Abstract
ANTIDEPRESSANTS FOR JUVENILES: WHAT ABOUT ST. JOHN'S WORT?Analyses of juvenile depression studies with long-established antidepressants (tricyclic ADs, TCA) have revealed discouragingly little benefit, while side effects have been profound. Modern ADs like selective serotonin reuptake inhibitors (SSRIs) seemed to solve part of this problem until they were found to be associated with an increased risk of suicidal attempts, hostile behaviour and self-harm, while meta-analyses have revealed only marginal therapeutic effects for the majority. Indeed, no drug is unequivocally accepted as the gold-standard for young depressive patients. Today, St. John's Wort is by far the most frequently prescribed medication for child and adolescent depression in Germany. Some pilot and observational studies from Germany, Canada and the US have delivered promising results. However, randomised controlled trials for this age group have yet to be carried out and are long overdue.
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