Your child's health care provider recommended that your child start taking a medicine to help treat their depression. When used along with talk therapy, these medicines can help improve your child's depression symptoms.

To treat depression in children and teens, health care providers usually use SSRIs (selective serotonin reuptake inhibitors) and SNRIs (selective norepinephrine reuptake inhibitors). These medicines work by increasing the amount of specific chemicals (serotonin and norepinephrine) in the brain. This helps improve symptoms of depression. These medicines include fluoxetine (Prozac®), escitalopram (Lexapro®), and sertraline (Zoloft®).

The most common side effects of these medicines include:

• nausea, stomachaches, diarrhea
• headaches
• sleep disturbances
• irritability
• feeling jittery, restless, or anxious

Some side effects will improve as your child's body gets used to the medicine. Other side effects can be easily managed. For example, if the medicine makes your child tired, they can take it at bedtime. It's important to talk to your health care provider about any side effects your child has while taking the medicine.

SSRIs can take up to 4 to 6 weeks to improve symptoms. Your health care provider will meet with you and your child regularly after your child starts the medicine. They may change the dose because it can take some time to find the right one for your child. Do not let your child stop taking the medicine without talking with the health care provider first.

• Have your child take the medicine at the same time every day. It might help to set an alarm or provide reminders.
• Support your child. Check in with them regularly about how they're feeling. Give them chances to discuss their emotions with you or another trusted adult.
• Encourage a regular sleep routine, healthy eating habits, and regular exercise. 
• Help your child develop ways to improve their mood in the moment, like calling a friend, going for a walk, or listening to music.

Your child:

• has any side effects from the medicine 
• has trouble taking the medicine as prescribed
• has depression symptoms that get worse

• Your child develops confusion, sweating, tremors, and fever. These could be signs of a rare but serious side effect known as serotonin syndrome. It most often happens when people take more than one medicine that affects serotonin levels.
• You think your child is suicidal, or threatening to harm themselves or someone else.

What is the FDA Black Box Warning on antidepressants? In 2004, the FDA issued a warning indicating that these medicines were associated with an increased risk of suicidal thinking and behavior in children and adolescents, especially at the beginning of treatment. They recommended close monitoring for worsening symptoms, signs of suicidal thoughts, or changes in behaviors. This does not mean these medicines cannot be safely used. In fact, many children and adolescents see an improvement in their symptoms when they take these medicines, especially in combination with therapy. 

What can I do to help my child stay safe with depression? You can help your child develop a safety plan that includes ways to manage mood, get support, and know when to reach out for help. Make their environment as safe as possible by removing access to all dangerous tools, such as knives, weapons, and firearms. Keep all medicines in a safe place.

Are there other side effects of these medicines? Other side effects of these medicines include decreased sexual drive, symptoms of mania (such as decreased need for sleep and impulsiveness), and irrational behaviors.