Do SSRIs Stunt Growth in Adolescents? What We Know So Far
Starting medication for your child’s mental health can feel like navigating a minefield—especially when the long-term effects aren't fully understood. At Philadelphia Integrative Psychiatry, Dr. Danish and his team take great care to weigh the full cost-benefit profile of each treatment we recommend. When it comes to selective serotonin reuptake inhibitors (SSRIs)—commonly used for conditions like OCD, anxiety, and depression—we closely follow the emerging research on how these medications may affect the developing body, not just the mind.
One potential concern is whether SSRIs suppress height growth during puberty. While the data is still limited, two studies suggest there may be a real, measurable impact on growth hormone signaling and linear growth. At present, this is a topic without a clear consensus—even among pediatric endocrinologists. Dr. Danish has consulted with three specialists in the field, all of whom acknowledged the possibility but did not take a strong stance due to a lack of definitive research. Still, this potential risk is important to consider when deciding whether to start an SSRI in a child who has not yet completed puberty.
What the Research Says About SSRIs and Growth Suppression
1. Case Study Series: SSRIs Linked to Reduced Growth Hormone Response
A 2002 article in Archives of Pediatrics & Adolescent Medicine followed four adolescents (ages 11.6–13.7) who were treated with SSRIs (fluoxetine or fluvoxamine) for psychiatric conditions ranging from OCD to Tourette syndrome. Dosages ranged from 20 mg to 100 mg/day, with treatment durations of 6 months to 5 years [1].
Key findings included:
All four children experienced growth attenuation, especially during stages of puberty when a growth spurt was expected.
Three patients showed reduced GH response to stimulation testing (clonidine and/or glucagon), suggesting impaired growth hormone secretion.
IGF-1 levels were low or borderline in several cases.
Two patients improved with GH therapy while continuing SSRIs.
Growth velocity normalized in the other two after discontinuing SSRIs (e.g., from 1.4 cm/year during treatment to 6.6 cm/year after stopping fluoxetine).
These findings point toward a potentially selective effect of SSRIs on the somatotrophic axis (the hormonal system that drives linear growth).
2. Newer Cohort Study Confirms Dose-Dependent Growth Suppression
A 2024 study published in the Journal of Clinical Psychopharmacology analyzed the effects of fluoxetine and sertraline on height gain and IGF-1 levels in 66 children ages 8–15 over six months, comparing them to 36 unmedicated controls [2]. All participants were in Tanner stages 2–4 of puberty at baseline.
Key findings included:
SSRI dose was inversely associated with height growth (β = −0.18; 95% CI: −0.35, −0.02).
Compared to unmedicated controls, SSRI users had significantly reduced height gain over time (β = −1.30; 95% CI: −2.52, −0.09).
IGF-1 levels were significantly lower in a dose-dependent fashion (β = −63.5; 95% CI: −112.2, −14.7).
Sertraline and fluoxetine had similar effects on height, but sertraline was associated with more BMI increase compared to fluoxetine.
These results reinforce the possibility that SSRIs may suppress height gain through a downregulation of IGF-1, a key hormone in pubertal growth.
Interpreting the Data: What Does It Mean for Your Child?
While these two studies provide some of the only direct data on SSRIs and adolescent growth, both come with limitations. The case series is small, and the cohort study only spans six months. That said, both show a consistent pattern of growth suppression linked to SSRIs, particularly fluoxetine and sertraline, during puberty.
At this time:
More definitive research is lacking—no large-scale, long-term randomized controlled trials have evaluated this issue.
Even among pediatric endocrinologists, opinions vary and often default to "wait and see."
For now, this is a potential risk that may not affect every child—but it's real enough to factor into shared decision-making, especially when treating prepubertal or early pubertal youth.
Getting in Touch with Dr. Danish and His Team
Whether you're deciding whether to start an SSRI or simply want a comprehensive mental health plan that respects your child’s developmental trajectory, Dr. Danish and the team at Philadelphia Integrative Psychiatry are here to help. Our integrative evaluations consider not only symptom relief but also long-term effects on physical, hormonal, and emotional development. If you're navigating this complex decision, you're not alone—we're ready to guide you with science, compassion, and care.
For More on This Topic and Related Subjects, Check Out These Blogs by Dr. Danish:
https://phillyintegrative.com/blog/unlocking-whole-body-wellness-the-power-of-functional-medicine
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Disclaimer: This guide is for informational purposes only and not a substitute for medical advice. Any treatment—whether a supplement, medication, procedure, injection, therapy, or device—carries potential risks, especially when used in excess or by individuals with certain medical conditions or genetic predispositions. Always consult a qualified healthcare provider before starting any treatment.
