Fluoxetine and Sertraline Inhibit Height Growth and Growth Hormone Signaling During Puberty

Area of Science:

• Pediatric Endocrinology
• Pharmacology
• Child Development

Background:

• Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for pediatric depression.
• Pubertal growth is a critical period for development, influenced by various hormonal and environmental factors.
• Potential impacts of SSRIs on growth and endocrine function in children require thorough investigation.

Purpose of the Study:

• To investigate the effects of fluoxetine and sertraline on height growth in pubertal children.
• To assess the relationship between SSRI treatment and insulin-like growth factor-1 (IGF-1) levels during puberty.

Main Methods:

• A 6-month cohort study involving 8- to 15-year-old participants initiating fluoxetine or sertraline.
• Exclusion of participants with conditions affecting growth; confirmation of sexual maturation stages 2-4.
• Anthropometric assessments and phlebotomy were performed; a control group of unmedicated children was included.

Main Results:

• SSRI treatment was associated with reduced height gain in a dose-dependent manner compared to unmedicated children.
• Both fluoxetine and sertraline showed similar effects on height growth.
• SSRI dosage was inversely correlated with IGF-1 levels, but not insulin growth factor binding protein-3.
• Body mass index Z-score increased with SSRI treatment, with a more significant increase observed with sertraline.

Conclusions:

• Fluoxetine and sertraline can decrease height gain and IGF-1 concentration in children during puberty.
• The observed effects on growth and IGF-1 are dose-dependent.
• Further long-term studies are recommended to fully understand the implications of SSRI use on pediatric growth.