Medication Consultation for Anxiety and Depression in Teens

Medication consultation

Is Liyou suitable for adolescents under 18? Should it be taken 1 hour before bedtime? It is classified as a selective serotonin reuptake inhibitor (SSRI), which aims to increase serotonin levels, correct? Why is it called a reuptake inhibitor? My condition includes anxiety and mild depression, particularly with fear in subjects I struggle with and social interactions, leading to nausea, difficulty concentrating, and impaired understanding.
I also have poor sleep quality, waking up in the middle of the night and unable to fall back asleep.
Am I suitable for Liyou or should I consider Lexapro instead? Is Lexapro a sleeping medication that could lead to drug dependence? Which one would be better for me? Is it necessary to take medication?

Youxin, 10~19 year old female. Ask Date: 2021/09/04

Dr. Peng Liyun reply Psychiatry

Hello~ I can sense your anxiety regarding medication, but most questions require an in-person consultation for a comprehensive assessment, such as which medication is suitable for you or whether you absolutely need to take medication, etc.
I can explain that the mechanism of selective serotonin reuptake inhibitors (SSRIs) involves inhibiting the reabsorption of serotonin at the synaptic receptors, which increases the concentration of serotonin in the synaptic cleft.
Lexapro is not classified as a sleep aid; it is a type of anxiolytic, which carries a risk of dependence.
For other concerns, I recommend returning to your physician for further discussion or seeking a more trusted doctor for treatment.
Thank you for your inquiry! Peng Li-Yun, Department of Child and Adolescent Psychiatry, Chia Nan Psychiatric Hospital.

Reply Date: 2021/09/04

More Info

When it comes to treating anxiety and depression in teenagers, it's essential to approach the situation with care and a comprehensive understanding of the medications available. You mentioned "離憂" (Liyou) and "樂力靜" (Lelixin), which are commonly prescribed medications for anxiety and depression. Let's break down your questions and concerns regarding these medications and their suitability for someone under 18.

1. Suitability of Liyou for Teens:
Liyou, which is a selective serotonin reuptake inhibitor (SSRI), is often prescribed to help increase serotonin levels in the brain. Serotonin is a neurotransmitter that plays a crucial role in mood regulation. By inhibiting the reabsorption (or reuptake) of serotonin, these medications allow more serotonin to remain available in the synaptic cleft, which can help improve mood and reduce anxiety. SSRIs like Liyou can be effective for treating anxiety and depression in adolescents, but they must be prescribed and monitored by a qualified healthcare professional.

2. Understanding Reuptake Inhibition:
The term "reuptake inhibition" refers to the process where the medication prevents the reabsorption of serotonin back into the presynaptic neuron after it has been released. This means that more serotonin remains available to bind to the receptors on the postsynaptic neuron, which can enhance mood and alleviate symptoms of anxiety and depression.

3. Your Symptoms and Medication Choice:
Given your symptoms of anxiety, fear of social interactions, and sleep disturbances, it is crucial to have a thorough evaluation by a psychiatrist or a healthcare provider. They can assess whether Liyou or another medication like "樂力靜" (which may be a sedative or anxiolytic) is more appropriate for your specific situation. While Liyou can help with both anxiety and depression, "樂力靜" may be more focused on alleviating anxiety and promoting sleep. However, it is important to note that some sedative medications can lead to dependence if used long-term.

4. Concerns About Medication Dependence:
You expressed concern about "樂力靜" being an anxiolytic that could lead to dependency. This is a valid concern, especially for younger individuals. While these medications can be effective for short-term relief of anxiety symptoms, they should be used cautiously and typically not as a first-line treatment for long-term management. SSRIs like Liyou are generally preferred for long-term treatment of anxiety and depression because they do not carry the same risk of dependence.

5. Is Medication Necessary?
The decision to start medication should be made collaboratively with your healthcare provider. It is essential to weigh the benefits and potential side effects. In many cases, a combination of therapy (such as cognitive-behavioral therapy) and medication can provide the best outcomes for managing anxiety and depression. Lifestyle changes, such as regular exercise, a healthy diet, and good sleep hygiene, can also play a significant role in improving mental health.

6. Final Thoughts:
In conclusion, both Liyou and "樂力靜" have their roles in treating anxiety and depression, but the choice between them should be based on a thorough evaluation of your symptoms and needs. It is crucial to have open communication with your healthcare provider about your concerns regarding side effects, dependency, and the overall treatment plan. Remember, you are not alone in this journey, and seeking help is a positive step toward feeling better.

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