Child and Adolescent Depression: Should Antidepressants Be Used in Treatment?

This paper examines the controversy over the use of selective serotonin-reuptake inhibitors (SSRIs) in the treatment of children and adolescents. Arguments for and against the use of SSRIs with pediatric populations are evaluated. Supporting SSRI treatment are findings that SSRIs are effective, the potential accessibility of medication, and findings that SSRIs have played a role in the overall decline in adolescent suicide rates. Arguments against the use of SSRIs among child and adolescent populations include findings of associated increases in suicidality and of potential impulsivity and violence in response to the medication. Arguments against treating children and adolescents with SSRIs also include the complications of side effects, dosage, and duration of treatment, and concerns over an approach limited to the neurobiological level. The role of psychotherapy, both alone and in combination with SSRI treatment is discussed.