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Review: Antidepressants are of limited efficacy in juvenile depression

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QUESTION

Question:

What is the efficacy of antidepressants in children and adolescents with depression?

Outcomes:

Responder rate, defined as the proportion of the study sample reaching a study specified level of improvement in clinical ratings, typically a 50% or greater reduction in depressive symptoms.

METHODS

Design:

Systematic review with meta-analysis.

Data sources:

MEDLINE, PsycINFO, EMBASE, Cochrane Library, PsiTri and ClinicalTrials.gov were searched from inception to May 2006 for randomised controlled trials (RCTs). Reference lists of identified studies were hand searched. Trial authors and experts in the field were consulted for unpublished information. Websites of pharmaceutical companies, the UK Committee on Safety of Medicines and the US FDA were also searched.

Study selection and analysis:

Two reviewers appraised the studies and selected RCTs comparing antidepressants with placebo in children and adolescents aged 20 years or less with major depression, dysthymia or depression not otherwise specified (DSM-III or later); depressive disorder (ICD-9/10); or depression diagnosed by clinical or structured diagnostic interview. Two reviewers assessed the quality of the RCTs. Included trials had to be double blind with random assignment to parallel antidepressant or placebo groups. Responder rates had to be reported as …

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