist suggests an antidepressant, you’ll walk to ask about the specific drug’scommon side effects.

One of the most commonly prescribedclasses of antidepressantsfor adolescent depression is selective serotonin reuptake inhibitors (SSRIs).

While these medications can be safe and effective, they can have side effects:

With many antidepressants, the side effects are mild and temporary.When your teen is first starting a medication, it’s important for them to know that the physical discomfort is likely to get better soon.

Although not necessarily a drawback, it is important for parents and teens to know that the medicationsdo not work instantly. It can take, on average, four to six weeks for the full effect of antidepressants to be felt.

Just like it takes time for the side effects to improve, it also takes some time for the medication to fully work. Discussing how antidepressants work with your teen ahead of time will help you both avoid disappointment when your child’s depression doesn’t immediately get better.

The Food and Drug Administration (FDA) cautions that young adults between the ages of 18 to 24 who are taking an antidepressant may be at risk for an increase in suicidal thoughts and actions.The risk has been noted at the beginning and through the first few months of treatment.

The agency requested that drug manufacturers indicate this risk with a warning on the package inserts for the medications they make (called a black box warning).

Parents, caregivers, and professionals need to watch for a potential increase in suicidal thinking and behavior in children and teens taking antidepressants.

If your child is having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

For more mental health resources, see ourNational Helpline Database.

The Pros and Cons of Antidepressants

Your teen is an individual in many ways—from their sense of style to personality to hobbies. They are also unique in how they will respond to an antidepressant. While many teens do not experience an increase in suicidal thoughts, it is possible.

The FDA recommends looking for the following warning signs which may indicate your teen is considering suicide or deteriorating psychologically:

Becoming familiar with these signs and staying involved and alert is especially important during the first few months of treatment, as well as when changes are made to your teen’s treatment plan (such as an increase or decrease in dose, addition of new medications, discontinuation of medications, or a change in medication).

If you notice these signs or your teen brings any of them to your attention, it is imperative that you contact your teen’s physician, psychiatrist, or counselor immediately.

If your teen has depression, it is important for you and your teen to discuss the pros and cons of antidepressant use with your teen’s physician.

Teens need to take their antidepressants exactly as their doctor prescribes them, usually daily. Tell your teen’s doctor if your child is taking any other medications or supplements, as they may interact with antidepressants.

You and your teen should also know that antidepressant medications should never be stopped abruptly. If your teen suddenly stops taking their antidepressant, they may experiencesymptoms of withdrawal.

If you or your teen think it’s time to change medications or alter the dose, talk to your teen’s doctor about tapering off the medication gradually.

A Word From Verywell

Teens with depression may have difficulty sleeping, issues related to eating, and problems at school or with friends. For some teens, antidepressant medications may be able to help. When making a choice about treatment, you and your family need to become familiar with the benefits and drawbacks of these medications so you can make an informed decision.

Depression can have serious, even deadly, consequences—but early recognition, intervention, and treatment can help your whole family recovery. Antidepressants and counseling can make a big difference to a teen who is depressed, as well as offer your family with information and strategies for coping.

How to Help Your Depressed Teenager

6 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Oberlander TF, Miller AR.Antidepressant Use in Children and Adolescents: Practice Touch Points to Guide Paediatricians.Paediatr Child Health. 2011 Nov; 16(9):549-53. doi:10.1093/pch/16.9.549DeFilippis M, Wagner KD.Management of treatment-resistant depression in children and adolescents.Paediatr Drugs. 2014;16(5):353–361. doi:10.1007/s40272-014-0088-yJane Garland E, Kutcher S, Virani A, Elbe D.Update on the Use of SSRIs and SNRIs with Children and Adolescents in Clinical Practice.J Can Acad Child Adolesc Psychiatry. 2016;25(1):4–10.Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context. 2015;4:212290. Published 2015 Oct 8. doi:10.7573/dic.212290U.S. Food and Drug Administration (FDA).Suicidality in Children and Adolescents Being Treated With Antidepressant Medications.Hussain H, Dubicka B, Wilkinson P.Recent developments in the treatment of major depressive disorder in children and adolescents.Evid Based Ment Health. 2018;21(3):101–106. doi:10.1136/eb-2018-102937Additional ReadingBrent D, Poling K, Goldstein T.Treating Depressed and Suicidal Adolescents. New York: Guilford Press; 2011:37-42.Johnston H, Fruehling J.Handbook of Depression in Children and Adolescents. (Reynolds W, ed.). New York: Springer Science & Business Media; 2013:365-369.

