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

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).

Effectiveness in Teens

Antidepressants are there to help with the uncomfortable, disturbing, and even disabling symptoms of depression. Antidepressants can improve your teen's mood, appetite, sleep, ability to focus, and may even relieve the physical aches and pains that sometimes come with depression. These medications also help treat anxiety symptoms.

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

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.

Potential Adverse Effects

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

One of the most commonly prescribed classes of antidepressants for adolescent depression is selective serotonin reuptake inhibitors (SSRIs).

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

• Nausea
• Diarrhea
• Insomnia
• Sedation
• Headaches
• Dry mouth
• Dizziness
• Weight gain
• Sexual 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.

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 Risk

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.

What to Watch For

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:

• Expression of new or persistent thoughts of suicide
• Worsening depression
• Anxiety
• Agitation 
• Feelings of restlessness (akathisia)
• Panic attacks
• Insomnia
• New or worsening irritability
• Aggressive behavior
• Hostility or impulsivity
• Unusual changes in behavior
• Hypomania or mania

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.

Next Steps

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 experience symptoms 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.