Background: This review summarizes the published clinical experience with the serotonin selective reuptake inhibitors (SSRIs) in children and adolescents.
Method: A computerized literature search was conducted using MEDLINE back to 1986 to retrieve all reports of SSRI use in children and adolescents. Additional hand searches were performed with key journals. All reports relating clinical experience of SSRIs in children or adolescents were collated according to primary diagnosis.
Results: We found 3 double-blind, placebo-controlled clinical trials (65 patients), 16 open- label trials (322 Patients), and 23 case reports (41 patients) on the use of SSRIs in younger populations. The reports described clinical effects, mostly benefits, for 13 indications. A theoretical rationale exists for use of SSRIs in most conditions for which they are prescribed.
Conclusion: The most convincing evidence for efficacy for SSRIs in adolescents exists for treatment of depression and obsessive-compulsive disorder. Only sparse evidence, mostly anecdotal, exists for efficacy in other conditions. The reported side effects were modest, but behavioral disturbances in some cases limit recommendations and warrant caution for widespread use.