Antidepressants in teens and young adults

The purpose of this activity is to explore methods for building rapport, trust and engagement with young people presenting to primary care with mental health concerns such as anxiety and depression. The role of antidepressants and their clinical efficacy in this younger cohort is examined, and the importance of treatment aligning with best practice guidelines and individual patient needs is discussed.

Mental health conditions are a primary cause of disease burden among young people. In 2020–22, almost 40% of Australians aged 16–24 years reported having experienced a mental health disorder in the past 12 months. This is almost double the national average of 21.5%. The overall prevalence of mental health disorders in this group has increased by nearly 50% in the past 15 years.

In 2022, anxiety (26%) and depression (17%) were the most common mental health and behavioural chronic conditions in people aged 15–24 years. First Nations young people, those from the lesbian, gay, bisexual, transgender, intersex, queer and others community, and those in rural and remote areas are all overrepresented in these statistics but face the greatest barriers to appropriate care.

Antidepressant prescribing in young people has also risen significantly. Pharmaceutical Benefits Scheme data show that over the past decade, use has increased by one-third among individuals aged 18–24 years and by almost 80% among those aged 12–17 years.

Managing anxiety and depression in younger people requires careful consideration of developmental needs and long-term impacts. The consequences of untreated or undertreated mental health conditions can have long-term effects on many facets of young people’s lives, including their education, employment, relationships and physical health.

General practitioners are often the first point of contact for young people and their families and/or carers. Early recognition, comprehensive assessment and collaborative management are key. Clinical guidelines advocate a stepped-care approach, prioritising supportive and non-pharmacological strategies such as lifestyle changes, psychological therapies and social supports. For some, medication such as SSRIs might also be appropriate, forming part of a comprehensive strategy that adopts a broad, developmentally informed and holistic plan.

In this activity, general practitioners explore methods for building rapport, trust and engagement with young people presenting to primary care with mental health concerns such as anxiety and depression. The activity highlights tools to support age-appropriate conversations, establish safety planning and encourage shared decision making to optimise management. This includes emphasising the role of non-pharmacological treatments like improving sleep, promoting exercise, supporting social interventions and using psychological therapies. The role of antidepressants and their clinical efficacy in this younger cohort will also be examined, ensuring that treatment aligns with best practice guidelines and individual patient needs.

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Learning outcomes

At the end of this activity, participants will be able to:

• identify key factors that influence the presentation, diagnosis and management of depression or anxiety in young people
• apply age-appropriate communication strategies to build rapport and support shared decision making when discussing treatment options for depression or anxiety with young people
• assess the evidence for the effectiveness of antidepressants and evaluate the risks associated with prescribing antidepressants for young people with depression or anxiety
• implement individualised management plans for depression or anxiety that include non-pharmacological strategies and treatment goals
• establish processes for regular review and monitoring to optimise management, minimise potential harms and support deprescribing, when appropriate.

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Case studies

Below is a list of the case studies found in this month's edition of check. To see how these case studies unfold and gain valuable insights into this month's topic, log into gplearning to complete the course. 

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