NEW YORK (Reuters Health) Jul 17 - Findings from a small case study suggest that treatment with selective serotonin reuptake inhibitors (SSRI) during childhood can decrease growth. As the use of such agents is expected to increase in pediatric populations, it is important that larger studies be conducted to verify this finding.

In the July issue of the Archives of Pediatric and Adolescent Medicine, Dr. Naomi Weintrob, from the Schneider Children’s Medical Center of Israel in Petah Tikva, and colleagues describe the medical histories of four children, 11 to 13 years of age. Two of the children received SSRI therapy for obsessive-compulsive disorder and two were treated for Tourette syndrome. The duration of therapy ranged from 6 months to 5 years.

Three children demonstrated growth retardation at a pubertal stage when a growth spurt was expected. A decreased growth hormone response to clonidine stimulation was observed in three children, including two whose response to glucagon stimulation was also attenuated. One patient showed decreased 24-hour secretion of growth hormone that normalized after treatment discontinuation.

SSRI therapy did not appear to have an effect on serum levels of thyroid hormone or prolactin or on urinary cortisol levels, the researchers point out.

In two patients, normal growth resumed after SSRI therapy was stopped. In the other two children, SSRI therapy could not be discontinued due to the psychiatric symptoms present, but their growth rate improved after somatropin therapy was begun.

“As the large studies conducted in children and adolescents treated with SSRIs have not addressed growth, and our study includes only four patients, an individual variation in the effect of SSRIs on the somatotrophic axis cannot be ruled out,” the investigators note. Therefore, larger studies are needed to verify the current findings.

Still, the present results may raise awareness of this potential problem among physicians who manage children with psychiatric disorders, the authors state.

Arch Pediatr Adolesc Med 2002;156:696-701.

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