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Psychopharmacologic treatment of pediatric major depressive disorder

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Abstract

Rationale

The role of pharmacotherapy in the treatment of major depressive disorder (MDD) in youth has received much attention in recent years due to concerns of efficacy and safety of the antidepressants for the treatment of MDD in youth.

Objectives

This review describes the existing published and unpublished literature regarding the efficacy and short-term safety of the antidepressants and decision-making process required for the use of these medications for youth with MDD. In addition, current continuation and maintenance treatments are discussed.

Results

In general, nine depressed youth must be treated with an antidepressant to obtain one clinical response above that achieved with placebo. To date, fluoxetine has showed the most consistent positive treatment effects. Depressed youth had also acutely responded to other antidepressants, but the response to placebo has also been high. Overall, the antidepressants are well tolerated, but 1–3 children and adolescents of 100 taking antidepressants showed onset or worsening of suicidal ideation and, more rarely, suicide attempts.

Conclusions

There is a positive risk–benefit ratio for the use of antidepressants in the acute treatment of depressed youth. First-line antidepressant treatment with—or without—specific types of psychotherapy is indicated for youth with MDD of at least moderate severity. All youth taking antidepressants must be closely monitored for suicidality and medication side effects. Many youth will likely require psychotherapy or additional medication treatments to address comorbid disorders. Treatments to prevent relapses and recurrences require further study.

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References

  • Alderman J, Wolkow R, Chung M, Johnston HF (1998) Sertraline treatment of children and adolescents with obsessive–compulsive disorder or depression: pharmacokinetics, tolerability, and efficacy. J Am Acad Child Adolesc Psychiatry 37:386–394

    Article  PubMed  CAS  Google Scholar 

  • Altschuler LL, Suppes T, Black DO, Nolen WA, Leverich G, Keck PE Jr, Frye MA, Kupka R, McElroy SL, Grunze H, Kitchen CMR, Post R (2006) Lower switch rate in depressed patients with bipolar II than bipolar I disorder treated adjunctively with second generation antidepressants. Am J Psychiatry 163:313–315

    Article  Google Scholar 

  • American Academy of Children and Adolescent Psychiatry (1998) Practice parameters for the assessment and treatment of children and adolescents with depressive disorder. J Am Acad Child Adolesc Psychiatry 37(Suppl 10):63–83

    Google Scholar 

  • American Academy of Child and Adolescent Psychiatry (2004) Practice parameter for use of electroconvulsive therapy with adolescents. J Am Acad Child Adolesc Psychiatry 43:1521–1539

    Google Scholar 

  • American Academy of Child and Adolescent Psychiatry (2006) Practice parameters for the assessment and treatment of children and adolescents with depressive disorder. J Am Acad Child Adolesc Psychiatry (submitted)

  • American Psychiatric Association (1994a) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 4th edn. Washington, D.C.

  • American Psychiatric Association (1994b) Practice guideline for the treatment of patients with bipolar disorder. Am J Psychiatry 41:1–35

    Google Scholar 

  • American Psychiatric Association (2000) Practice guideline for the treatment of patients with major depressive disorder (revision). Am J Psychiatry 157(Suppl 4):1–45

    Google Scholar 

  • Axelson D, Perel J, Rudolph G, Birmaher B, Brent D (2000a) Sertraline pediatric/adolescent PK-PD parameters: dose/plasma level ranging for depression. Clin Pharmacol Ther 67:169

    Google Scholar 

  • Axelson D, Perel J, Rudolph G, Birmaher B, Nuss S, Brent D (2000b) Significant differences in pharmacokinetics/dynamics of Citalopram between adolescents and adults: implications for clinical dosing. Proceedings of the 39th annual meeting of the American College of Neuropsychopharmacology, p 122 (abstract)

  • Beck AT (1967) Depression: clinical, experimental, and theoretical aspects. Harper & Row, New York

    Google Scholar 

  • Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J, Dahl R, Perel J, Nelson B (1996a) Childhood and adolescent depression: a review of the past 10 years—part I. J Am Acad Child Adolesc Psychiatry 35:1427–1439

    Article  PubMed  CAS  Google Scholar 

  • Birmaher B, Ryan ND, Williamson DE, Brent DA, Kaufman J (1996b) Childhood and adolescent depression: a review of the past 10 years—part II. J Am Acad Child Adolesc Psychiatry 35:1575–1583

