Treatment options in the management of adolescent depression

Treatment for depression in children and adolescents often requires pharmac otherapy with tricyclic antidepressants (TCAs) or selective serotonin reupt ake inhibitors (SSRIs), followed by psychotherapy. Most studies have not fo und the TCAs to be more effective than placebo in the treatment of depressi on in children and adolescents. Initial reports, however, have found the SS RIs to be more effective and better tolerated. In the small proportion of c hildren who have treatment-resistant depression, TCAs plus lithium, monoami ne oxidase inhibitors (MAOIs) or electroconvulsive therapy (ECT) may be use ful. More studies on the treatment of depression in children and adolescent s are needed, as adult data cannot simply be extrapolated. (C) 2000 Elsevie r Science B.V. All rights reserved.