Hello XXXXXXX,
Welcome to Healthcare Magic and thanks for your query.

I understand your concerns regarding your brother's child's treatment. I shall clarify all your doubts.

1) Feliz-S is the brand name for a medication called "Escitalopram", which is an anti-depressant belonging to a class called SSRIs (Selective Serotonin Re-uptake Inhibitors). Antidep is the brand name for a medication called "Imipramine", which is also an anti-depressant belonging to a class called TCAs (Tricyclic Antidepressants). Like any medication, antidepressants can also have some side effects. But comparatively, Feliz-S is a safer medication with relatively minimal side effects. Some of the common side effects which it can cause are sleep disturbances, gastric symptoms like indigestion, nausea, poor appetite, etc., temporary increase in anxiety (usually subsides withing 2 weeks), sexual problems like erectile dysfunction, delayed ejaculation, etc. Antidep can cause some side effects like sedation, drowsiness, nausea, vomiting, dry mouth, blurred vision, constipation, urinary retention, etc. Now, these are just a list of side effects and does not mean that everyone will have them. Also, most of the side effects are mild, temporary and usually subside on their own within a few weeks. SSRI antidepressants (including Feliz-S) have to be used with caution in children and adolescents, since some studies have shown evidence that they can increase suicidal ideas. Please don't be alarmed by this because this risk is very minimal and it doesn't mean that these medication should not be used in children. The benefits which these medication give when used appropriately significantly outweighs the minimal side effects and risks involved.

2) Typically, these medications are considered as non-addictive, but if taken for a long period of time, there can be some discontinuation symptoms. The common discontinuation symptoms are increased anxiety, restlessness, irritability, sleep disturbances, dizziness, rebound depression, etc.

3) It is not advisable to stop the medication suddenly because it can cause discontinuation symptoms or sometimes cause a rebound of his previous problems. Even if a decision is made to stop the medication, this has to be done very gradually - probably over a few months period.

4) The decision about the how long to continue treatment will depend on a variety of factors like type and severity of the initial problem, treatment response, current functional state, etc. It is extremely unlikely that he will have to continue the medication for life. Usually, for mild to moderate problems, we advise a minimum duration of treatment of 6 months to 1 year, after which, if the patient is doing well, then medication can be gradually decreased and stopped.

5) These medication does not cause any permanent adverse effects and there will not be any health problems in future like sexual dysfunction due to the medication. So, you don't have to worry about any long term or permanent effects due to the medication.

6) These medication have an effect on mood and behaviour (this is often a beneficial effect). These medication may change only the abnormal mood and behaviour symptoms, which depends on the type and severity of the psychiatric problem. They don't cause any change in normal mood and behaviour on their own.

7) Behavioural and emotional problems are very common in childhood. Some children, who have significant problems may need medication to control these symptoms for a temporary period of time, till they gradually normalize. Even in these cases, if appropriate treatment is given promptly and if the parents follow proper parenting techniques and ensure a supportive environment for the child to grow up, then there will be normal childhood development and he will grow into a normal adult.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist

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