For the treatment of depression in patients under 18 years old, which antidepressant has shown efficacy in clinical trials?

• A. Sertraline
• B. Citalopram
• C. Fluoxetine
• D. Paroxetine

Answer: (C)

When treating depression in patients under 18, solid, well-designed clinical trial evidence supports fluoxetine. Multiple randomized trials have shown that fluoxetine reduces depressive symptoms and improves functioning in children and adolescents with major depressive disorder, and it carries regulatory approval for ages roughly 8 to 18. This robust efficacy data makes it the best-supported pharmacologic option in this age group. Other antidepressants have been studied, but the results are less consistent or safety concerns limit their use in youth—for example, paroxetine has been linked with increased suicidality risk and is generally not recommended, while citalopram and sertraline have weaker or less consistent efficacy signals.