A prescription for antidepressant drugs is often given to alleviate migraines, anxiety, depression or chronic pain.
When the patient is a small child, however, there's added concern about the possibility of these drugs causing children to have suicidal thoughts which is also known as suicidality.
The question of whether antidepressant drugs trigger suicidal behavior continues to be debated by scientists, but doctors say there are a number of cases reported that suggest a correlation.
"What you will usually see is the mood changes, the irritability, and then, something extreme," warns Dr. David Lelio, Director of Child and Adolescent Psychiatry at Carolinas Medical Center-Randolph.
In general, antidepressants can be very helpful in treating a wide range of medical conditions.
The black box warning printed on the paperwork which comes with these pills was created to alert consumers about suicidality.
A study of clinical trials conducted by the U.S. Food and Drug Administration found that children taking antidepressants had a four percent chance of developing suicidal thoughts, as compared to a two percent chance among those who only received a placebo.
The bold, framed label, however, is not found on all prescription antidepressant medications.
Your physician should talk with you about the black box warning and your child's risk before beginning treatment.
Parents can also seek out a second opinion and look for other options.
If the issue is depression, psychotherapy might be the first stop before starting medication.
Psychotherapy, or talk therapy, can determine the degree of depression and whether antidepressants are even necessary.
If antidepressants are the chosen remedy, Lelio says parents need to be mindful of the difference between a child being moody or suicidal.
"Can a 7-year-old really communicate, 'I'm depressed, I'm suicidal, I need help?'" Lelio asks.
He says children often don't know the words to describe how they are feeling. So, that's why adults should monitor their child's behavior and look to see if there are any sudden changes in the child's moodiness, appetite, energy level, or a tendency for them to cry.
You should also watch to see if they are sleeping more or playing less and if they appear to be aggressive, restless or isolated.
The FDA recommends children see their doctor every week during the first month while taking an anti-depressant drug. During the second month, visits to your doctor can be scaled back to every two weeks. You should have a follow-up visit with your doctor after 12 weeks of taking the drug, and meet thereafter based on your doctor's recommendation.
If a child exhibits feelings of aggression or hopelessness, make sure they are safe and immediately call your doctor.
Experts say you should never stop taking prescribed medications 'cold turkey' because it can cause withdrawal-like symptoms.
Ultimately, parents should not brush off any big changes in behavior for any reason.
With anti-depressants, consider the risks versus the benefits for your child's unique case.
While there is lots of fine print information packaged along with any medication, when it comes to antidepressants, its worth peeling through all the paperwork to know as much as you can about these drugs.
1. Thoughts about suicide or dying
2. Attempts to commit suicide
4. Feeling very agitated or restless
5. Panic attacks
6. Sleeping problems
7. Increasing sadness
8. An extreme increase in talking or activity
9. Aggression, violence or hostility
10. New or worsening anxiety
11. Social or academic problems at school
12. Spending more time alone
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