Depressive disorders confer a high risk for substance abuse, physical illness, early pregnancy and poor vocational, academic and psychosocial functioning. The longer an episode of major depressive disorder (MDD) in school-aged children or adolescents persists, the greater the risk for long-lasting impairment in school, social or family domain. Looking at mood states and depressive syndromes from a psycho-pharmacological point of view shows remarkable differences, but also similarities between childhood/adolescence and adulthood. This chapter discusses these, providing an overview of the present state of pharmacological treatment of depressive syndromes in young people. Antidepressant medication in childhood and adolescence is indicated in cases of severe depressive symptomatology which are unresponsive to psycho-therapeutic interventions. For patients requiring pharmacotherapy, selective serotonin reuptake inhibitors (SSRIs) are the initial antidepressants of choice. Several psychopharmacological strategies are recommended for adults: optimization, augmentation or combination, and switching to the same or a different class of medications.