    Article  PubMed  CAS  Google Scholar 

  • Birmaher B, Brent DA, Kolko D, Baugher M, Bridge J, Holder D, Iyengar S, Ulloa RE (2000) Clinical outcome after short-term psychotherapy for adolescents with major depressive disorder. Arch Gen Psychiatry 57:29–36

    Article  PubMed  CAS  Google Scholar 

  • Birmaher B, Arbelaez C, Brent D (2002) Course and outcome of child and adolescent major depressive disorder. Child Adolesc Psychiatr Clin N Am 11:619–637

    Article  PubMed  Google Scholar 

  • Birmaher B, Axelson DA, Monk K, Kalas C, Clark DB, Ehmann M, Bridge J, Heo J, Brent DA (2003) Fluoxetine for the treatment of childhood anxiety disorders. J Am Acad Child Adolesc Psychiatry 42:415–423

    PubMed  Google Scholar 

  • Birmaher B, Williamson D, Dahl R, Axelson D, Kaufman J, Dorn L, Ryan N (2004) Clinical presentation and course of depression in youth. Does onset in childhood differ from onset in adolescence? J Am Acad Child Adolesc Psychiatry 43:63–70

    Article  PubMed  Google Scholar 

  • Boyer EW, Shannon M (2005) The serotonin syndrome. N Engl J Med 352:1112–1120

    Article  PubMed  CAS  Google Scholar 

  • Brent DA (2004) Antidepressants and pediatric depression: the risk of doing nothing. N Engl J Med 351:1598–1601

    Article  PubMed  CAS  Google Scholar 

  • Brent DA, Poling K, McCain B, Baugher M (1993) A psychoeducational program for families of affectively ill children and adolescents. J Am Acad Child Adolesc Psychiatry 32:770–774

    Article  PubMed  CAS  Google Scholar 

  • Brent DA, Kolko D, Birmaher B, Baugher M, Bridge J, Roth C, Holder D (1998) Predictors of treatment efficacy in a clinical trial of three psychosocial treatments for adolescent depression. J Am Acad Child Adolesc Psychiatry 37:906–914

    Article  PubMed  CAS  Google Scholar 

  • Bridge JA, Salary CB, Birmaher B, Asare AG, Brent DA (2005) The risks and benefits of antidepressant treatment for youth depression. Ann Med 37:404–412

    Article  PubMed  CAS  Google Scholar 

  • Bridge JA, Iyengar S, Salary CB, Barbe RP, Birmaher B, Pincus H, et al (2006) Efficacy and risk of emergent suicidality with antidepressant medication treatment for pediatric major depressive, obsessive-compulsive, and non-OCD anxiety disorders: A meta-analysis of randomized placebo-controlled trials. (Submitted)

  • Cheung AH, Emslie GJ, Mayes TL (2005) Review of the efficacy and safety of antidepressants in youth depression. J Child Psychol Psychiatry 46:735–754

    Article  PubMed  Google Scholar 

  • Clarke G, Debar L, Lynch F, Powell J, Gale J, O’Connor E, Ludman E, Bush T, Lin EH, Von Korff M, Hertert S (2005) A randomized effectiveness trial of brief cognitive-behavioral therapy for depressed adolescents receiving antidepressant medication. J Am Acad Child Adolesc Psychiatry 44:888–998

    PubMed  Google Scholar 

  • Clein PD, Riddle MA (1995) Pharmacokinetics in children and adolescents. Child Adolesc Psychiatr Clin N Am 4:59–75

    Google Scholar 

  • Daviss WB, Bentivoglio P, Racusin R, Brown KM, Bostic JQ, Wiley L (2001) Bupropion sustained release in adolescents with comorbid attention deficit hyperactivity. J Am Acad Child Adolesc Psychiatry 40:307–314

    Article  PubMed  CAS  Google Scholar 

  • Daviss WB, Perel JM, Rudolph GR, Axelson DA, Gilchrist R, Nuss S, Birmaher B, Brent DA (2005) Steady-state pharmacokinetics of bupropion SR in juvenile patients. J Am Acad Child Adolesc Psychiatry 44:349–357

