In the treatment of depression in children and adolescents, the basis is the implementation of psychotherapy, which, if necessary, is supplemented with pharmacotherapy based on selective serotonin reuptake inhibitors. The full effects of pharmacological treatment are visible after about 4-6 weeks.
Diagnosis and therapy in depression in children
The first specialist to notice disturbing symptoms is the family doctor, therefore his vigilance and intuition are very important in the diagnosis of childhood depression. The psychiatrist diagnoses the disease on the basis of an interview with the patient and his caregivers, and assesses the scale and severity of symptoms, excluding comorbidities.
The basic and most important therapy is psychotherapy, depending on the case – group, family or individual. When this is not enough, and severe symptoms make it impossible for the child to function on a daily basis, pharmacotherapy is started – always as an addition to psychotherapy, not “instead”.
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Drug treatment of depression in children
The most important group of drugs used in the treatment of moderate and severe childhood depression are SSRIs – selective serotonin reuptake inhibitors. The most popular active substances are:
- Sertraline
- Fluoxetine – the most widely used antidepressant drug in the world
- Fluvoxamine
- Paroxetine
- Citalopram and escitalopram
They are activating drugs, devoid of excessive sedative effects. They are safe, although they may interact with drugs from other classes of antidepressants. Only taking paroxetine is associated with a higher risk of liver damage, therefore it is not the drug of first choice in the treatment of children and adolescents.
A serious side effect of this group of drugs, which makes the patient more closely monitored during the first weeks of treatment, is depressed mood, trouble sleeping, and even suicidal thoughts and attempts. A psychiatrist who decides to include such a preparation always weighs the benefits over the potential risk, however, close cooperation of the child’s caregivers with the doctor and monitoring of the child’s condition is required.
Other side effects are rather mild and transient with continued treatment. Belong to them:
- Gastrointestinal disorders: nausea, vomiting, diarrhea
- Headaches
- Insomnia
- Concentration disorders
- Muscle tremors
- Excessive sweating
The physician should advise the treatment of minor side effects in advance, so that the patient does not get discouraged and does not stop the treatment, because the full effects of pharmacotherapy occur after about 4-6 weeks.
Treatment is carried out by monitoring the patient approximately every 3 months and up to a year after achieving satisfactory results. Discontinuation of treatment should be gradual to avoid effects such as flu-like symptoms, headache, dizziness, agitation or excessive tiredness.
Resources: Feinberg Consulting
Article Submitted By Community Writer
