Selective serotonin reuptake inhibitors:: use in children and adolescents with major depressive disorder

Treatment of depression in children and adolescents is a health care question of primary importance and it is presently associated to significant social concern. In recent years some studies have appeared that throw light on the question of the use of antidepressants in these sectors of the population in which they have been used. Information provided by national agencies, associations of health professional's guidelines and other publications have been reviewed. The results show an increase in aggressive and desinhibitional behavior, irritability, self-injuries and an increase in suicidal motivation with the use of antidepressants in children and adolescents. It can be added that no completed suicides have been recorded. Proof of antidepressant effectiveness only appears in the case of fluoxetine for moderate to severe depressions in children and adolescents and for tricyclic antidepressants in adolescents. The important methodological difficulties and the lack of studies only allow to consider the results as exploratory and it is hard to obtain definitive clinical results, however, they are useful to guide future investigation.