Use Of Antidepressants In Children Research Articles

Trends in Use of Antidepressants, Lithium, and Anticonvulsants in Kaiser Permanente-Insured Youths, 1994–2003

In view of the current controversy regarding the use of antidepressants in children and adolescents, we examined trends from 1994 to 2003 in the use of antidepressants, lithium, and anticonvulsants by enrollees, aged 5-17 years, of Kaiser Permanente in Northern California. We found that the use of antidepressants more than doubled from 9.4 per 1000 enrollees to 21.3 per 1000. Most of this increase is associated with selective serotonin reuptake inhibitors (SSRIs), which increased from 4.6 to 14.5 per 1000. The use of tricyclic antidepressants (TCAs) decreased markedly, while the increase of other newer antidepressants rose from 1.3 to 6.5 per 1000. The use of anticonvulsants nearly doubled, from 3.5 to 6.9 per 1000, while lithium use was relatively stable at a rate of nearly 1 per 1000. Use of SSRIs, newer antidepressants, and anticonvulsants increased in boys as well as girls in each of three age groups: 5-9, 10-14, and 15-17 years. An increasing percentage of the antidepressant users had a diagnosis of depression, and an increasing percentage of anticonvulsant users had a diagnosis of bipolar disorder. Although the safety and efficacy of antidepressants in youths needs to be more firmly established, these findings may reflect progress in the diagnosis and treatment of mental illness.

Depression, antidepressants and suicidality: a critical appraisal

Regulatory agencies in the United Kingdom and United States have been critically examining the possible link between suicidality and antidepressant use in children and adults, which has resulted in an FDA directive to the manufacturers of all antidepressant medications to add a 'black box' warning that describes the increased risk of suicidal behaviour in children and adolescents who take antidepressants. A crucial issue in this debate, as we discuss here, is the assessment of the capacity of antidepressants to increase suicidality over and above what is caused by the underlying disorder, major depression, which is itself the principal cause of suicide.

Depression in Children with HIV Infection: A Case Series

About 46,000 individuals younger than 25 years of age currently have a diagnosis of human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). During their lifetime, approximately one-third of patients with HIV may develop depression. While antidepressants have been studied in adults with HIV, no data exist to support the use of antidepressants in children and adolescents with HIV. We report a case series of seven pediatric patients with HIV who were prescribed antidepressants. Six of seven patients had mild to moderate improvements in depressive symptoms. None of our patients experienced any suicidal ideations, and adverse events were minor. No drug-drug interactions were reported, and no significant changes in CD4 counts, CD4 percentages, or viral loads occurred during antidepressant therapy. Placebo-controlled, randomized studies are needed to confirm our results in this patient population.

Congress Hammers FDA Over Handling of SSRIs

Congress Hammers FDA Over Handling of SSRIs

Antidepressant use in children--safe or not? Hiding unfavorable data makes it hard to know.

Antidepressant use in children--safe or not? Hiding unfavorable data makes it hard to know.

Opinion: Antidepressants and the Risk of Suicide in Children and Adolescents: What's the Link?

Free AccessOpinion: Antidepressants and the Risk of Suicide in Children and Adolescents: What's the Link?Adil ViraniAdil Virani1. Adjunct Professor with the College of Pharmacy and a Lecturer with the Department of Psychiatry at Dalhousie University. Also practices at the IWK Health Centre as the Clinical Pharmacy Consultant for the Pharmacy Department where he specializes in the area of child and adolescent psychiatry.Search for more papers by this authorPublished Online:June 2005https://doi.org/10.1521/capn.9.4.1.48742PDFPDF PLUS ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations AboutSuggested ReadingsGarland , E.J. (2004). Facing the evidence: Antidepressant treatment in children and adolescents. Canadian Medical Association Journal, 170(4), 489–91. Google ScholarOlfson , M., Gameroff, M.J., Marcus, S.C., & Waslick, B.D. (2003). Outpatient treatment of child and adolescent depression in the United States. Archive of General Psychiatry, 60, 1236–1242. Crossref, Google ScholarThe American College of Neuropsychopharmacology. Executive Summary. Preliminary Report of the Task Force on SSRIs and Suicidal Behavior in Youth. Available at URL: http://www.acnp.org/exec_summary.pdf. Accessed August 15,2004 Google ScholarTreatment for Adolescents With Depression Study Team. Fluoxetine, cognitive–behavioral therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study (TADS) randomized controlled trial. JAMA. 2004;292:807–820 Crossref, Google ScholarUS Food and Drug Administration, Centre for Drug Research and Evaluation: Antidepressant Use in Children, Adolescents, and Adults. Available at URL: http://www.fda.gov/cder/drug/antidepressants/default.htm. Accessed August 16, 2004. Google ScholarVitiello , B., Swedo, S. (2004). Antidepressant medications in children. New England Journal of Medicine, 350, 1489–1491. Crossref, Google ScholarWhittington , C.J., Kendall, T., Fonagy, P., Cottrell, D., Cotgrove, A., Boddington, E. (2004). Selective serotonin reuptake inhibitors in childhood depression: Systematic review of published versus unpublished data. Lancet, 363, 1341–1345. Crossref, Google Scholar Next article FiguresReferencesRelatedDetails Volume 9Issue 4Jun 2004 Information© The Guilford PressPDF download

