Questions for parents with kids on antidepressants...

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Just thinking down the road my daughter may need this. She has been "feeling sad" since second grade so it's been about three years. We have seen her up and down, in therapy, she says she can be happy at times but there is always a sadness there. I know we will need to exhaust all the therapies, she needs to start Cognitive Behaviorial Therapy, she has been doing more "play" therapy to explore feelings of anger, anxiety in the past. Plus we are waiting for the school eval to see if some accomodations during the day will help but my gut is telling me she would do well on a low dose of antidepressant. After the school eval I am sure we may get our own eval by a child psychatrist, at least for a baseline. My husband is adamant that she NOT be medicated until after puberty as there is a documented propensity to sucicide in teens on these meds. Any advice/experience, good or bad? When did your child start meds? HOw long did you notice before a difference? Did you need to change or try different doses? Do you think it was helpful for your child overall? I realize EVERY child is completely different physically, chemically, emotionally but just wanted to hear from other parents what your own experiences have been. Thanks so much!

I'd advice you to do a lot of research on antidepressants. The studies I have seen come out recently say antidepressants don't even work. The studies say CBT or CBT plus a placebo works better than CBT plus antidepressants or antidepressents alone.

The point your husband brings out about suicide risk with psych meds is a very important point. Thing is a lot of those meds say the risk is still high in young adulthood so waiting till she hits adolescences doesn't lower the risk. Also think about how fragile girls today are concerning body image and antidepressents often cause tremendous weight gain in females. Does she need one more thing to be depressed about? Being an overweight female is the most devastating part of my life because of the way I am treated even though I have autoimmune illness with short life expectancy its the weight that troubles me more. Think about it.

Perhaps explore other avenues in addition to CBT. I'm getting TFT treatments which my psych says speeds up recovery.

Anecdote does not equal data. Even if someone here has a wonderful rave about what anti-depressants did for their kid, you should still research the overwhelming studies that say it increases suicide risk while at the same time being no more effective than placebo.

Go read the Lancet, Nature, the American Journal of Psychiatry, or have a trusted medical friend do the research for you, it's out there.

http://www.nimh.nih.gov/health/topics/c ... vers.shtml

"Twice the rate" sounds scary, but "2% more" doesn't seem so bad.

In terms of actual completed suicides by kids, the same article says they found more of 'em in regions where fewer kids are on antidepressants.

The studies about adults look pretty much the same. I get the impression from them that depressed people on meds are less likely to kill themselves but more likely to admit that they've thought about it. There's also this business where somebody who's depression is starting to lift may still feel terrible, but suddenly have more energy to act. And the thing where you get the side-effects that make you feel crappy (which usually go away) before you start to get the benefits.



61% responding to 'Prozac' while 35% responded to the placebo means that 'Prozac' is more effective than a placebo.

Not saying your daughter ought or ought not be on meds, but I don't think the meds should be vilified. Starting them was, for me, a month of feeling worse, utterly terrible, and I can't imagine how a kid could cope with it, but now that I'm at a steady-state with them, I'm enormously pleased.

Just a thought- before subjecting anyone to psych meds the person really ought to have a full blood work up looking for things like hypothyroidism, high estrogen, low progesterone and low pregnenolone as those things can create a depressive state but the person not really have true depression. Hypothyroidism is the biggie too.

A recent study found that antidepressants aren't very effective in children. You might be better off with other therapies. But most studies suggest antidepressants + CBT has the best results.

my AS son started on antidepressants when he was 13. they have kept him alive during a period in time when suicidal ideation seemed to be everything in his world. We made several emergency hospital trips. Our house turned into a 24 hour a day suicide watch- some days were better than others. We made the choice to work less and monitor our son more instead of having him hospitalized. This was a very difficult decision. The stress of it all caused me to go into perimenopause & gain 50 pounds. It put a strain on our marriage. Looking back, I don't know that it was the best decision on our part. Psych hospitals, however, have a way of making parents feel inept & like their child's problems are due to abuse in the home..........We tried several antidepressants before we found the one that works best for our son.
CBT , as well as traditional therapy, have helped him to be able to process events better & more accurately. He started traditional therapy prior to medications- ultimately, he was non-functioning without the meds. the meds help him to function. The CBT has helped him to thrive.
without a dx of depression, no ethical doctor will put your child on anti-depressants. Unless you have an extreme case as we did, I reccommend having your child try CBT prior to medicating.