    Article  PubMed  Google Scholar 

  • Depression Guideline Panel (1993) Depression in primary care: vol I. Treatment of major depression. Clinical practice guidelines. U.S. Department of Health and Human Services, Public Health Services, Agency for Health Care Policy and Research, Rockville, MD

  • Emslie GJ, Mayes TL (2001) Mood disorders in children and adolescents: psychopharmacological treatment. Biol Psychiatry 49:1082–1090

    Article  PubMed  CAS  Google Scholar 

  • Emslie GJ, Rush AJ, Weinberg WA, Kowatch RA, Hughes CW, Carmody T, Rintelmann J (1997) A double-blind, randomized, placebo-controlled trial of fluoxetine in children and adolescents with depression. Arch Gen Psychiatry 54:1031–1037

    PubMed  CAS  Google Scholar 

  • Emslie GJ, Rush AJ, Weinberg WA, Kowatch RA, Carmody T, Mayes TL (1998) Fluoxetine in child and adolescent depression: acute and maintenance treatment. Depress Anxiety 7:32–39

    Article  PubMed  CAS  Google Scholar 

  • Emslie GJ, Mayes TL, Laptook RS, Batt M (2003) Predictors of response to treatment in children and adolescents with mood disorders. Psychiatr Clin North Am 26:435–456

    Article  PubMed  Google Scholar 

  • Emslie GJ, Heiligenstein JH, Hoog SL, Wagner KD, Findling RL, McCracken JT, Nilsson ME, Jacobson JG (2004a) Fluoxetine treatment for prevention of relapse of depression in children and adolescents: a double-blind, placebo-controlled study. J Am Acad Child Adolesc Psychiatry 43:1397–1405

    Article  PubMed  Google Scholar 

  • Emslie GJ, Hughes CW, Crismon ML, Lopez M, Toprac MG, Boemer C (2004b) A feasibility study of the childhood depression medication algorithm: the Texas Children’s Medication Algorithm Project (CMAP). J Am Acad Child Adolesc Psychiatry 43:519–527

    Article  PubMed  Google Scholar 

  • Emslie GJ, Mayes TL, Ruberu M (2005) Continuation and maintenance therapy of early-onset major depressive disorder. Paediatr Drugs 7:203–217

    Article  PubMed  Google Scholar 

  • Ferro T, Verdeli H, Pierre F, Weissman MM (2000) Screening for depression in mothers bringing their offspring for evaluation or treatment of depression. Am J Psychiatry 57:375–379

    Article  Google Scholar 

  • Findling RL, Reed MD, Myers C, O’Riordan MA, Fiala S, Branicky L, Waldorf B, Blumer JL (1999) Paroxetine pharmacokinetics in depressed children and adolescents. J Am Acad Child Adolesc Psychiatry 38:952–959

    Article  PubMed  CAS  Google Scholar 

  • Findling RL, McNamara NK, Stansbrey RJ, Feeny NC, Young CM, Peric FV, Youngstrom EA (2006) The relevance of pharmacokinetic studies in designing efficacy trials in juvenile major depression. J Child Adolesc Psychopharmacol 16:131–145

    Article  PubMed  Google Scholar 

  • Fleck MP, Horwath E (2005) Pharmacologic management of difficult-to-treat depression in clinical practice. Psychiatr Serv 56:1005–1111

    Article  PubMed  Google Scholar 

  • Fombonne E, Wostear G, Cooper V, Harrington R, Rutter M (2001) The Maudsley long-term follow-up of child and adolescent depression. 2. Suicidality, criminality and social dysfunction in adulthood. Br J Psychiatry 179:218–223

    Article  PubMed  CAS  Google Scholar 

  • Geller B, Fox LW, Clark KA (1994) Rate and predictors of prepubertal bipolarity during follow-up of 6- to 12-year-old depressed children. J Am Acad Child Adolesc Psychiatry 33:461–468

    Article  PubMed  CAS  Google Scholar 

  • Gershon AA, Dannon PN, Grunhaus L (2003) Transcranial magnetic stimulation in the treatment of depression. Am J Psychiatry 160:835–845

    Article  PubMed  Google Scholar 

  • Goodyer IM, Herbert J, Secher SM, Pearson J (1997) Short-term outcome of major depression: I. Comorbidity and severity at presentation as predictors of persistent disorder. J Am Acad Child Adolesc Psychiatry 36:179–187

