When should GPs prescribe SSRIs for adolescent depression?

Depression is a common disorder, increasing in prevalence in all ages. Research on the effective treatment of adolescent depression is lacking. Concern is growing about the recent increase in general practitioner prescribing of antidepressants and reports that selective serotonin reuptake inhibitors (SSRIs) may precipitate suicidal behaviour in adolescents.

This article discusses the importance of recognising and treating adolescent depression, methodological issues in research and recommendations for SSRI prescribing by Australian GPs.

The lack of access to the mental health services and harmful effects of untreated adolescent depression are a cause for concern. On the balance of current information, the only SSRI Australian GPs may prescribe for the treatment of depression in adolescents is fluoxetine, and then only where cognitive behavioural therapy has failed or the depression is life threatening. The key to successful antidepressant drug treatment in adolescents is frequent review to monitor response, compliance and side effects.