Although there are no antidepressant medications currently approved by the US Food and Drug Administration for the treatment of depressive disorders in children and adolescents, antidepressant medications should be considered in cases of non-rapid-cycling bipolar depression, psychotic depression, depression with severe symptoms preventing effective psychotherapy, and depression that fails to respond to an adequate trial of psychotherapy. Before prescribing antidepressants, clinicians should inform parents and patients about adverse effects, dosing, timing of therapeutic effects, and the danger of overdose, particularly with tricyclic antidepressants. In addition, the symbolic meaning of taking medication, which will be different for each child and family, should be addressed. Selective serotonin reuptake inhibitors are currently the antidepressants of choice to treat depressive disorders in children and adolescents because of their safety, side effect profile, ease of use, and suitability for long-term maintenance. Given the psychosocial context in which depression unfolds, pharmacotherapy is never sufficient as the sole treatment for this condition. Combined treatment (medication plus individual, family, and group therapy treatment modalities) increases not only the likelihood of mitigating depressive symptoms, but it also increases the self-esteem, coping skills, and adaptive strategies of children and adolescents with depression, as well as improving family and peer relationships.
- Selective serotonin reuptake inhibitors.
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