Depression in pregnant adolescents: considerations for treatment.

Pregnancy in adolescents continues to be a major public health concern in the US. Depression in adolescent females, is also a major health concern. Adolescence is a time of rapid metabolic, hormonal, physiologic, and developmental changes, and when the physiologic and psychological changes that occur during pregnancy are superimposed upon normal developmental changes, a complex medical picture may emerge which can include depressive symptomatology. Treating depression in the pregnant adolescent is complex due to the concerns about the use of selective serotonin reuptake inhibitors (SSRIs) in any pregnant woman, the fact that only one SSRI (fluoxetine) is FDA-approved for depression in the pediatric population, the concern over the black box warning for antidepressants in the pediatric population, and the reality that untreated depression in pregnancy has been shown to be associated with poor outcomes for both mother and baby. This article discusses these concerns and provides some recommendations/considerations for treatment of depression in pregnant adolescents.