Use of SSRIs to Treat Pediatric Anxiety And Depression

The safety and effectiveness of selective serotonin reuptake inhibitors, or SSRIs, for the treatment of depression in children and adolescents continues to be highly controversial.

"The myths and misconceptions about SSRIs will leave millions of children and adolescents untreated and at risk for adverse outcomes. It is time for the public to understand the science of SSRIs and the facts and knowledge the field has obtained from scientifically sound research studies," says journal Editor Harold S. Koplewicz, M.D., Director, Child Study Center, and Vice Chairman, Department of Psychiatry, New York University School of Medicine, and Director, Division of Child and Adolescent Psychiatry, Bellevue Hospital Center.

SSRIs have been shown to be effective in treating a variety of psychiatric disorders in children and adolescents, including major depressive disorder, anxiety disorders, and obsessive-compulsive disorder. When administered properly they are both safe and effective. However, recent warnings about an increased risk for suicidal ideation and attempts associated with SSRI use continue to fuel this ongoing debate.

"Once hailed by some as a panacea and at times casually prescribed as if devoid of any risk, later demonized by others as toxic agents of questionable utility, SSRIs are neither," writes Guest Editor Benedetto Vitiello, M.D., Branch Chief, Child and Adolescent Treatment and Preventive Intervention Research Branch, National Institute of Mental Health, NIH, Bethesda, MD. "...reports from drug prescription data show a decline of up to 20% in the pediatric use of antidepressants," says Vitiello, which "may mean that more youths with depression or anxiety disorders are left untreated."

The effects of the ongoing SSRI controversy, both positive and negative, are evaluated, discussed, and debated in a special compendium of papers in the February/April double issue (Volume 16, Number 1/2) of Journal of Child and Adolescent Psychopharmacology.

Vitiello B.
Editorial: Selective Serotonin Reuptake Inhibitors (SSRIs) in Children and Adolescents
J Child Adolesc Psychopharmacol Mar 2006, 16(1-2): vii. [Full text ( 4 pages : 37KB)]

Kratochvil CJ, Vitiello B, Walkup J, Emslie G, Waslick BD, Weller EB, Burke WJ, March JS.
Selective serotonin reuptake inhibitors in pediatric depression: is the balance between benefits and risks favorable?
J Child Adolesc Psychopharmacol. 2006;16(1-2):11-24. [Abstract | Full text ( 14 pages : 114KB)]

Mosholder AD, Willy M.
Suicidal Adverse Events in Pediatric Randomized, Controlled Clinical Trials of Antidepressant Drugs Are Associated with Active Drug Treatment: A Meta-Analysis.
J Child Adolesc Psychopharmacol. 2006;16(1-2):25-32. [Abstract | Full text ( 8 pages : 78KB)]

Mosholder AD, Pamer CA.
Postmarketing surveillance of suicidal adverse events with pediatric use of antidepressants.
J Child Adolesc Psychopharmacol. 2006;16(1-2):33-6. [Abstract | Full text ( 4 pages : 67KB)]

Wallace AE, Neily J, Weeks WB, Friedman MJ.
A cumulative meta-analysis of selective serotonin reuptake inhibitors in pediatric depression: did unpublished studies influence the efficacy/safety debate?
J Child Adolesc Psychopharmacol. 2006;16(1-2):37-58. [Abstract | Full text ( 22 pages : 170KB)]

Berard R, Fong R, Carpenter DJ, Thomason C, Wilkinson C.
An international, multicenter, placebo-controlled trial of paroxetine in adolescents with major depressive disorder.
J Child Adolesc Psychopharmacol. 2006;16(1-2):59-75. [Abstract | Full text ( 18 pages : 138KB)]

Apter A, Lipschitz A, Fong R, Carpenter DJ, Krulewicz S, Davies JT, Wilkinson C, Perera P, Metz A.
Evaluation of suicidal thoughts and behaviors in children and adolescents taking paroxetine.
J Child Adolesc Psychopharmacol. 2006;16(1-2):77-90. [Abstract | Full text ( 14 pages : 114KB)]

March JS, Klee BJ, Kremer CM.
Treatment benefit and the risk of suicidality in multicenter, randomized, controlled trials of sertraline in children and adolescents.
J Child Adolesc Psychopharmacol. 2006;16(1-2):91-102. [Abstract | Full text ( 12 pages : 101KB)]

Gualtieri CT, Johnson LG.
Antidepressant side effects in children and adolescents.
J Child Adolesc Psychopharmacol. 2006;16(1-2):147-57. [Abstract | Full text ( 12 pages : 99KB)]

Safer DJ, Zito JM.
Treatment-Emergent Adverse Events from Selective Serotonin Reuptake Inhibitors by Age Group: Children versus Adolescents.
J Child Adolesc Psychopharmacol. 2006;16(1-2):159-69. [Abstract | Full text ( 12 pages : 117KB)]

Seidel L, Walkup JT.
Selective serotonin reuptake inhibitor use in the treatment of the pediatric non-obsessive-compulsive disorder anxiety disorders.
J Child Adolesc Psychopharmacol. 2006;16(1-2):171-9. [Abstract | Full text ( 10 pages : 95KB)]