Journal
WORLD JOURNAL OF BIOLOGICAL PSYCHIATRY
Volume 12, Issue -, Pages 11-15Publisher
TAYLOR & FRANCIS LTD
DOI: 10.3109/15622975.2011.600295
Keywords
Antidepressants; depressive episode; child and adolescent psychiatry; selective serotonin reuptake inhibitor; tricyclic antidepressant
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In children and adolescents, antidepressants are used in the treatment of depressive symptoms and several other psychiatric conditions. In the treatment of mild and moderate depressive symptoms, non-pharmacological approaches such as psychotherapy play a major role, a severe symptomatology may demand a combination with antidepressants. As first-choice medication for the treatment of juvenile depression, the selective serotonin reuptake inhibitor (SSRI) fluoxetine is recommended, due to its efficacy and approval. As second-choice antidepressants the SSRIs sertraline, escitalopram and citalopram might be used. Other antidepressants - such as tricyclic antidepressants, a 2 - adrenoceptor antagonists, selective noradrenalin reuptake inhibitors (SNRI) - may be alternatively used, but not as first-or second-choice medications. In the case of off-label use, patients and parents have to be carefully informed prior to the start of medication, after a thorough risk - benefit analysis. In the following overview we address a general framework, therapeutic strategies and the issues of antidepressant pharmacotherapy for the treatment of unipolar depression in childhood and adolescence.
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