Nontricyclic antidepressants: Current trends in children and adolescents

Objectives: First, to review the extant data on the safety and efficacy of the use of nontricyclic antidepressants in children and adolescents; second , to identify the main limitations of our current knowledge in this area; a nd third, to point to future research directions. Method: A Medline search and a review of previous scientific meetings were conducted; all available reports on the efficacy and safety of nontricyclic antidepressants in child ren and adolescents were critically reviewed. Results: As in adults, also i n children nontricyclic antidepressants are potentially useful in treating a variety of psychiatric disorders. The data supporting their efficacy, how ever, are quite limited. Obsessive-compulsive disorder is the only psychiat ric diagnosis for which pediatric use of selective serotonin reuptake inhib itors has been approved. One placebo-controlled study in children and adole scents with major depression supports the efficacy of fluoxetine. Other cli nical trials of nontricyclic antidepressants in depressed adolescents are i n progress. Available data indicate that the safety of these medications is good, at least in the short term. Conclusions: The potential usefulness of nontricyclic antidepressants for children and adolescents suffering from a range of disorders is considerable. While information from adults can sugg est potential areas of possible efficacy in pediatric patients suffering fr om similar psychopathology, further research is essential to provide the ne cessary information on the efficacy, safety, and pharmacokinetics of these medications in children and adolescents.