Posted by ed_uk2010 on December 11, 2011, at 15:02:24
In reply to 15 yr. old nephew pot addict and depressed. How, posted by Laney on December 11, 2011, at 14:19:21
> likely is an AD going to work for him while he is self medicating numerous times per day and getting worse with increased dose of citalopram.
>
> Thanks!
>
> LaneyTo be honest, it is not very likely.
The efficacy of antidepressants in the <16 age group is normally poor. Fluoxetine and escitalopram have shown marginally better activity than placebo in some, but not all trials. Other ADs have not shown efficacy, and psychiatric adverse effects such as aggression, agitation, aggravation of depression, impulsive behaviour, suicidal thoughts and hypomania appear to be a lot more common in children than in adults. If the citalopram is making him feel worse, it will need to be tapered off.
This is not to say that he cannot be treated, it's just that the focus at this stage should not be too centered on medication. In order to get better, he will most likely need a support program which involves a combination of psychological therapy and help to reduce his drug usage. He may benefit from additional support at school, if this is possible.
Also, severe depression in young people is sometimes the presenting symptom of bipolar disorder, especially if there is a family history. This is just one thing to consider.
Hope this helps.
poster:ed_uk2010
thread:1004677
URL: http://www.dr-bob.org/babble/20111208/msgs/1004686.html