    Article  PubMed  CAS  Google Scholar 

  • Goodyer IM, Herbert J, Altham PM (1998) Adrenal, steroid secretion and major depression in 8- to 16-year-olds, III. Influence of cortisol/DHEA ratio at presentation on subsequent rates of disappointing life events and persistent major depression. Psychol Med 28:265–273

    Article  PubMed  CAS  Google Scholar 

  • Gould MS, Fisher P, Parides M, Flory M, Shaffer D (1996) Psychosocial risk factors of child and adolescent completed suicide. Arch Gen Psychiatry 53:1155–1162

    PubMed  CAS  Google Scholar 

  • Guy W (1976) Clinical global improvement scale. In: ECDEU assessment manual for psychopharmacology. U.S. National Institute of Mental Health, Psychopharmacology Research Branch, Rockville, MD, p 76

  • Hammad (2004) US Food and Drug Administration. Relationship between psychotropic drugs and pediatric suicidality. http://www.fda.gov/ohrms/dockets/ac/04/briefing/2004-4065b1-10-TAB08-Hammads-Review.pdf

  • Hammad TA, Laughren T, Racoosin J (2006) Suicidality in pediatric patients treated with antidepressant drugs. Arch Gen Psychiatry 63:332–339

    Article  PubMed  CAS  Google Scholar 

  • Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–61

    PubMed  CAS  Google Scholar 

  • Hamilton JD, Bridge J (1999) Outcome at 6 months of 50 adolescents with major depression treated in a health maintenance organization. J Am Acad Child Adolesc Psychiatry 38:1340–1346

    Article  PubMed  CAS  Google Scholar 

  • Hazell P (2005) Depression in children and adolescents. Clin Evid 13:329–342

    PubMed  Google Scholar 

  • Hughes C, Preskorn S, Weller E, Weller R, Hassanein R, Tucker S (1990) The effect of concomitant disorders in childhood depression on predicting treatment response. Psychopharmacol Bull 26:235–238

    PubMed  CAS  Google Scholar 

  • Hughes CW, Emslie GJ, Crismon ML, Wagner KD, Birmaher B, Geller B, Pliszka SR, Ryan ND, Strober M, Trivedi MH, Toprac MG, Sedillo A, Llana ME, Lopez M, Rush AJ (1999) The Texas Children’s Medication Algorithm Project: report of the Texas consensus conference panel on medication treatment of childhood major depressive disorder. J Am Acad Child Adolesc Psychiatry 38:1442–1454

    Article  PubMed  CAS  Google Scholar 

  • Joffe RT, Singer W (1990) A comparison of triidothryonine and thyroxine in the potentiation of antidepressants. Psychiatry Res 32:241–252

    Article  PubMed  CAS  Google Scholar 

  • Kendall PC (1994) Treating anxiety disorders in children: results of a randomized clinical trial. J Consult Clin Psychol 62:100–110

    Article  PubMed  CAS  Google Scholar 

  • Keller MB, Ryan ND, Stober M, Klein RG, Kutcher SP, Birmaher B, Hagino OR, Koplewicz H, Carlson GA, Clarke GN, Emslie GJ, Feinberg D, Geller B, Kusumakar V, Papatheodorou G, Sack WH, Sweeney M, Wagner KD, Weller EB, Winters NC, Oakes R, McCafferty JP (2001) Efficacy of paroxetine in the treatment of adolescent major depression: a randomized, controlled trial. J Am Acad Child Adolesc Psychiatry 40:762–772

    Article  PubMed  CAS  Google Scholar 

  • Klein DN, Lewinsohn PM, Seeley JR, Rohde P (2001) A family study of major depressive disorder in a community sample of adolescents. Arch Gen Psychiatry 58:13–20

    Article  PubMed  CAS  Google Scholar 

  • Kovacs M (2001) Gender and the course of major depressive disorder through adolescence in clinically referred youngsters. J Am Acad Child Adolesc Psychiatry 40:1079–1085

    Article  PubMed  CAS  Google Scholar 

  • Kovacs M, Goldston D, Gatsonis C (1993) Suicidal behaviors and childhood-onset depressive disorders: a longitudinal investigation. J Am Acad Child Adolesc Psychiatry 32:8–20

