Editorial Perspective: Antidepressants and the depressed adolescent

Child and Adolescent Mental Health
Ian M Goodyer

Abstract

A paper considering the role of antidepressants for adults with major depression was recently published in the Lancet, a world leading medical journal (Cipriani et al. 2018). The review was the largest ever on this topic based on 28,552 citations including 522 trials comprising 116,477 participants. The authors note that, in adults with major depression, all antidepressants were more efficacious than placebo. In head-to-head studies, the authors also note that agomelatine, amitriptyline, escitalopram, mirtazapine, paroxetine, venlafaxine, and vortioxetine were more effective than other antidepressants whereas fluoxetine, fluvoxamine, reboxetine, and trazodone were the least efficacious. The authors report that the standardised mean difference was 0.3 a moderate effect size for any antidepressant over placebo, this is confirmatory of past reviews noting rather similar magnitudes of effect. In clinical terms the results suggest a choice for practitioners in regard to their individual patients. For many adult depressed patients however, there is also the implication that antidepressants may not work. The old adage 'what works for whom' remains unanswered. What does seem reasonable to conclude is that we have learnt that these medi...Continue Reading

References

Aug 19, 2004·JAMA : the Journal of the American Medical Association·John MarchUNKNOWN Treatment for Adolescents With Depression Study (TADS) Team
Jul 4, 2007·The American Journal of Psychiatry·Gregory E Simon, James Savarino
Nov 3, 2012·The British Journal of Psychiatry : the Journal of Mental Science·Ian M Goodyer
Dec 12, 2012·Journal of Affective Disorders·Ross J BaldessariniLeonardo Tondo
Aug 27, 2014·JAMA : the Journal of the American Medical Association·Laura P RichardsonWayne Katon
Nov 15, 2014·Psychological Medicine·J StochlP B Jones
Mar 7, 2015·Journal of Psychopharmacology·Lesley Cousins, Ian M Goodyer
Jul 15, 2016·The New England Journal of Medicine·Deepak L Bhatt, Cyrus Mehta
Nov 9, 2016·Clinical Psychology Review·Aliza Werner-SeidlerHelen Christensen
Nov 22, 2016·Journal of Clinical Child and Adolescent Psychology : the Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53·V Robin WeersingCarl Bolano

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