Anyone with experience of teens and antidepressants?

[Hamnet]

I have a 15 year old who I think is depressed. She says she doesn’t enjoy anything any more. She has low self esteem and finds the pressure of school very stressful. She constantly thinks she’s disappointing us.

On the outside she seems fine: she gets up, dressed, never asks for time off school, exercises and hangs out with us in the evening. But she rarely wants to see friends and can be tearful. She says nothing is fun or good anymore. She has self harmed a few times but not many.

She’s seeing a counsellor but so far it hasn’t helped. I just want her to be happy again. Would a GP prescribe ADs in a situation like this and would it be wise?

I’d be really interested in hearing of experience of ADs in teens. Good and bad stories.

Unfortunately general GP’s are not allowed to prescribe antidepressants for under 18’s. It has to be a specialist/psychiatrist from CAMH’s, CEDS or a private psychiatrist. Your GP would need to make a referral to your local CAMH’s team but it is not a given that your DD would meet the criteria for referral and the majority of NHS CAMH’s are stretched beyond capacity, are woefully underfunded and have sickeningly long waiting lists.

DD (15) is on Fluoxetine to help with her crippling anxiety and low mood (they don’t like to call it depression in young people) whilst recovering from an eating disorder. The CEDS psychiatrist was very reluctant to start DD on the medication but it became apparent that the anxiety was preventing her from moving on from her ED. It’s still fairly early days for DD so we are not 100% sure if the AD’s are working just yet. She’s just started on a higher dose so fingers crossed they help.

Thanks @Rollergirl11 that is really helpful information. I had no idea it was so hard to get ADs for teens. I doubt we would get near CAHMS right now as they are so over burdened. My friend whose daughter has anorexia hasn’t even managed to secure a referral. Maybe we should try a private psychiatrist.

I’m sorry that your 15 year old has been struggling too. I hope the ADs aid her recovery.

We saw a private psychiatrist for low mood and OCD. Initially on 20mg of fluoxetine which helped with the anxiety and OCD really dialled it down my DD said. She also has another medication for mood issue but the local GP has agreed to do a shared agreement with the psychiatrist so the medication is on the NHS but backed by the psychiatrist say so.
I’m a genuine medication believer because I have had hormonal imbalances that affect mood and it’s not always due to a psychological trauma it can just be an imbalance. We did have some psychotherapy just to talk through everything but they agreed my DD did not have anything she needed analysing as such. Anyway it was quite expensive but worth every penny and we have had 6 months where she feels loads better but still has some low moods just not as severe.
The teen years can be so hard I feel if she can just have some support though this difficult time it does not have to be forever.
Hope this helps.

My son (14) was prescribed fluoxetine by GP in Sept while we waited for CAMHS to pick him up. GP is amazing and she felt he has anxiety and low mood. He has since taken an overdose twice but in between times I’ve seen an improvement in mood. Sorry to say that I think it’s not CAMHS that have helped, it’s the medication but I think he needs a higher dose now. I’m also looking to go private for MH services as CAMHS can’t provide the help he needs consistently. I hope you can get some help for your daughter OP, it’s such a worrying time as a parent.

@Supervixen80 do you think the suicide attempts are a result of the fluoxetine? They list suicide ideation in young people under 20 as one of the rarer side effects.

I did think that but it’s happened today (currently in A&E waiting for bloods) and also in half term - they say the suicide attempts often happen in first few weeks. Also he seems to be lashing out rather than being actively suicidal, although I could be completely wrong. He doesn’t know how to manage these emotions and he is mixed up with some really toxic friendships, all seem to be encouraging each other in a bizarre competition to have the worst mental health. It’s so hard and I don’t know what I can do to help him anymore.

Gosh @Supervixen80 I’m so sorry. You must be at your wits end. What have CAMH’s said about the suicide attempts? Did they not think it was linked to the fluoxetine? Although yes you’re right they say it will usually be in the first few weeks. What dose is he on? What are CAMH’s doing to help your son? They did nothing to help my DD other than eventually give her some medication. They wouldn’t offer therapy as they say ED sufferers don’t have the capacity to engage until they are weight restored. But my DD really needed help with her intrusive/compulsive thoughts so I took her to a private therapist. I think this is helping DD.

Honestly think CAMHS is not helping I’m sorry to say. The last time they basically blamed me for not hiding the medications - I had some paracetamol around because he fractured his wrist and needed them, and there were no signs at all that he would do this. This time he went to the shop and brought it himself. Again, no warning signs. He doesn’t engage with the safety plan either. He thinks it’s there to make me feel better and not to help him.
I’m glad to hear the private help might be working for your DD. Our teens have such a hard time of it.

Thank you so much for your replies by the way x

My DS15 is on fluoxetine. Our GP fast tracked him to the CAMHs crisis hub at Easter. He was seen very quickly and diagnosed with anxiety and depression.
He was totally unable to access talk based therapy at that point and started the meds. He had a super low dose (liquid) to start so it took many months to hit his optimum dose.
Now he is doing very well. He had some 1:1 therapy through CAMHs and started an online support group but didn't like it.
I'd say our experience doesn't seem to be the norm with CAMHs, maybe we got lucky.

My just 17yo have been on fluoxetine for nearly a year. It has made all the difference. On 40mg dose. Prescribed by private psychiatrist but after first month is on the NHS. On the meds she was able to engage with counselling and having missed y11 is attending college (just about).
In terms of cost going privately it was ~£300 for initial consultation and ~£200 for each review (every 3 months or so.)

Sorry to hear of the difficult times others are having. My DD was referred to CAMHS for low mood, self harm and eating issues (pre Covid though, I think thresholds are higher now). She found the talking therapy completely unhelpful and because she didn’t respond to this, was referred to a psychiatrist who prescribed 20mg fluoxetine (Prozac). It’s been like a miracle for us, it provided the lift she needed so that she could put in self help measures herself, like exercise. She is adamant that medication is what she needed - she’s not one for talking stuff through at all. I’ve got a background in clinical/ research stuff so I found it helpful to look at the NICE guideline on this - the risk of suicidal ideation is small but consistent so I felt you do need to take it seriously. DD said she did feels bit worse initially (increase in suicidal thoughts) but it passed quickly. They start them on a half dose of 10mg which is below treatment threshold so I found that - and the confidence of the psychiatrist in it - very reassuring. Hope that helps and you can teach a better place, it is very tough.

DD ramped up v slowly, starting at 5, then 10, then 15, then 20.
Then she showed some signs which could have been a side effect so was ramped down again while it was checked, but turned out to be something not connected. Then started up again but this time ramped up to 40 which was better, and she has been on that now for 6 months.

No experience but marking thread to come back too