Tricyclic antidepressants and selective serotonin reuptake inhibitors: use during pregnancy, in children/adolescents and in the elderly.

Depressive disorders can occur at any point in the lifespan. One way of differentiating antidepressants is by examining their efficacy and safety in the special patient populations that exist along the lifespan. Thus, we examine clinical data that is available regarding the use of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) at three distinct points in the lifespan: childhood and adolescence, pregnancy and late adulthood. Literature regarding the use of antidepressants in children and adolescents, pregnancy and the elderly was reviewed. Clinical data suggest that SSRIs should be first line treatment in children and adolescents as TCAs have questionable efficacy and definite safety issues. Similarly, although TCAs and SSRIs show equivalent efficacy in elderly patients, the safety profile of the SSRIs makes them a more prudent choice in this population. Finally, although there is no definitive data that contraindicates the use of a particular antidepressant in pregnancy, the bulk of reassuring pregnancy outcome data exists for the SSRIs, specifically for fluoxetine. Although no single antidepressant can ever be recommended for every patient, SSRIs should be considered the first-line choice in the treatment of depression in special patient populations.

Critical Review of Tricyclic Antidepressant Use in Children and Adolescents

To provide a critical review of the role of tricyclic antidepressant (TCA) medications in children and adolescents. Multiple resources including a Medline search (1966-1998) were used. There were few double-blind, placebo-controlled studies of TCAs, and even fewer with positive results. Also, potentially serious cardiovascular side effects have been described. The future therapeutic role of TCAs for children and adolescents needs to be seriously weighed against lethality of overdose, the unresolved issue of possible sudden unexplained death, and the availability of safer and easier to monitor medications. Ongoing future research on heart rate variability and epidemiology of psychotropic medication-related deaths will address developmental aspects of TCA use.

Companies seek approval for antidepressant use in children

Companies seek approval for antidepressant use in children

Sudden Death and Tricyclic Antidepressants: Clinical Considerations for Children

ABSTRACT The sudden collapse and death in three prepubertal children during routine treatment with desipramine was recently reported in brief statements. Insufficient clinical information is available to infer a cause-and-effect relationship between the therapeutic use of desipramine and sudden death in these children. Speculatively, a variety of possible mechanisms could account for sudden death in children receiving treatment with tricyclic antidepressants: a cardiac event, an increase or decrease in blood pressure, an increase in pulse, a seizure (with complications), or heat stroke. The extent of medical monitoring in the three cases is not clear, leaving unresolved whether a change in standard monitoring procedures is indicated. The total number of children who have received desipramine treatment is not known, so it is not possible to specify the incidence of this putative adverse effect. It is clear that the incidence of death from accidental overdose is substantially higher. Given the current available level of knowledge about these cases, no clinical recommendations are offered concerning when to avoid or to use desipramine; however, certain clinical considerations regarding the use of antidepressants in children are raised and discussed.

Hypertension in Neuroblastoma Induced by Imipramine

Hypertension is a well-known finding in some patients with neuroblastoma. However, it has not previously been described in association with the use of Imipramine. We report the occurrence of severe hypertension (blood pressure 190/160) in a 4-year-old girl with neuroblastoma who was given Imipramine to control a behavior disorder. It was determined later that this patient's tumor was recurring at the time of her hypertensive episode. Since she had no blood pressure elevation at initial diagnosis and none following discontinuation of the Imipramine (when she was in florid relapse), we believe that this drug rather than her underlying disease alone caused her hypertension. The mechanism for this reaction is believed to be increased levels of vasoactive catecholamines due to interference of their physiologic inactivation by Imipramine. From this experience, we urge extreme caution in the use of tricyclic antidepressants in children with active neuroblastoma.