Although in the past there were objections against the use of selective serotonin reuptake inhibitors (SSRIs) for the treatment of depression in children and adolescents, recent studies have shown that SSRIs, in particular fluoxetine, are effective against depression in this age group. Cognitive behavioural therapy has a questionable effect in children and adolescents with severe depression. Other unequivocally effective treatment options are not available. More suicidal behaviour was reported in children and adolescents using sertraline or venlafaxine, but fluoxetine did not clearly enhance this behaviour. Children with severe depression or a depression not responding to psychological therapy can be treated with SSRIs. Fluoxetine is the treatment of first choice.

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