Updated June 09, 2015.

Each child should be carefully and thoroughly evaluated by a physician to determine if medication is appropriate. Those who are prescribed an SSRI should receive ongoing medical monitoring, with particular care paid in the first few weeks of taking the drug.

Should nervousness, agitation, irritability, mood instability, or sleeplessness emerge or worsen during treatment with SSRIs, parents should obtain a prompt evaluation by a clinician with expertise in these medications.

Children already on any of the SSRIs should remain on the drug if it has been helpful but they should also be carefully monitored by a physician for evidence of side effects. Once started, treatment with these medications should not be abruptly stopped, because the body can react with further agitation and restlessness. Families should not discontinue treatment without consulting with their physician. All potentially effective treatments can be associated with side effects. A careful weighing of risks and benefits, with appropriate follow-up to help reduce risks, is the best that can be currently recommended.

What NIMH Is Doing

NIMH is conducting research to help clarify the potential value and risks of antidepressants, and to explore how medications compare with psychotherapy in adolescent depression. In particular, an NIMH-funded, multi-site controlled clinical trial, the Treatment for Adolescents with Depression Study (TADS), was launched in the late 1990s to directly compare the efficacy of fluoxetine, cognitive-behavioral therapy, and a combination of the two.

Results are expected later in 2004.

Other studies are in progress to test the efficacy and safety of both medications and psychotherapy for youths with treatment-resistant depression and youths at increased risk for suicide attempts.

For more information on this topic, see: Antidepressant Medications in Children. Vitiello, B, Swedo, S. National Institute of Mental Health, Bethesda, MD. New England Journal of Medicine Apr 8;350(15):1489-91.

The SSRIs (serotonin reuptake inhibitors) include:

• fluoxetine (Prozac)
• sertraline (Zoloft)
• paroxetine (Paxil)
• citalopram (Celexa)
• escitalopram (Lexapro)
• fluvoxamine (Luvox)
• venlafaxine (Effexor)?another antidepressant closely related to the SSRIs
  Content reviewed and updated 11/5/05