Treating major depression in children and adolescents: Depressed adolescents may lose out

doi:10.1136/bmj.328.7438.525

BMJ 2004;328:525 (28 February), doi:10.1136/bmj.328.7438.525

Letter

Treating major depression in children and adolescents

Depressed adolescents may lose out

The first 150 words of the full text of this article appear below.

EDITOR—Ramchandani discusses the treatment of major depressivedisorder in children and adolescents.¹ The conclusion of theCommittee on Safety of Medicines is based on two premises: lackof effectiveness and increased risk of suicide.

None of the evidence stacks up. Even the paper of the Food andDrug Administration points out that the effectiveness of sertralineand fluoxetine is likely to be the same.²

Furthermore, it says that in all the organised trials, no completedsuicide was reported. It also points out that in major depressivedisease, suicide is a likely event anyway. (In any case, thecorrect management of depressed children entails suicide watch.)If the risk increases it is likely to only be at the beginningof treatment, when the disinhibiting effects of selective serotoninreuptake inhibitors are not yet balanced by improving mood patterns.

What I find most unsatisfactory is the failure to publish the. . . [Full text of this article]

Kenneth D Shenderey, senior partner in general practice

Medical Centre, Leeds, West Yorkshire LS14 6DX ken@shenderey.com