How Long Should Teens Remain On Medication

Once your child is on the right dose and some benefit is observed, it is usually worth continuing the medication for at least six months to one year. There is some evidence that a year may be preferable, to reduce the risk of relapse if your child is still in a depressive episode at six months. Then, an attempt to taper the medication (decreasing the dose very gradually) can be made, especially if your child has devel­oped coping skills from a cognitive-behavioral psychotherapy program. The goal is to have your child on the minimum dose needed. In some children, the medication can be discontinued at this point, while others require medication longer term. Tapering is usually best done at a time of average life stress, to minimize the risk of relapse. If your child grows or encounters a greater-than-average degree of life stress, a dosage increase may be needed.

Long-term effects of SSRIs in children and teens are not well studied. These medications have not yet been used in children long enough for such studies to have been done. Adults sometimes develop an apathetic state termed "amotivational syndrome" and there are case reports of this syndrome in adolescents, but it tends to resolve with dosage reduction. Several children and teens at our centre have required SSPds for more than a couple of years, and "so far so good." They seem to grow and develop normally. There is even some animal evidence that SSRIs may increase the body's ability to produce serotonin in the brain, but this has not yet been studied in humans.



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