Explain adolescent depression and fluoxetine plan to a parent — CASC communication station

Open. Name time; ask mother's main fears first (addiction, personality, suicide warning). Validate concern; state shared goal of safety and recovery.[3]

Explain diagnosis. "Major depression is a medical syndrome — persistent low or irritable mood and loss of pleasure plus changes in sleep, energy, concentration and self-view lasting weeks, severe enough to affect school and life. It is common in teenagers and treatable. It is not weakness or bad parenting alone."[4]

Explain plan. CBT skills plus medication often work better together for moderate depression (TADS-style combination rationale). Fluoxetine is the best-studied antidepressant for young people. Start low (about 10 mg then 20 mg daily). Benefits build over weeks; early nausea or headache may settle. We review soon because a small number of young people feel more agitated or have more suicidal thoughts after starting — if that happens, contact us or emergency services the same day. Antidepressants are not intoxicating addictions like alcohol, but we plan duration and do not stop abruptly later without advice.[1][2][3]

Black-box in absolute terms. Studies found a small increase in reported suicidal thoughts or behaviours on antidepressants versus sugar pill in short paediatric trials; they did not show that most young people become suicidal, and untreated depression itself carries suicide risk. Our response is closer follow-up and a written safety plan, including locking surplus medication.[2][3]

Confidentiality. We will see your child alone at times; we keep private what we can, but if safety is at risk we will share what is needed with you and services — we will try to do that with your child's knowledge.[3][4]

Close. Summarise, teach-back, written info and crisis numbers, book early review, offer school liaison letter with consent.[3]