Experts Answer Your Questions on Antidepressants

April 19, 2007 — -- Previously on "World News With Charles Gibson," we asked you for your questions about antidepressant use in adolescents. Here are some of the questions we received on our message board, with answers from two depression experts.

Dr. John Constantino is an associate professor of Psychiatry and Pediatrics at Washington University School of Medicine.

Dr. Richard D. Todd is professor of Psychiatry and Genetics and director of the Division of Child Psychiatry at Washington University School of Medicine.

Question From WorriedDad:

My 10-year-old daughter has been on Zoloft for over two years, even though I have expressed concerns. She has never been depressed. She has gained an abnormal amount of weight. I worry about all the other side effects besides suicide. No tests are run by the doctor who prescribes this medication to check on what this is doing to her physically. What can I do?

Answer:

Although there are no standard tests for physiologic response to antidepressant medications, excessive weight gain is important to take seriously.

It would be reasonable to discuss these concerns with her doctor and for her doctor to consider tests of her thyroid and liver function, as well as to consider a discontinuation trial of the medication given her relatively young age and the duration of time on the medication.

Zoloft is a medication that treats not only depressive symptoms but also anxiety-related symptoms and obsessional symptoms. If her doctor's clinical judgment is that she is not depressed because she has been on the medication all this time, it is important to consider that and to watch closely for any deterioration in her condition if a discontinuation trial is pursued.

Another important option for her if she needs the Zoloft is to switch to a "sister" medication in Zoloft's class, which might be less likely to incur weight gain. Fluoxetine, Duloxetine and escitralopram would all be worth considering on that basis.

Question from subodot:

My question has to do with the 39 percent that improved on placebo pills. This culture wants a magic bullet for everything -- I've known people who were prescribed Prozac as part of a weight loss diet.