Treating major depression in children and adolescents: Use of selective serotonin reuptake inhibitors needs urgent clarification

doi:10.1136/bmj.328.7438.525-a

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

Letter

Treating major depression in children and adolescents

Use of selective serotonin reuptake inhibitors needs urgent clarification

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

EDITOR—Ramchandani's editorial focuses entirely on theuse of selective serotonin reuptake inhibitors in the treatmentof major depressive disorder, just as did the statements ofthe chairman of the Committee on Safety of Medicines on whichhe comments.¹ Did he not think it odd that the statement saidnothing about obsessive-compulsive disorder, panic disorder,social phobia, or general anxiety disorder, for which variousselective serotonin reuptake inhibitors are also prescribed?

The committee does not say whether the use of these drugs forthese conditions in people under 18 is justified and appropriate.Presumably the committee's expert working group is consideringthese questions, but that requires a clear official statementnow.

The British National Formulary notes the following indications²:

Citalopram:panic disorder child not recommended (adolescentnot mentioned)
Escitalopram: child and adolescent under 18not recommended(strange, since it is virtually identical withcitalopram)
Fluoxetine: bulimia, obsessive-compulsive disorder,child . . . [Full text of this article]