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Most adolescents achieve longer term remission from major depressive disorder regardless of type of short-term second-line treatment

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In adolescents who are resistant to selective serotonin reuptake inhibitor (SSRI) treatment for major depressive disorder (MDD) what are the long-term outcomes for second step treatment options?


This was a naturalistic follow-up of participants in the Treatment of SSRI-Resistant Depression in Adolescents study, which recruited 334 adolescents between the ages of 12–18 years who had been diagnosed with DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) MDD that had not responded to treatment with an SSRI for 8 weeks.


Six clinical sites in the USA; 2001–2007.


Alternative SSRI or venlafaxine or alternative SSRI plus cognitive–behavioural therapy (CBT) or venlafaxine plus CBT for 12 weeks. Responders continued on their assigned treatment for an additional 12 weeks; non-responders were given open treatment. After 24 weeks, naturalistic treatment was given in the community.


Remission (≥3 consecutive weeks with ≤1 clinically significant symptom and no associated functional impairment on the Adolescent Longitudinal Interval Follow-up Evaluation (A-LIFE)); relapse (≥2 weeks with probable or possible depressive disorder on the A-LIFE (score of 3 or 4) after remission).

Patient follow-up

35% at 48 weeks and 39% at 72 weeks. Analyses used the last observation carried forward (LOCF) approach.



Naturalistic follow-up of a randomised controlled trial.




Medication was …

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