“Discuss the use of antidepressants in adolescence”
Antidepressants and antipsychotics are widely prescribed to children and adolescents worldwide for a variety of indications such as mood disorders, anxiety disorders, behavioural disorders, or psychosis. Antidepressants are second-line treatment options after psychological therapy for anxiety and obsessive-compulsive disorder in adolescence. In fact, 78% of prescriptions for antidepressants are prescribed to adolescents aged 15-17 by the general practitioner. This is concerning as prescribing antidepressants to adolescents exposes them to this treatment during a period of life when these patients undergo marked developmental, hormonal, and neurobiological changes. Whilst taking antidepressants, adolescent patients must be monitored for rare but serious adverse effects, especially because research shows that suicide-related behaviours occur in about 4% of adolescents starting antidepressant drugs. For example, adolescents treated with antidepressants seem to have a greater risk of neurological complications compared with adults.
The response to antidepressant treatment is generally good for anxiety and obsessive-compulsive disorder, but results are less convincing for major depressive disorder. Because of this, antidepressant therapy is considered a first-line option mainly for severe cases of major depressive disorder. Adolescents who do not respond to an adequate trial of one antidepressant should be referred for a psychiatric opinion for further treatment.
The perceived severity of their impact on daily lives in adolescent patients may also differ from that in adults. The possibly increased risk of suicidal ideations and behaviours in adolescence when starting antidepressants has received much attention and has led to safety alerts by regulatory agencies, despite uncertainty about causality. Given these critical safety issues with potentially high impact on the individual patient and the resulting burden on health care systems, the importance of short- and long-term drug safety monitoring as well as the introduction of efficient pharmacovigilance methods in adolescent trials and as part of routine clinical practice have been increasingly recognized.
In this session, you will:
- Discuss the use of antidepressants in adolescence
- Consider the severity of the adverse effects associated with the use of antidepressants in adolescence
- Establish the role of GP in interpreting and communicating efficacy data derived from the adolescent population
- Revise the conditions where antidepressants have been shown to be beneficial
Lilliana Levada is an experienced clinician with over 35 years of clinical experience in perioperative nursing (instrument, circulatory, anaesthetic, PACU, educator, consultant and manager nursing roles), intensive care nursing, patient flow management, after-hours hospital management and patient safety management…Read More>>