Selective serotonin reuptake inhibitors and depression in the child and adolescent

Child and adolescent depression is a serious psychiatric disorder with a considerable impact on psychosocial functioning, and an associated risk of mortality due to suicide. The potential interest of selective serotonin reuptake inhibitors (SSRI) for child and adolescent depression treatment is now well recognized. Since a recent date, this class of antidepressants is recommended as first-line medication (18, 24). Open studies have shown a response rate to SSRI from 60% to 75% and their efficiency was demonstrated through a controlled trial of high methodological quality, conducted by Emslie et al. in 1997 (10). The side effects of SSRI are generally mild and seldom require to discontinue the treatment. Research on this domain is tending toward increasing data on the efficacy, safety and pharmacokinetics of SSRI on children and adolescents. The different SSRI specificities and the potentialisation of these compounds by a molecule of the same class, or by other medications (lithium, buspirone, triodothyronine), are currently studied. It seems useful to us to do a review of this category of antidepressants, even though data are incomplete; it has not gone through AMM approval in children below the age of 15, but it appears to be efficient and promising.