Benefits and risks of using antidepressants in children and adolescents.

The present controversy about the use of selective serotonin re-uptake inhibitors in paediatric patients has been the subject of many publications. This article summarises the available data on the efficacy and safety of selective serotonin re-uptake inhibitors and other non-tricyclic antidepressants in children and adolescents with mental disorders. These data are compared with those related to the efficacy and safety of tricyclic antidepressants. If selective serotonin re-uptake inhibitors appear to be the drugs of choice in depressive and anxiety disorders, their effects are strongest in non-obsessive-compulsive anxiety disorders, intermediate in obsessive-compulsive disorders and more modest in major depressive disorders. All antidepressants may induce psychiatric and suicide-related adverse events. In this respect, the balance of benefit and risk seems to favour fluoxetine as the first-choice antidepressant. Above all, this review emphasises research questions that need to be answered fully about the potential role of antidepressants in the management of children and adolescents with psychiatric disorders. Given these unanswered questions, the use of antidepressant medications in children and adolescents should remain cautious and well monitored.