    Article  PubMed  CAS  Google Scholar 

  • Kowatch RA, Fristad M, Birmaher B, Wagner KD, Findling RL, Hellander M (2005) Treatment guidelines for children and adolescents with bipolar disorder. J Am Acad Child Adolesc Psychiatry 44:213–235

    Article  PubMed  Google Scholar 

  • Kroll L, Harrington R, Jayson D, Fraser J, Gowers S (1996) Pilot study of continuation cognitive-behavioral therapy for major depression in adolescent psychiatric patients. J Am Acad Child Adolesc Psychiatry 35:1156–1161

    Article  PubMed  CAS  Google Scholar 

  • Lake MB, Birmaher B, Wassick S, Mathos K, Yelovich AK (2000) Bleeding and selective serotonin reuptake inhibitors in childhood and adolescence. J Child Adolesc Psychopharmacol 10:35–38

    Article  PubMed  CAS  Google Scholar 

  • Leonard HL, March J, Rickler KC, Allen AJ (1997) Review of the pharmacology of the selective serotonin reuptake inhibitors in children and adolescents. J Am Acad Child Adolesc Psychiatry 36:725–736

    Article  PubMed  CAS  Google Scholar 

  • Lewinsohn PM, Allen NB, Seeley JR, Gotlib IH (1999) First onset versus recurrence of depression: differential processes of psychosocial risk. J Abnorm Psychol 108:483–489

    Article  PubMed  CAS  Google Scholar 

  • Lim CJ, Leckman JF, Young C, Martin A (2005) Antidepressant-induced manic conversion: a developmentally informed synthesis of the literature. Int Rev Neurobiol 65:25–52

    PubMed  CAS  Google Scholar 

  • Luby JL, Mrakotsky C, Heffelfinger A, Brown K, Hessler M, Spitznagel E (2003) Modification of DSM-IV criteria for depressed preschool children. Am J Psychiatry 160:1169–1172

    Article  PubMed  Google Scholar 

  • Mandoki MW, Tapia MR, Tapia MA, Sumner GS, Parker JL (1997) Venlafaxine in the treatment of children and adolescents with major depression. Psychopharmacol Bull 33:149–154

    PubMed  CAS  Google Scholar 

  • Mann JJ, Emslie G, Baldessarini RJ, Beardslee W, Fawcett JA, Goodwin FK, Leon AC, Meltzer HY, Ryan ND, Shaffer D, Wagner KD (2006) ACNP task force report on SSRIs and suicidal behavior in youth. Neuropsychopharmacology 31:473–492

    Article  PubMed  CAS  Google Scholar 

  • Martin A, Young C, Leckman JF, Mukonoweshuro C, Rosenheck R, Leslie D (2004) Age effects on antidepressant-induced manic conversion. Arch Pediatr Adolesc Med 158:773–780

    Article  PubMed  Google Scholar 

  • March JS, Biederman J, Wolkow R, Safferman A, Mardekian J, Cook EH, Cutler NR, Dominguez R, Ferguson J, Muller B, Riesenberg R, Rosenthal M, Sallee FR, Wagner KD, Steiner H (1998) Sertraline in children and adolescents with obsessive–compulsive disorder: a multicenter randomized controlled trial. JAMA 280:1752–1756. Erratum in: JAMA 283:1293

    Article  PubMed  CAS  Google Scholar 

  • Merry S, McDowell H, Hetrick S, Bir J, Muller N (2004) Psychological and/or educational interventions for the prevention of depression in children and adolescents. The Cochrane Database of Systematic Reviews 2004, issue 2. Art. No.: CD003380.pub2. DOI:10.1002/14651858.CD003380.pub2

  • Mufson L, Weissman MM, Moreau D, Garfinkel R (1999) Efficacy of interpersonal psychotherapy for depressed adolescents. Arch Gen Psychiatry 56:573–579

    Article  PubMed  CAS  Google Scholar 

  • Mufson L, Dorta KP, Wickramaratne P, Nomura Y, Olfson M, Weissman MM (2004) A randomized effectiveness trial of interpersonal psychotherapy for depressed adolescents. Arch Gen Psychiatry 61:577–584

