Abstract
Reviews the use of antidepressant medications in the treatment of child and adolescent psychopathology. Antidepressants have been used in the treatment of attention deficit hyperactivity disorder (ADHD), as well as in child and adolescent major affective disorder. Despite reports of a positive response of depressed children to antidepressants in open trials, controlled studies of these drugs have generally been negative. Possible reasons for this finding (which conflicts with the well-established efficacy of antidepressants in depressed adults) are discussed. In contrast, antidepressants have been shown to be superior to placebo, although not as effective as stimulants, in the treatment of ADHD. Recent issues regarding the cardiac effects of tricyclic antidepressants are discussed. Guidelines for the clinical use of antidepressants in ADHD and major affective disorders of childhood are proposed.

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