Antidepressants are efficacious in the treatment of depression but they are not without side effects. The recent findings on the risk of suicide with selective serotonin reuptake inhibitor treatment, however, have raised serious concerns about the risk-benefit ratio of their use. The development of the concerns is traced and the risks discussed, particularly in the child and adolescent group. The prescriber needs to be aware of the issues and of the need for close clinical monitoring of patients started on selective serotonin reuptake inhibitor treatment.