Antidepressants and Adolescent Brain Development

Emily Karanges; Iain S McGregor


Future Neurology. 2011;6(6):783-808. 

In This Article


Despite their status as the current treatment of choice for depressive and anxiety disorders in children and adolescents, many questions remain concerning the efficacy and safety of SSRIs in this population. Given the malleability of the adolescent brain to environmental stimuli, exposure to psychotropic drugs during this developmental period can have unexpected short-term and enduring neural consequences. Indeed, studies in laboratory animals demonstrate a myriad of differences between the adult and adolescent neural response to SSRIs. Most notable are the age-specific alterations in monoaminergic components. Differential effects on the serotonin system (such as regional 5-HTT upregulation and the absence of typical desensitization in serotonergic receptor function) likely underlie differential dopaminergic and noradrenergic responses. Antidepressant administration during adolescence may also modify normal developmental neurotrophic processes, having lasting effects on the maturation of the brain regions involved in emotional regulation. However, the nature of these effects may be moderated by genetic and environmental factors including early life experiences, sex and coexisting psychopathology. In the absence of more certain conclusions on the short-term and enduring behavioral and neural consequences of antidepressant exposure during adolescence, the treatment of young persons with these agents should be approached with caution.


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