My son is only ten years old, yet his doctor has prescribed Paxil for anxiety and depression. Isn’t this an early age to be diagnosed with these disorders and isn’t ten years of age too young for this kind of medication? I need your opinion.

Depression and anxiety do occur in children and adolescents. The good news is that we can help most kids who have these kinds of problems. Treatment will often include individual therapy or counseling, as well as work with the child’s family or school. It may also include the use of medication. Antidepressant medications, such as Paxil, can be extremely helpful for some children, but medication alone is rarely an appropriate treatment for complex child psychiatric problems like depression or anxiety disorders. In general, they should only be used as part of a broader and more inclusive approach to treatment. Parents should also ask lots of questions before placing a child on medication. They should make sure they understand the risks and benefits, as well as any potential side effects. Parents should also never feel pressured to place a child on medication. If they are uncomfortable with a diagnosis, a doctor, or a recommendation, they should always feel free to seek a second opinion. Fortunately, these medications are generally well tolerated by children. Properly used, they can be an important component of a comprehensive treatment plan. More information about children and medication is available from the American Academy of Child and Adolescent Psychiatry (www.aacap.org).

David Fassler, M.D.
Member, Work Group on Consumer Issues
American Academy of Child and Adolescent Psychiatry

Depression often begins in early childhood and is sometimes associated with a variety of anxiety symptoms. We are seeing a significant rise in early onset depression accompanied by anxiety. Experts consider this combination to be very treatable in both adults and children, with up to 85% returning to previous functioning levels. New antidepressants called SSRI’s are the first drug of choice for depression and anxiety. These disorders involve a chemical imbalance in the brain, often brought on by stress. Antidepressants are used to regulate the levels of brain chemicals, which are known as neurotransmitters. Paxil is one of the SSRI’s which has been approved by the FDA for depression and all anxiety disorders in adults. Antidepressants are also commonly prescribed to children. All antidepressants have a response rate of close to 70%. If one is causing side effects or there is no response, we try another one. Children suffering from depression and anxiety may become irritable, withdrawn and inhibited. They may lose their self-confidence. These disorders can affect all aspects of a child’s everyday life at home and school, including peer and other relationships. So, in addition to medication, we recommend parent education, as well as individual and family counseling to address current problems and learn to more effectively deal with future ones. Some school consultation may also be necessary. If you have specific questions, you should discuss them with your mental health provider.

Elly Barua Bhuyan MD, FAPA
Child & Adolescent Psychiatrist
St. Louis County, MO

Want to see other Open Mind columns?  Click here for Archive Index.