Antidepressants and Pediatric Depression — The Risk of Doing Nothing

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There is great concern that antidepressants used in children and adolescents may paradoxically increase their risk of suicidal thoughts and behavior. Is this concern valid, and if so, how should it modify our clinical approach to pediatric depression?Twenty-five years ago, long before the introduction of selective serotonin-reuptake inhibitors (SSRIs), the adolescent suicide rate was increasing rapidly, having tripled over the previous two decades, but the risk factors involved were unknown. Adolescents who committed suicide were regarded as misunderstood teenagers who had been under too much stress. There was debate about whether depression could occur in children, and the prevailing . . .