Antidepressants are nowadays used not only in the treatment of depressive symptoms, but in diverse child psychiatric disorders, such as obsessive compulsive disorder, social phobia, generalized anxiety disorder, posttraumatic stress disorder and eating disorder. Although these drugs are frequently used “off-label” in children and adolescents, increased amount of studies has supported the positive effects of selective serotonin reuptake inhibitors (SSRIs) on depression and anxiety disorders in this age group. Therefore, the use of antidepressants in young patients has increased markedly. SSRIs are the most preferred antidepressants in children and adolescents. Because, they are generally well-tolerated and adverse effects usually subside after approximately a week of treatment. However, clinicians should take into account some rare side effects of these drugs including suicidality, increasing bleeding, manic symptoms, serotonin syndrome, discontinuation syndrome and behavioral activation. Drug interactions should also always be considered in patients taking SSRIs, because some of them are moderate to potent inhibitors of various CYP enzymes. Additionally, there is lack of long-term safety data about the effects of antidepressant exposure on physical growth and the developing brain. In conclusion, clinician who prescribe antidepressants should keep in mind their potential risks. Future research to identify which pediatric patients may not be safely treated with antidepressants is warranted.