6 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Oberlander TF, Miller AR.Antidepressant Use in Children and Adolescents: Practice Touch Points to Guide Paediatricians.Paediatr Child Health. 2011 Nov; 16(9):549-53. doi:10.1093/pch/16.9.549DeFilippis M, Wagner KD.Management of treatment-resistant depression in children and adolescents.Paediatr Drugs. 2014;16(5):353–361. doi:10.1007/s40272-014-0088-yJane Garland E, Kutcher S, Virani A, Elbe D.Update on the Use of SSRIs and SNRIs with Children and Adolescents in Clinical Practice.J Can Acad Child Adolesc Psychiatry. 2016;25(1):4–10.Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context. 2015;4:212290. Published 2015 Oct 8. doi:10.7573/dic.212290U.S. Food and Drug Administration (FDA).Suicidality in Children and Adolescents Being Treated With Antidepressant Medications.Hussain H, Dubicka B, Wilkinson P.Recent developments in the treatment of major depressive disorder in children and adolescents.Evid Based Ment Health. 2018;21(3):101–106. doi:10.1136/eb-2018-102937Additional ReadingBrent D, Poling K, Goldstein T.Treating Depressed and Suicidal Adolescents. New York: Guilford Press; 2011:37-42.Johnston H, Fruehling J.Handbook of Depression in Children and Adolescents. (Reynolds W, ed.). New York: Springer Science & Business Media; 2013:365-369.

Oberlander TF, Miller AR.Antidepressant Use in Children and Adolescents: Practice Touch Points to Guide Paediatricians.Paediatr Child Health. 2011 Nov; 16(9):549-53. doi:10.1093/pch/16.9.549DeFilippis M, Wagner KD.Management of treatment-resistant depression in children and adolescents.Paediatr Drugs. 2014;16(5):353–361. doi:10.1007/s40272-014-0088-yJane Garland E, Kutcher S, Virani A, Elbe D.Update on the Use of SSRIs and SNRIs with Children and Adolescents in Clinical Practice.J Can Acad Child Adolesc Psychiatry. 2016;25(1):4–10.Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context. 2015;4:212290. Published 2015 Oct 8. doi:10.7573/dic.212290U.S. Food and Drug Administration (FDA).Suicidality in Children and Adolescents Being Treated With Antidepressant Medications.Hussain H, Dubicka B, Wilkinson P.Recent developments in the treatment of major depressive disorder in children and adolescents.Evid Based Ment Health. 2018;21(3):101–106. doi:10.1136/eb-2018-102937

Oberlander TF, Miller AR.Antidepressant Use in Children and Adolescents: Practice Touch Points to Guide Paediatricians.Paediatr Child Health. 2011 Nov; 16(9):549-53. doi:10.1093/pch/16.9.549

DeFilippis M, Wagner KD.Management of treatment-resistant depression in children and adolescents.Paediatr Drugs. 2014;16(5):353–361. doi:10.1007/s40272-014-0088-y

Jane Garland E, Kutcher S, Virani A, Elbe D.Update on the Use of SSRIs and SNRIs with Children and Adolescents in Clinical Practice.J Can Acad Child Adolesc Psychiatry. 2016;25(1):4–10.

Santarsieri D, Schwartz TL.Antidepressant efficacy and side-effect burden: a quick guide for clinicians.Drugs Context. 2015;4:212290. Published 2015 Oct 8. doi:10.7573/dic.212290

U.S. Food and Drug Administration (FDA).Suicidality in Children and Adolescents Being Treated With Antidepressant Medications.

Hussain H, Dubicka B, Wilkinson P.Recent developments in the treatment of major depressive disorder in children and adolescents.Evid Based Ment Health. 2018;21(3):101–106. doi:10.1136/eb-2018-102937

Brent D, Poling K, Goldstein T.Treating Depressed and Suicidal Adolescents. New York: Guilford Press; 2011:37-42.Johnston H, Fruehling J.Handbook of Depression in Children and Adolescents. (Reynolds W, ed.). New York: Springer Science & Business Media; 2013:365-369.

Brent D, Poling K, Goldstein T.Treating Depressed and Suicidal Adolescents. New York: Guilford Press; 2011:37-42.

Johnston H, Fruehling J.Handbook of Depression in Children and Adolescents. (Reynolds W, ed.). New York: Springer Science & Business Media; 2013:365-369.

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