Further evaluation of the long-term safety and efficacy of sertraline in the treatment of childhood panic disorder is needed. Periodically reassess the need for continued treatment.
A usual starting dose is 25 mg PO once daily with flexible dosing titration no more often than weekly, based upon response and tolerability. The mechanism of growth inhibition in children may be due to the suppression of growth hormone secretion, which is known to occur in adults taking SSRIs.Ĭhildren† and Adolescents† 8 years and older Data are inadequate to determine whether the chronic use of SSRIs causes long-term growth inhibition however, decreased weight gain has been observed in children and adolescents receiving SSRIs. The potential for growth inhibition in pediatric patients should be monitored during SSRI therapy monitor height and weight periodically. Caregivers and/or patients should immediately notify the prescriber of changes in behavior or suicidal ideation. All patients should be monitored for symptom worsening or suicidality, especially at treatment initiation or after dose changes. The need for an antidepressant in children or adolescents for any use must be weighed against the risk of suicidality it is unknown if this risk extends to long-term use. Data from a cohort of 36,842 children (Age: 6 to 18 years) suggested those who use multiple antidepressants have a higher risk of suicide behavior, most likely a result of increased severity of depression rather than drug effect. No suicides occurred in any of the pediatric trials. The difference in absolute risk of suicidal thoughts and behaviors across different indications was highest in those with major depression. In a pooled analysis of placebo-controlled trials of antidepressants (n = 4,500 pediatrics and 77,000 adults), there was an increased risk for suicidal thoughts and behaviors in patients 24 years of age and younger receiving an antidepressant versus placebo, with considerable variation in the risk of suicidality among drugs. Results from 2 placebo-controlled trials in pediatric patients were insufficient to support an indication for treating major depressive disorder. The safety and efficacy of sertraline have been established in the treatment of obsessive-compulsive disorder (OCD) in children and adolescents 6 to 17 years of age. Children, growth inhibition, suicidal ideation
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