Antidepressants for functional gastrointestinal disorders in children.

QUESTION Functional gastrointestinal disorders (FGIDs) are complex conditions I see in some of my pediatric patients. The indications for antidepressants such as selective serotonin reuptake inhibitors (SSRIs) do not include treatment of FGIDs; however, some children are prescribed SSRIs for this condition. Are antidepressants effective and safe to use for treating FGIDs in children and adolescents? ANSWER The pathogenesis of FGIDs is largely idiopathic, and although theories exist to explain why SSRIs might be used to treat FGIDs, there is no conclusive evidence of their effectiveness. No large, well controlled studies have investigated the use of SSRIs to treat FGIDs in the pediatric population. There is also evidence that suggests an increased risk of suicidal thoughts when adolescents use SSRIs. Currently, there is no recommendation to use SSRIs to treat FGIDs in children.