Babies prescribed antidepressants
The past few decades have seen a surge in antidepressant use. Antidepressants are now the second most commonly prescribed drug type in the U.S. Though the increase in usage has not been only in adults, but also children and even babies.
In 2014, a reported 83,000 children in the U.S. aged 2 and under were prescribed the antidepressant Prozac. A 23% increase from the previous year.
Doctors are using the medication to treat early signs of depression in children and believe it may also protect them from developing adult depression in later life. Though with the fear of over-prescription and pharmaceutical dependence, many are concerned about the use of antidepressant medication in young people.
The rise of infant antidepressant drugs has been documented not only in the U.S. The use of psychotropic drugs, which include stimulants, antipsychotics, antidepressants and anti-anxiety medication, in children has increased in the UK, Denmark, Germany and Netherlands. Australia, too, has seen an increase in child prescriptions of psychotropics though predominantly for the treatment of schizophrenia, autism and ADHD.
Can babies even be depressed?
It’s hard to imagine a baby needing antidepressants. They don’t exactly have too many pressures in their life. No work on Monday morning, no relationship drama or 2000 word essays due. At 2 years old children typically are still learning to walk, talk and are not yet emotionally developed.
So, understandably, depression looks different for children at this age compared adults. It is typically characterised as a consistent:
- lack of emotion or disinterest
- behavioural issues such as temper tantrums
- decreased appetite
- sleeping issues
Some of these symptoms in themselves don’t sound like particularly unusual behaviours for a newborn baby or toddler. Though doctors may become concerned if the child’s parents have or have had mental health issues. As children with a family history of mental illness are at a greater risk for depression and are more likely to start displaying symptoms at a young age.
Does medication even work?
The only medication that has clinically shown to be effective in the treatment of childhood depression is Prozac. Prozac (pharmaceutically known as fluoxetine) falls into a class of drugs known as SSRIs, Selective Serotonin Reuptake Inhibitors.
Serotonin is a chemical found in the brain (as well as the digestive system) that’s involved in regulating mood and emotion. Ordinarily, it is released from neurons in the brain into synapses (gaps between neurons). The influx of serotonin triggers a series of events that cause connected neurons to fire and pass messages throughout the brain.
SSRIs increase serotonin in the brain by preventing its reuptake at the brain’s synapses. So the serotonin stays in the synapses longer and is not broken down. Allowing the serotonin to have a longer lasting effect and increasing the overall concentration in the brain.
Though scientists are unsure exactly how the increase in serotonin improves mood. There are some that claim that people with depression have an imbalance of serotonin that effects positive thought pathways. There are others that believe depression is linked to reduced neuron regeneration and that serotonin helps to reverse this process. It appears that Prozac does reduce symptoms of depression.
Is it safe?
Brain imaging has found no abnormal effects of antidepressant on children’s brains. In fact, the neurological differences seen in depressed children appear to eradicate with antidepressant medication.
Although there are still concerns about the potential long term effects of antidepressant medication in the developing minds of children. While antidepressants may improve positive thought pathways, they may also be creating a reliance on medication or preventing normal brain development.
Additionally, due to the recency of antidepressant development and an understandable unwillingness on behalf of parents to volunteer their children for such an experiment. There have been no longitudinal studies on how antidepressant use in childhood effects development.
There are also concerns that antidepressants are being over-prescribed and used unnecessarily. Though medical protocol requires practitioners to recommend therapy and psychological counselling as the first port of call. There are long wait-lists for therapy, even more so for specialist child psychologists, and the appointments themselves are expensive. Especially in places such as America which lack affordable public healthcare. That anti-depressant medication is sometimes the only available solution for depression.
Though overall, medical institutions including the Royal Australian and New Zealand College of Psychiatrists, suggest that benefits of antidepressants outweigh the potential risk. That “not treating depression is more likely to result in harm than is appropriate use of antidepressants”.
*I would also like to append that this blog post is not intended to serve as medical advice, for any issues concerning depression or psychological disorders please see a medical professional.