Citing a dearth of recent research assessing the use of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) in children and adolescents who have a range of common psychiatric disorders, researchers conducted a systematic review and meta-analysis to evaluate the efficacy and safety of using SSRIs-such as citalopram-and SNRIs-such as duloxetine-in this population. They also sought to measure variations in drug and placebo responses among children and adolescents who have different types of disorders, including depression, anxiety, obsessive-compulsive disorder, and posttraumatic stress disorder. This review included 36 randomized, double-blind, placebo-controlled trials, and 6,778 participants.

The researchers found that SSRIs and SNRIs were more beneficial than placebo in treating these common psychiatric disorders in children and adolescents. The benefits were greater in those who had anxiety disorders than in those who had depression disorders, particularly among those taking SSRIs. Patients receiving any type of antidepressant reported more adverse events (including suicidal thoughts and attempts) and more incidents of study withdrawal compared with those receiving placebo.

The researchers concluded that although these agents can be helpful, the high risk of severe adverse events supports concerns about the safety of antidepressant use in children and adolescents. Understanding the extent to which SSRIs and SNRIs pose a genuine risk to young people, they note, is urgent given this potential for life-threatening adverse drug events.

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