In general, antidepressants should be used in children only with great caution. Children may be especially sensitive to side effects associated with Tricyclic antidepressants (TCAs). Common side effects in children include:

• Nervousness
  
  
• Sleeping problems
  
  
• Tiredness
  
  
• Mild stomach upset

In addition, the U.S. Food and Drug Administration (FDA) in 2005 instructed all manufacturers of antidepressants to include new warnings on their labeling about certain dangers associated with these medications. These dangers include increased risk of suicidal thoughts in children and adolescents. According to the results of numerous clinical trials:

• Antidepressants increase the risk of suicidal thoughts in children and adolescents with psychiatric disorders, especially major depressive disorder.
  
  
• Clinicians should carefully weigh the risks of antidepressants with the potential benefits before prescribing them for children and adolescents.
  
  
• Youngsters taking antidepressants should be carefully observed for increased depression, suicidality and other behavioral changes.
  
  
• Families of youngsters taking antidepressants should carefully observe the patient and communicate frequently with the clinician.
  
  
• Parents should consult their child’s physician if they have concerns about their child taking these medications in light of the FDA’s recommendations. 
  
  
• There is little research on the use of antidepressants for childhood pain conditions.  As a result, their use for these conditions cannot be recommended at this time.