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.

Cross-cultural child and adolescent psychiatry research in developing countries

“…Similarly, the efficacy of psychological treatments for common mental disorders among children and adolescents has been established in systematic reviews (James et al . 2013 ) and so is their safety ahead of pharmacological treatments (Picouto & Braquehais, 2013 ). Psychological interventions such as cognitive-behavioral therapy derive from understanding of the social cognition which drives thinking and behavior.…”