Skip to content

Advertisement

  • Poster presentation
  • Open Access

Efficacy of antidepressants in juvenile depression: meta-analysis

  • 1, 2, 3,
  • 3, 4,
  • 3, 5 and
  • 3
Annals of General Psychiatry20087 (Suppl 1) :S350

https://doi.org/10.1186/1744-859X-7-S1-S350

  • Published:

Keywords

  • Public Health
  • Placebo
  • Systematic Review
  • Randomise Control Trial
  • Fluoxetine

Background

Safety of antidepressants in children and adolescents is being questioned and their efficacy in juvenile depression remains uncertain. Our aim was to assess antidepressant efficacy in juvenile depression.

Materials and methods

Systematic review and meta-analysis of randomised controlled trials (RCTs) comparing responses to antidepressants, overall and by type, vs. placebo in depressed juveniles.

Results

Thirty drug-placebo contrasts in RCTs lasting 8 weeks (median), involved 2979 subjects (456 person-years) of average age 13.5 years. Meta-analysis yielded a modest pooled drug/placebo response rate ratio (RR=1.22, 95%CI: 1.15-1.31), with little separation among antidepressant-types. Findings were similar for rate differences (RD) and Corresponding number-needed-to-treat (overall NNT: 10; TCAs [13] > SRIs [9] > Others [8]). NNTs decreased with increasing age: children (22) > mixed-ages (11) > adolescents (8).

Conclusions

Antidepressants of all types showed limited efficacy in juvenile depression, but fluoxetine might be more effective, especially in adolescents. Studies in children, severely depressed, hospitalised or suicidal juveniles are needed, and effective, safe, and readily accessible treatments for juvenile depression are urgently required.

Declarations

Acknowledgements

The authors thank the Royal College of Psychiatrists of England for awarding an Eli Lilly Travelling Fellowship to EMT, the Ph.D. program in Psychiatry of the University of Pisa, the Harvard School of Public Health doctoral program in Epidemiology, and the IDEA Foundation, Milan for supporting FS, and the Bruce J. Anderson Foundation and the McLean Private Donors Psychopharmacology Research Fund for research grants to RJB.

Authors’ Affiliations

(1)
MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
(2)
“Aghios Charalambos” Mental Health Unit, Heraklion, Crete, Greece
(3)
Department of Psychiatry, Harvard Medical School and Psychopharmacology Program, McLean Division of Massachusetts General Hospital, Boston, Massachusetts, USA
(4)
Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
(5)
Lucio Bini Mood Disorder Centre and Department of Psychology, University of Cagliari, Sardinia, Italy

Copyright

Advertisement