title: Use of antidepressants for major depressive disorder in children and adolescents: clinical considerations.
abstract: Major depressive disorder (MDD) is a frequent condition among children and, especially, among adolescents. However, its clinical presentation usually differs from that of adults. It is also associated with other diagnoses and with an increased morbidity and mortality. However, MDD in this population remains underrecognized and undertreated. Antidepressants (ATDs) are chosen when psychoeducational, psychosocial and/or psychotherapeutic approaches have failed. ATDs are generally used in severe cases, and are always combined with psychological treatments. The objective of this work is to discuss the role of ATD in child and adolescent MDD. We focus on the recommendations of the most cited and updated clinical guidelines and discuss some controversial aspects with regards efficacy and safety issues that have been raised based on the information obtained from clinical trials. Finally, we offer some practical recommendations for clinicians. All these findings also pose some doubt on the hypothesis of MDD as a homogeneous phenomenon during the human life cycle.
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Picouto
authors.forename: María Dolores
authors.initials: MD
authors.lastname: Braquehais
mesh_terms: D000293:Adolescent; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D003951:Diagnostic Errors / Q000009:adverse effects / Q000517:prevention & control; D006801:Humans; D017410:Practice Guidelines as Topic; D011569:Psychiatric Status Rating Scales; D011580:Psychological Techniques; D016032:Randomized Controlled Trials as Topic; D013405:Suicide / Q000523:psychology; D016896:Treatment Outcome; D000092864:Suicide Prevention
chemical_list: D000928:Antidepressive Agents