Growth and growth hormone secretion were evaluated in 4 children (3 boys), aged 11.6 to 13.7 years, treated with selective serotonin reuptake inhibitors (SSRIs) for obsessive compulsive disorder or Tourette syndrome, at Schneider Children’s Medical Center of Israel, Petah Tikva, and Sackler School of Medicine, Tel Aviv University, Tel Aviv. SSRIs (fluvoxamine, fluoxetine) were administered for 6 months to 5 years (dosage, 20-100 mg/day) and patients were examined for height, bone age, pubertal progression, and hypothalamic-pituitary function. Growth retardation occurred in all 4, and in 3 when a growth spurt was anticipated. Three had a decreased growth hormone response to clonidine stimulation, and 1 had decreased 24-hour secretion of growth hormone that became normal after SSRI treatment was discontinued. Two resumed normal growth when therapy was discontinued, and in 2 patients somatropin was added to the SSRI regimen. 
COMMENT. A decrease in growth rate and delayed puberty may occur during treatment with SSRI for various psychiatric disorders in children. Suppression of growth hormone secretion is suspected. Further studies are indicated, but the use of SSRIs in children should be reevaluated and carefully monitored. Caution is especially important if SSRIs are used in children with ADHD, in combination with methylphenidate or amphetamines, drugs with proven growth retardation potential.