BMJ  2007;335:221 (4 August), doi:10.1136/bmj.39289.575058.BE

Letters

Depression in adolescents

Study was not a trial of antidepressants

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

Goodyer et al tell us something about the role of cognitive behaviour therapy in adolescent depression but nothing about the use of drugs.1 The response rate is not strikingly different from what would be expected from placebo, and, as with other studies of combinations of antidepressant and cognitive behaviour therapy,2 we can draw no conclusions about the efficacy of antidepressants without a placebo arm. The authors justify its absence on the basis that a placebo arm would be unethical in such ill patients. That justification is questionable, given that at least 19 out of 20 studies of newer antidepressants in children and adolescents fail to show meaningful advantage of drug over placebo on their primary outcomes.3 Although Goodyer et al make few direct claims about the effectiveness of antidepressants, the implication that benefit is attributable to the drug will likely be used by others to support prescribing.

Jon N Jureidini, head

Department of Psychological Medicine, Women's and Children's Hospital, North Adelaide 5006, Australia

jon.jureidini@cywhs.sa.gov.au

Competing interests: None . . . [Full text of this article]


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Relevant Article

Selective serotonin reuptake inhibitors (SSRIs) and routine specialist care with and without cognitive behaviour therapy in adolescents with major depression: randomised controlled trial
Ian Goodyer, Bernadka Dubicka, Paul Wilkinson, Raphael Kelvin, Chris Roberts, Sarah Byford, Siobhan Breen, Claire Ford, Barbara Barrett, Alison Leech, Justine Rothwell, Lydia White, and Richard Harrington
BMJ 2007 335: 142. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

  • Shearer, M C, Bermingham, S L (2008). The ethics of paediatric anti-depressant use: erring on the side of caution. J. Med. Ethics 34: 710-714 [Abstract] [Full text]  
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