Selective serotonin reuptake inhibitors and newer antidepressive substances in child and adolescent psychiatry

Abstract

Since the first report on a selective serotonin reuptake inhibitor (SSRI) in 1974, not only have new substances in the group of the SSRI been developed, but also completely new groups of antidepressants. Among these newer groups, characterised by their pharmacological properties, are the serotonin2-antagonists/serotonin reuptake inhibitors (SARI), the noradrenergic and specific serotonergic antidepressants (NaSSA), the noradrenaline and dopamine reuptake inhibitors (NDRI) and the serotonin and noradrenaline reuptake inhibitors (SNRI). This review describes the properties and side effects of the newer antidepressants and compares them to those of the older substance groups like tricyclic antidepressants (TCA), MAO inhibitors (MAOI) and SSRI. Studies of antidepressants in children and adolescents with depression are presented and compared for differences between the older and newer substances. A Medline search was performed up to and including January 2002. Three double-blind, placebo-controlled studies of SSRI and one double-blind, placebo-controlled study of the newer antidepressant venlafaxine in children and adolescents with depression have been conducted. However, there is a great number of prospective and retrospective studies. Furthermore, seven double-blind, placebo-controlled studies of SSRI, as well as several prospective and retrospective of the newer antidepressants have been carried out in children and adolescents with other psychiatric disorders. The studies of the SSRI and the newer antidepressants conducted to date are promising. Nonetheless, further double-blind, placebo-controlled studies are necessary.