Efficacy of antidepressants in child and adolescent depression: a meta-analytic study.
OBJECTIVE
To examine whether antidepressant drugs are superior to placebo in the treatment of juvenile depression.


METHODS
Extensive literature search was done to retrieve all randomised controlled and all uncontrolled trials describing children and adolescents with a diagnosis of depression who underwent any antidepressant drug treatment. In order to combine results, separate analyses using random effect models were conducted first for controlled and then for both controlled and open studies.


RESULTS
18 controlled and 23 open trials were submitted to meta-analysis. Tricyclics showed no significant benefit over placebo. Odds ratios for SSRIs were 1.84 (95% CI 1.35-2.50) for controlled and 1.83 (95% CI 1.40-2.40) for controlled and uncontrolled studies suggesting a significant benefit over placebo. Combining all antidepressants also gave confidence interval excluding the value one.


CONCLUSIONS
Despite some promising data concerning the use of SSRIs in the treatment of adolescent depression, caution is warranted until the long-term safety of these agents can be demonstrated. Insufficient data are available to judge even the short term merits of these agents in prepubertal children. There is no evidence to support the use of tricyclics in this population.
Papanikolaou
K
K
Department of Child Psychiatry, University of Athens, Agia Sophia Children's Hospital, Athens, Greece. apechlib@med.uoa.gr
Richardson
C
C
Pehlivanidis
A
A
Papadopoulou-Daifoti
Z
Z
D000293:Adolescent; D000367:Age Factors; D000928:Antidepressive Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000929:Antidepressive Agents, Tricyclic / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003866:Depressive Disorder / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D015990:Placebo Effect; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
D000928:Antidepressive Agents; D000929:Antidepressive Agents, Tricyclic; D017367:Selective Serotonin Reuptake Inhibitors