Decreased growth during therapy with selective serotonin reuptake inhibitors.
BACKGROUND
There is no information on the effects of selective serotonin reuptake inhibitors (SSRIs) on growth and puberty in children. We examined growth and growth hormone secretion in 4 children treated with SSRIs for various psychiatric disorders.


METHODS
Case study.


METHODS
Four children (3 boys) aged 11.6 to 13.7 years with obsessive-compulsive disorder or Tourette syndrome.


METHODS
Growth, pubertal progression, and hypothalamic pituitary function.


METHODS
The patients were treated with SSRIs for 6 months to 5 years (dosage, 20-100 mg/d). All were regularly examined for changes in height and bone age and for pubertal progression. They also underwent evaluation of somatotrophic axis and hypothalamic-pituitary axis function.


RESULTS
All 4 patients had growth attenuation. Three of them exhibited growth retardation at a pubertal stage when a growth spurt was anticipated. Three had a decreased growth hormone response to clonidine hydrochloride stimulation and 2 to both clonidine and glucagon stimulation, and 1 had decreased 24-hour secretion of growth hormone that normalized when therapy was stopped. The rest of the endocrine evaluations were within reference ranges in all patients. At follow-up, 2 patients were being treated with somatropin while continuing SSRI therapy, and the other 2 resumed normal growth after discontinuation of therapy.


CONCLUSIONS
A decrease in growth rate, possibly secondary to suppression of growth hormone secretion, may occur during SSRI therapy. As the use of this group of drugs is expected to increase in the young age groups, larger studies are warranted to investigate their effect on growth and growth hormone secretion.
Weintrob
Naomi
N
Institute for Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, 14 Kaplan St, Petah Tikva 49202, Israel. nweintrob@clalit.org.il
Cohen
Daniela
D
Klipper-Aurbach
Yaffa
Y
Zadik
Zvi
Z
Dickerman
Zvi
Z
D000293:Adolescent; D001827:Body Height / Q000187:drug effects*; D001846:Bone Development / Q000187:drug effects; D002648:Child; D005260:Female; D006130:Growth Disorders / Q000139:chemically induced* / Q000188:drug therapy; D019382:Human Growth Hormone / Q000187:drug effects / Q000378:metabolism / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009771:Obsessive-Compulsive Disorder / Q000188:drug therapy; D011627:Puberty / Q000187:drug effects*; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D013997:Time Factors; D005879:Tourette Syndrome / Q000188:drug therapy
D019382:Human Growth Hormone; D017367:Selective Serotonin Reuptake Inhibitors