My plan is to find someone who specializes in CBT and go from there. That combined with psychotherapy once a week hopefully will do the trick. I may have her evaluated by a child psychatrist however to see what they say and get a baseline eval in the event things take a turn for the worse in the future. I am mildly clincially depressed and benefit from a low dose of antidepressant. My DD knows this, I have chosen to share this information to educate her about the benefits of Meds if necessary. Yes Meds for her would be a last resort. Hopefully the CBT will help. It does make me sad though that she is sad all the time and I think she will remember her childhood as being pretty hard.

I think you're looking at the data wrong.

35% of people responded to placebo. Separating prozac from placebo results, 26% of people responded to Prozac.

The medical community agrees with this definition of statistically significant, not yours.

http://www.newscientist.com/article/dn1 ... ients.html

UK and US researchers led by Irving Kirsch of Hull University, UK, studied all clinical trials submitted to the FDA for the licensing of the four SSRIs: fluoxetine (Prozac), venlafaxine, nefazodone, and paroxetine (Seroxat or Paxil), for which full datasets were available.

Don't be daft. There is more detail about this TADs study on NIMH's site. The study group was divided into four sub-groups. Group 1 got 'Prozac' (fluoxetine) and CBT, group 2 got just prozac, group 3 got CBT alone, and group 4 got a placebo. After 12 weeks, 71% of group 1 had improved, 61% of group 2 had improved, 44% of group 3 had improved, and 35% of the placebo group had improved. After 12 weeks they told everybody if they were on placebo or not, and those who had not improved on placebo were allowed to join any of the other groups. At 18 weeks, 85% of those getting CBT with prozac had improved, 68% of those on prozac alone had improved, and 65% of those getting just CBT had improved. At 36 weeks it was 86% of the CBT+prozac group and the other two groups were at 81%.

It did show some scary stuff in the early stage, with 15% of the kids who were on prozac alone having new suicidal thinking or behavior. 8% on the combonation did that, 6% on CBT alone did that. But overall all the active treatment groups showed reduced suicidal thinking over the full 36 weeks.



This article doesn't say what studies he was looking at, or even how many. It's got other people, admittedly drug-company reps complaining that he looked at only a small subset of studies. It says they are effective for the most severely depressed people and then says, "in this group the small effect is "due to decreased responsiveness to placebo, rather than increased responsiveness to medication"." which doesn't make sense.

As for "GPs should not be dishing these drugs out as first-line treatment for mild depression," well, yeah. They are not worth it, or even dangerous, if used by people who don't really need them, you shouldn't be getting them from a GP, but a genuine psychiatrist, you should try talk-therapy first and continue it.

Another trouble with that article is the drugs it looked at. Venlafaxine ("Effexor") isn't really SSRI, and as far as I know isn't usually prescribed until after others have failed and often goes with an antipsychotic, leading one to suppose that the study-groups might include a lot of people who's depression is treatment-resistant in general and are surely not on the appropriate cocktail or the results wouldn't be about Effexor alone, or it's a bunch of people who have been inappropriately clobbered with a last-resort med for their first antidepressant. Nefazodone is the mildest SSRI around and already proven ineffective anyway. The study ignores the most commonly prescribed two, and the two that are usually the ones to try first. And, like any study about how well antidepressants work, it fails to recognise that certain drugs work for some people and others don't and eventually if you take the time and the agony to try them you will probably find the right one. Probably there's a right drug or combonation of them at a right dosage to effectively treat the vast majority of people with depression, but it's very unlikely that there's any specific drug and dosage that's going to work for even a quarter of them.

Maybe GP's shouldn't be handing out SSRI's. But should psychs either? Twice I've had the same stupid psych try to dope me up and both times the medication was contraindicated for either someone with my medical problem (heart condition) or else the manufacturer warns it will interact with another medication I am on. I let two GP's put me on two different psych meds years ago. One gave me breathing trouble and the other gave me seizures. And yet a third SSRI almost killed my best friend last year because it gave her kidney failure. She told me she weaned herself off it with her psych's permission and she feels like she has a better mood now than she did on it! Hmmm!

I say whatever you decide to do make sure you do lots of research, ask the doctor lots of questions and make sure you check and double check contraindications with dr and pharmacist and the manufacturer's website.

I was anti depressants as a child. I needed them or I would get really angry and go into a rage.

At what age did you start antidepressants? Which one? Did it help? How long did you need to stay on? How often did the psychatrist monitor you? Thanks!! Lucy

every med works differently for every person. for anyone to suggest a specific med would be misleading. you need to go to the psych and talk about your concerns. in the initial period of beginning a new medication, son was monitored by his psych on a monthly basis. once we knew that he would be staying on a specific med, he dropped down to seeing the psych every 3 months. of course, psych had us watch son extremely carefully for the 1st day or 2 to look for any adverse effects. son started on anti-depressants when he was 13.