    Article  PubMed  Google Scholar 

  • Pine DS, Cohen P, Gurley D, Brook J, Ma Y (1998) The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Arch Gen Psychiatry 55:56–64

    Article  PubMed  CAS  Google Scholar 

  • Pliszka S (2000) Patterns of psychiatric comorbidity with attention-deficit hyperactivity disorder. Child Adolesc Psychiatr Clin N Am 9:1056–4993

    Google Scholar 

  • Poznanski EO, Freeman LN, Mokros HB (1984) Children’s depression rating scale—revised. Psychopharmacol Bull 21:979–989

    Google Scholar 

  • Rao U, Hammen C, Daley SE (1999) Continuity of depression during the transition to adulthood: a 5-year longitudinal study of young women. J Am Acad Child Adolesc Psychiatry 38:908–915

    Article  PubMed  CAS  Google Scholar 

  • Renaud J, Brent DA, Baugher M, Birmaher B, Kolko DJ, Bridge J (1998) Rapid response to psychosocial treatment for adolescent depression: a 2-year follow-up. J Am Acad Child Adolesc Psychiatry 37:1184–1190

    Article  PubMed  CAS  Google Scholar 

  • Research Units of Pediatric Psychopharmacology (RUPP) Anxiety Group (2001) Fluvoxamine for anxiety in children. N Engl J Med 344:1279–1285

    Article  Google Scholar 

  • Riddle MA, Reeve EA, Yaryura-Tobias JA, Yang HM, Claghorn JL, Gaffney G, Griest JH, Holland D, McConville BJ, Pigott T, Walkup JT (2001) Fluvoxamine for children and adolescents with obsessive–compulsive disorder: a randomized, controlled, multicenter trial. J Am Acad Child Adolesc Psychiatry 40:222–229

    Article  PubMed  CAS  Google Scholar 

  • Rothschild AJ, Williamson DJ, Tohen MF, Schatzberg A, Andersen SW, Van Campen LE, Sanger TM, Tollefson GD (2004) A double-blind, randomized study of olanzapine and olanzapine/fluoxetine combination for major depression with psychotic features. J Clin Psychopharmacol 24:365–373

    Article  PubMed  CAS  Google Scholar 

  • Rueter MA, Scaramella L, Wallace LE, Conger RD (1999) First onset of depressive or anxiety disorders predicted by the longitudinal course of internalizing symptoms and parent–adolescent disagreements. Arch Gen Psychiatry 56:726–732

    Article  PubMed  CAS  Google Scholar 

  • Rush AJ, Trivedi MH, Wisniewski SR, Stewart JW, Nierenberg AA, Thase ME, Ritz L, Biggs MM, Warden D, Luther JF, Shores-Wilson K, Niederehe G, Fava M; STAR*D Study Team (2006) Buproprion-SR, sertraline, or venlafaxine—XR after failure of SSRIs for depression. N Engl J Med 354:1305–1307

    Article  Google Scholar 

  • Ryan ND, Puig-Antich J, Copper TB, Rabinovich H, Ambrosini P, Fried J, Davies M, Torres D, Suckow RF (1987) The clinical picture of major depression in children and adolescents. Arch Gen Psychiatry 44:854–861

    PubMed  CAS  Google Scholar 

  • Ryan ND, Puig-Antich J, Rabinovich H, Fried J, Ambrosini P, Meyer V, Torres D, Dachille S, Mazzie D (1988a) MAOIs in adolescent major depression unresponsive to tricyclic antidepressant. J Am Acad Child Adolesc Psychiatry 27:755–758

    Article  PubMed  CAS  Google Scholar 

  • Ryan ND, Meyer V, Dachille S, Mazzie D, Puig-Antich J (1988b) Lithium antidepressant augmentation in TCA-refractory depression in adolescents. J Am Acad Child Adolesc Psychiatry 27:371–376

    Article  PubMed  CAS  Google Scholar 

  • Sallee FR, Vrindavanam NS, Deas-Nesmith D, Carson SW, Sethuraman G (1997) Pulse intravenous clomipramine for depressed adolescents: a double-blind, controlled trial. Am J Psychiatry 154:668–673

    PubMed  CAS  Google Scholar 

  • Schachter SC (2004) Vagus nerve stimulation: mood and cognitive effects. Epilepsy Behav 5(Suppl 1):56–59

