Sections
Antidepressants: Introduction | Evaluating Antidepressant Studies | Pharmacodynamics | Outcome Assessments | Safety | Selective Serotonin Reuptake Inhibitors | Atypical Antidepressants | Tricyclic Antidepressants | Monoamine Oxidase Inhibitors | Alternative Antidepressant Treatments | Research Directions | Summary Points | References
Excerpt
Antidepressants are widely used in children
and adolescents for a variety of disorders, with significant increases
over the past 20 years. Primarily, antidepressants have been used
for the same disorders as in adults (depression, anxiety), with
additional potential use for attention-deficit/hyperactivity
disorder (ADHD), repetitive behaviors (e.g., autism spectrum disorders),
and reactive aggression. Newer antidepressants, particularly selective
serotonin reuptake inhibitors (SSRIs), have demonstrated efficacy
and safety in children and adolescents, with the greatest effect
seen in obsessive-compulsive disorder (OCD) and anxiety disorders,
followed by major depressive disorder (MDD). Yet, limited data are
available on pharmacokinetics and dosing in this age group. For
example, it is not known whether lower doses may be equally efficacious
in children or whether this age group does, in fact, require adult
dosing. Theoretically, children may metabolize medications more
quickly due to their proportionally larger liver mass.