Antidepressants in Children and Adolescents: Meta-Review of Efficacy, Tolerability and Suicidality in the Acute Treatment
Duration: 40 mins
Publication Date: 21 Mar 2024
Next Review Date: 21 Mar 2027
DOI: 10.13056/acamh.13591
Description
Antidepressants are prescribed for the treatment of a number of psychiatric disorders in children and adolescents, however there is still controversy about whether they should be used in this population. During this talk I will present and update the findings from a study we carried out in 2020 assessing the effects of antidepressants for the acute treatment of attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, autistic spectrum disorder, enuresis, major depressive disorder (MDD), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD) in children and adolescents. Efficacy was measured as response to treatment (either as mean overall change in symptoms or as a dichotomous outcome) and tolerability was measured as the proportion of patients discontinuing treatment due to adverse events. Suicidality was measured as suicidal ideation, behavior (including suicide attempts) and completed suicide. The scientific literature was systematically searched for existing systematic reviews and/or meta-analyses of double-blind randomized controlled trials. The quality of the included reviews was appraised using AMSTAR-2. Compared to placebo, selected antidepressants can be efficacious in the acute treatment of some common psychiatric disorders, although statistically significant differences do not always translate into clinically significant results. Little information is available about tolerability of antidepressants and on suicidal ideation/behavior. Findings from existing literature must be considered in light of potential limitations, such as the lack of comparative information about many antidepressants, the short-term outcomes and the quality of the available evidence.
Learning Objectives
A. To understand systematic reviews and meta-analyses
B. To appraise the quality of evidence from randomised trials and systematic reviews.
C. To critically interpret the findings about the use of antidepressants with children and adolescents
