Antidepressant drugs are not licensed for the treatment of depression in children under 16 years old.
The NICE guidelines on depression in children and young people, published in September 2005, recommend that antidepressants should only be given to children in combination with psychological therapies unless these are refused.
The only antidepressant that should be used initially is fluoxetine (Prozac) because this is the only one whose benefits outweigh its possible harms in children. Fluoxetine should be prescribed by a child psychiatrist. If fluoxetine cannot be used, citalopram or sertraline may be tried. Paroxetine, venlafaxine, St John’s wort and tricyclic antidepressants should not be used.
Antidepressants are not tested in children and when used they should be started cautiously at a dose appropriate to the child’s size. Due to reported cases of suicidal thoughts, suicide, self-harm and violence – especially by young people taking these drugs – children should be carefully monitored, especially in the initial stages of treatment.