In a study of 6,767 reports of antidepressant trials in juveniles treated for depressive and anxiety disorders, the risk of psychopathological behavioral or mood elevation was 3.5x greater with antidepressants than with placebo. The authors (which include Giovanni Fava of the University of Bologna and Ross Baldessarini of Harvard Medical School) urge “particular caution and monitoring for potential risk of future bipolar disorder.”
Offidani, E., Fava, G.A., Tomba, E., Baldessarini, R.J., Excessive Mood Elevation and Behavioral Activation with Antidepressant Treatment of Juvenile Depressive and Anxiety Disorders: A Systematic Review. Psychotherapy and Psychosomatics. 2013: 82(3) (online first)
Of further interest:
The Risks and Benefits of Antidepressants to Treat Pediatric-Onset Depression and Anxiety Disorders: A Developmental Perspective (Psychotherapy and Psychosomatics)