Children and young people
Children and young people with moderate to severe depression should first be offered a course of psychotherapy that lasts for at least 3 months.
In some cases, an SSRI called fluoxetine may be offered in combination with psychotherapy to treat moderate to severe depression in young people aged 12 to 18.
Other mental health conditions
Antidepressants can also be used to help treat other mental health conditions, including:
- anxiety disorder
- obsessive compulsive disorder (OCD)
- panic disorder
- serious phobias, such as agoraphobia and social phobia
- post-traumatic stress disorder (PTSD)
As with depression, SSRIs are usually the first choice of treatment for these conditions. If SSRIs prove ineffective, another type of antidepressant can be used.
Even though a type of antidepressant called tricyclic antidepressants (TCAs) weren't originally designed to be painkillers, there's evidence to suggest they're effective in treating chronic (long-term) nerve pain in some people.
Chronic nerve pain, also known as neuropathic pain, is caused by nerve damage or other problems with the nerves, and is often unresponsive to regular painkillers, such as paracetamol.
Amitriptyline is a TCA that's usually used to treat neuropathic pain. Conditions that may benefit from treatment with amitriptyline include:
- complex regional pain syndrome
- peripheral neuropathy
- multiple sclerosis (MS)
- conditions where a nerve becomes trapped, such as sciatica
Antidepressants have also been used to treat cases of chronic pain that don't involve nerves (non-neuropathic pain). However, they're thought to be less effective for this purpose. As well as TCAs, SSRIs and serotonin-noradrenaline reuptake inhibitors (SNRIs) can also be used to treat chronic non-neuropathic pain.
Bedwetting in children
TCAs are sometimes used to treat bedwetting in children, as they can help relax the muscles of the bladder. This increases bladder capacity and reduces the urge to urinate.