Depression-based presentations constitute some of the most commonly seen psychiatric manifestations within the school-age population. In conjunction with increased numbers of children and adolescents being diagnosed with depressive symptomology over the past 2-3 decades, there has been seen a concurrent increase in the amount of antidepressant agents being prescribed within this group. This increase is largely related to the development of the newer class antidepressants, the selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, which have demonstrated preferred efficacy and adverse effect profiles over the older monoamine oxidase inhibitors and tricyclics. This article discusses the primary differences between the various forms of antidepressants, including their utility and efficacy. Positive and negative impacts are also reviewed, including potential impact on schooling.