An Open Study of the Effects of Sertraline on Adolescent Major Depression

Abstract

This open study investigated the effects of sertraline in treating 13 adolescents, ages 12 to 18, who were hospitalized for treatment of a major depressive episode. The sample included 7 adolescents with nonendogenous depression and 6 with endogenous depression, as diagnosed by both Research Diagnostic Criteria (RDC) and Kiddie-SADS-P DSM-III-R endogenous subtype criteria. These patients were followed for an inpatient length of stay ranging from 9 to 38 days (mean 19 days), with later outpatient follow-up for a total of 12 weeks. Measures of depression were found to improve significantly, including suicidal ideation and most of the DSM-III-R symptoms of major depression. Sertraline (mean 110 mg or 1.96 mg/kg daily) significantly decreased scores on the 24-item Hamilton Depression Rating Scale and Montgomery-Asberg Depression Rating Scale from premedication baseline to treatment week 12, and also between weeks 1 (after a large week 1 improvement, presumably due to nondrug effects) and 12. There was a small but significant improvement on the Children's Global Assessment Scale between baseline and week 12, but the Family Global Assessment Scale showed no significant change; neither global assessment scale showed significant effects between weeks 1 and 12. Sleep disturbance was common (69%) after 12 weeks of treatment, but clinically significant improvements in sleep patterns were also observed. This open-label prospective study suggests that sertraline might be useful in treating adolescents with major depression. Adverse effects, mainly insomnia and drowsiness, were relatively common but usually manageable. One patient developed mania after 8 days of sertraline treatment at a dose of 100 mg daily.

Pediatric Psychopharmacology in a Capitated Managed Care System: How Do Patients Fare?

“…Of the 46 who remained in treatment for a mean duration of approximately 4 months, 72% improved and 28% did not, as manifested by their GII scores. These numbers are similar to outcome data in published reports of disorder-specific treatments (Jain et al 1992; Gammon and Brown 1993;McConville et al 1996).…”

“…In the total sample of 96 patients, the initial level of symptom severity and level of impairment appeared comparable with the level of severity and impairment reported in open trials of pharmacotherapy for specific disorders (Gammon and Brown 1993;McConville et al 1996). As can be seen in Table 1, the initial GAF scores in this study differentiated patients in need of different levels of care: hospitalized patients, patients treated psychiatrically, patients treated in a primary care setting, and patients for whom no pharmacotherapy was recommended had increasingly higher GAF scores.…”

Excessive Mood Elevation and Behavioral Activation with Antidepressant Treatment of Juvenile Depressive and Anxiety Disorders: A Systematic Review

“…1). They included 17 studies regarding AD trials in juvenile depressive disorders, with or without other psychiatric disorders (n = 2,637 subjects, 2,083 given an AD and 554 controls), 16 of which provided quantitative estimates of behavior outcomes considered as adverse events (see online supplementary table 1; for all online supplementary material, see www.karger.com?doi=10.1159/000345316) [34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50]; 25 studies involved AD trials in juvenile anxiety disorders, with or without other psychiatric disorders (n = 4,130 subjects, 3,211 given an AD and 919 controls; online suppl. table 2) [51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76].…”

Selective Serotonin Reuptake Inhibitors in pediatric psychopharmacology: A review of the evidence

“…There is no controlled evidence targeted at pharmacologic treatment of suicidality in depressed youth. 5 Open-label studies suggest variable response rates to SSRIs in children and adolescents with MDD, [6][7][8] higher than the rates observed in controlled studies (40% to 70%). Placebo response rates are also high in controlled trials (30% to 60%), indicating that overall effect sizes are modest and that underpowered studies are unlikely to demonstrate statistically significant efficacy.…”