    Article  Google Scholar 

  • Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S (1983) A children’s global assessment scale (CGAS). Arch Gen Psychiatry 40:1228–1231

    PubMed  CAS  Google Scholar 

  • Shaffer D, Craft L (1999) Methods of adolescent suicide prevention. J Clin Psychiatry 60(Suppl 2):70–74; discussion 75–76, 113–116

    PubMed  Google Scholar 

  • Shelton RC, Tomarken AJ (2001) Can recovery from depression be achieved? Psychiatr Serv 52:1469–1478

    Article  PubMed  CAS  Google Scholar 

  • Simon GE, Savarino J, Operskalski B, Wang PS (2006) Suicide risk during antidepressant treatment. Am J Psychiatry 163:41–47

    Article  PubMed  Google Scholar 

  • Strober M, Carlson G (1982) Bipolar illness in adolescents with major depression: clinical, genetic, and psychopharmacologic predictors in a three- to four-year prospective follow-up investigation. Arch Gen Psychiatry 39:549–555

    PubMed  CAS  Google Scholar 

  • Strober M, Freeman R, Rigali J, Schmidt S, Diamond R (1992) The pharmacotherapy of depressive illness in adolescence: II. Effects of lithium augmentation in nonresponders to imipramine. J Am Acad Child Adolesc Psychiatry 31:16–20

    PubMed  CAS  Google Scholar 

  • Swedo SE, Allen AJ, Glod CA, Clark CH, Teicher MH, Richter D, Hoffman C, Hamburger SD, Dow S, Brown C, Rosenthal NE (1997) A controlled trial of light therapy for the treatment of pediatric seasonal affective disorder. J Am Acad Child Adolesc Psychiatry 36:816–821

    Article  PubMed  CAS  Google Scholar 

  • Treatment for Adolescents with Depression Study (TADS) Team (2005) The Treatment for Adolescents With Depression Study (TADS): demographic and clinical characteristics. J Am Acad Child Adolesc Psychiatry 44:28–40

    Article  Google Scholar 

  • Valuck RJ, Libby AM, Sills MR, Giese AA, Allen RR (2004) Antidepressant treatment and risk of suicide attempt by adolescents with major depressive disorder: a propensity-adjusted retrospective cohort study. CNS Drugs 18:1119–1132

    Article  PubMed  CAS  Google Scholar 

  • Weissman MM, Wolk S, Goldstein RB, Moreau D, Adams P, Greenwald S, Klier CM, Ryan ND, Dahl RE, Wickramaratne P (1999a) Depressed adolescents grownup. JAMA 281:1707–1713

    Article  PubMed  CAS  Google Scholar 

  • Weissman MM, Wolk S, Wickramaratne P, Goldstein RB, Adams P, Greenwald S, Ryan ND, Dahl RE, Steinberg D (1999b) Children with prepubertal-onset major depressive disorder and anxiety grown up. Arch Gen Psychiatry 56:794–801

    Article  PubMed  CAS  Google Scholar 

  • Weisz JR, McCarty CA, Valeri SM (2006) Effects of psychotherapy for depression in children and adolescents: A meta-analysis. Psychol Bull 132:132–149

    Article  PubMed  Google Scholar 

  • Weller EB, Weller RA (2000) Treatment options in the management of adolescent depression. J Affect Disord 61(Suppl 1):23–28

    Article  PubMed  Google Scholar 

  • Wilens TE, Wyatt D, Spencer TJ (1998) Disentangling disinhibition. J Am Acad Child Adolesc Psychiatry 37:1225–1227

    Article  PubMed  CAS  Google Scholar 

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  1. Department of Psychiatry and Behavioural Neurosciences, McMaster University, 1200 Main St. W Box 2000, Hamilton, ON, L8N 3Z5, Canada

    Khrista Boylan

  2. Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, 3811 O’Hara Street, Pittsburgh, PA, 15213, USA

    Soledad Romero & Boris Birmaher

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  1. Khrista Boylan
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  2. Soledad Romero
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Correspondence to Khrista Boylan.

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Boylan, K., Romero, S. & Birmaher, B. Psychopharmacologic treatment of pediatric major depressive disorder. Psychopharmacology 191, 27–38 (2007). https://doi.org/10.1007/s00213-006-0442-z

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