Mental health

Antidepressants (Tricyclic Antidepressants, Selective Serotonin Reuptake Inhibitors) in adolescents with depressive episode/disorder

Question 11: Are antidepressants (Tricyclic antidepressants (TCA), Selective serotonin reuptake inhibitors (SSRI)) effective and safe in adolescents with depressive episode/disorder?

Management of child and adolescent mental disorders

  • Population: adolescents with depressive episode/disorder
  • Interventions: antidepressant drugs:
    • tricyclics and related
    • selective serotonin reuptake inhibitors
  • Comparison: placebo
  • Outcomes:
    • reduction of symptoms
    • improvement in functioning
    • acceptability profile
    • adverse effects of treatment (including suicide ideas/ behaviour for SSRIs


Fluoxetine, but not Tricyclic antidepressants (TCA) or other Selective serotonin reuptake inhibitors (SSRI), may be considered as one possible treatment of adolescents with depressive episode in non-specialist settings. Adolescents on fluoxetine should be monitored closely for suicide ideas/behaviour. For all adolescents on fluoxetine, support and supervision from a mental health specialist should be obtained, if available.
Strength of recommendation: STANDARD

Evidence profile