Antidepressant Use On the Rise Among Young People, What to Know

The AAP study adds to a growing body of evidence demonstrating an increase in mental health concerns among young adults and teens.

Before the COVID-19 pandemic, rates of depression and suicidal ideation among young people were already rising. These rates increased further from 2020 onward and have extended beyond the pandemic.

During the pandemic, social isolation and academic disruption, loss of parents or caregivers to COVID-19, unemployment in the family, or being victims of physical or emotional abuse at home are considered possible factors driving the increase in mental health disorders.

“Prior research has provided evidence that the stress, adversities, and social disruptions of the pandemic have contributed to a rise in mental health challenges and service needs for U.S. adolescents and young adults,” said Dr. Mark Olfson, MPH, professor of Epidemiology at Columbia University Mailman School of Public Health and professor of Psychiatry at Columbia University Irving Medical Center.

“With the onset of the pandemic, mental health services quickly pivoted to telemental health. For some young people, this provided a more convenient, private, and less stigmatizing means of providing mental healthcare, including initiation and monitoring treatment with antidepressant medications,” Olfson added.

Post-pandemic, young people are grappling with mounting concerns about social media use, mass violence, natural disasters, and climate change, explained Dr. Lokesh Shahani, MPH, a psychiatrist with UTHealth Houston.

“Antidepressants are important in the management of depression and anxiety in adolescents and young adults,” Shahani told Healthline. “The rise in antidepressant prescription is related to the rise in the prevalence of mental health conditions, as well as the receipt of care for these conditions.”

The new study indicates that female teens were far more likely to be prescribed antidepressants than males.

“The onset of depressive disorders peaks during puberty, and depression is known to be roughly twice as common among females than males after puberty, but not before when the prevalence is approximately equal for females and males,” Olfson explained.

Another plausible explanation, experts say, is that young males may be less likely to seek out and receive care for mental health symptoms compared to females.

Future research should investigate whether the decrease in antidepressant dispensing among male teens reflects the underuse of these medications relative to the level of need, Shahani said.

Olfson noted that telemental health, which became available at scale during the pandemic, may be more widely acceptable and used by young females than males.

“In the years leading up to the pandemic, there is evidence that while rates of depression were increasing among young people, little progress was made on closing the gap of unmet need for depression treatment among young people in the United States,” Olfson said.

“It is possible, but has not been established, that telemental health has helped to narrow the gap in unmet need for mental health treatment.”

Antidepressants are generally well tolerated with minimal adverse effects that tend to be dose-dependent.

Most antidepressant side effects are mild and subside within 1 to 2 weeks or with a reduction in dosage, Shahani explained, noting that common side effects may include:

• abdominal pain
• nausea
• diarrhea
• agitation
• jitteriness
• headache
• sleep changes

Serious adverse events from antidepressants are rare but may occur in some people.

For reasons that are not well understood, antidepressants may trigger an increase in suicidal thoughts and behaviors among a small percentage of young people. However, Olfson noted this risk appears to be highest early in treatment.

“With the increased use of antidepressants by young people, especially adolescent girls and young women, there is a need for careful vigilance concerning emerging suicidal symptoms so that appropriate support can be provided to young people who develop suicidal symptoms during antidepressant treatment,” he said.

Shahani added there’s a potential for increased suicidal ideation and behavior in pediatric patients who initiate treatment with antidepressants or with dose increases or decreases.

Antidepressants may also have adverse effects on people with bipolar disorder.

“The risk of patients with bipolar disorder switching from major depression to hypomania or mania due to treatment with antidepressants [also] needs to be considered,” Shahani said.

Lastly, people taking antidepressants should also be aware of potential drug interactions. Always consult with a healthcare professional before starting antidepressants.

According to a new study, antidepressant use among young adults and teens rose nearly 64% from 2020 onward.

The rate of antidepressant dispensing was different among males and females. After 2020, the rate of antidepressant use increased significantly for young females, whereas the rate decreased for young males.

Experts suggest potential causes for this increase could be pandemic-related stress and anxiety and pre-existing mental health issues that became exacerbated.

Additionally, more awareness of mental health issues and better access to mental healthcare resources could also be contributing factors.