Pediatric unipolar depression and pharmacotherapy: Choosing a medication
- C Scott Moreland, DO
C Scott Moreland, DO
- Clinical Assistant Professor
- Baylor College of Medicine
- Liza Bonin, PhD
Liza Bonin, PhD
- Associate Professor of Pediatrics and Psychiatry
- Baylor College of Medicine
- Section Editors
- David Brent, MD
David Brent, MD
- Section Editor — Childhood Mental Disorders
- Professor of Psychiatry, Pediatrics and Epidemiology
- University of Pittsburgh School of Medicine
- Diane Blake, MD
Diane Blake, MD
- Section Editor — Adolescent Medicine
- Professor of Pediatrics
- University of Massachusetts Medical School
- John K Triedman, MD
John K Triedman, MD
- Section Editor — Pediatric Cardiology
- Professor of Pediatrics
- Harvard Medical School
There have been several phases of pharmacotherapy studies for unipolar depression in children and adolescents :
●Tricyclic antidepressant phase
●Second-generation antidepressant phase, including selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors
●The era of the US Food and Drug Administration boxed warning about antidepressants and suicidal ideation and behavior (see "Effect of antidepressants on suicide risk in children and adolescents")
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- CHOICE OF MEDICATION FOR ACUTE TREATMENT
- First line
- Second line
- Third line
- CONTINUATION AND MAINTENANCE TREATMENT
- PSYCHOTIC DEPRESSION
- OVERVIEW OF EFFICACY
- All antidepressants
- - Second-generation antidepressants
- SELECTIVE SEROTONIN REUPTAKE INHIBITORS (SSRIs)
- - SSRIs as a class
- - Fluoxetine
- - Other specific SSRIs
- Adverse side effects
- - Cardiac events
- - Serotonin syndrome
- - Suicidality
- - Discontinuation (withdrawal) syndrome
- SEROTONIN-NOREPINEPHRINE REUPTAKE INHIBITORS
- Indications and efficacy
- - Venlafaxine
- - Duloxetine
- TRICYCLIC ANTIDEPRESSANTS
- Adverse effects
- - Overdose
- OTHER ANTIDEPRESSANTS
- ADJUNCTIVE AGENTS
- TREATMENT OPTIONS WITH LITTLE OR NO BENEFIT
- Omega-3 fatty acids
- St. John's wort
- INFORMATION FOR PATIENTS AND FAMILIES
- SUMMARY AND RECOMMENDATIONS