Selective Serotonin Reuptake Inhibitors for Children and Adolescents With Major Depression: Current Controversies and Recommendations

Published safety & efficacy trials of selective serotonin reuptake inhibitors for the treatment of youth with depression were critically reviewed & augmented by information from regulatory hearings in 2003-2004 & selected open-label reports. Based on this review, recommendations for medication treatment & monitoring are provided. Emerging data from several clinical trials show these drugs provide moderate benefits for youth with depression. In addition, selective serotonin reuptake inhibitor treatment may be associated with increased risk of behavioural activation, self-harm, & suicide ideation. Appropriate use requires careful diagnostic assessment, evaluation of comorbidity, & close monitoring, especially early in treatment. (28 refs.) JA