OBJECTIVES:   There has been much controversy over the prescribing of selective serotonin re-uptake inhibitors (SSRIs) and selective serotonin and noradrenaline re-uptake inhibitors (SNRIs) regarding their safety and efficacy in patients younger than 19 years with limited guidelines to prescribers from South African authorities.  The primary aim was to investigate the prescribing patterns of SSRIs and SNRIs to children and adolescents, younger than 19 years, in a primary practice setting in a South African patient population. METHODS:   Data from 2009 of patients younger than 19 years who were prescribed antidepressants belonging to a private medical aid scheme were retrospectively analysed. RESULTS:   There were 440 patients younger than 19 years receiving antidepressant drugs accounting for 6.20% of patients of any age receiving antidepressant therapy.  SSRIs and SNRIs were prescribed to 50.68% of these patients.  Female patients were prescribed SSRIs and SNRIs most frequently (62.33%).  The average age of patients was 14.21 (SD=3.05) years while the majority of patients were older than 12 years (77.13%).  Fluoxetine was prescribed most frequently (36.50%), followed by citalopram (22.14%) and escitalopram (17.15%).  The total cost of SSRIs and SNRIs amounted to R81201.69.  Escitalopram accounted for 30.28% of the cost while fluoxetine only accounted for 11.11% of the cost.  Venlafaxine accounted for 6.32% of prescriptions although being contraindicated in this patient population.  Paroxetine accounted for 5.96% of prescriptions although its use is not recommended due to possible suicidality side effects.  A total of 72.65% of patients received drug therapy for less than 6 months while 41.26% of patients received a single prescription for an SSRI or SNRI.  General practitioners prescribed 67.76% of prescriptions while psychiatrists only prescribed 14.96%. CONCLUSIONS:   The prescribing of these agents to children and adolescents needs to be further investigated using retrospective data which include clinical information and studies conducted over a longer time period.