Critical review of tricyclic antidepressant use in children and adolescents.
OBJECTIVE
To provide a critical review of the role of tricyclic antidepressant (TCA) medications in children and adolescents.


METHODS
Multiple resources including a Medline search (1966-1998) were used.


RESULTS
There were few double-blind, placebo-controlled studies of TCAs, and even fewer with positive results. Also, potentially serious cardiovascular side effects have been described.


CONCLUSIONS
The future therapeutic role of TCAs for children and adolescents needs to be seriously weighed against lethality of overdose, the unresolved issue of possible sudden unexplained death, and the availability of safer and easier to monitor medications. Ongoing future research on heart rate variability and epidemiology of psychotropic medication-related deaths will address developmental aspects of TCA use.
Geller
B
B
Washington University School of Medicine, St. Louis, MO 63110, USA.
Reising
D
D
Leonard
H L
HL
Riddle
M A
MA
Walsh
B T
BT
D000293:Adolescent; D000296:Adolescent Psychiatry / Q000639:trends; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D002648:Child; D002665:Child Psychiatry / Q000639:trends; D002986:Clinical Trials as Topic; D003866:Depressive Disorder / Q000188:drug therapy*; D006801:Humans; D012107:Research Design
D000929:Antidepressive Agents, Tricyclic