Texas children's medication algorithm project: Update from Texas consensus conference panel on medication treatment of childhood major depressive disorder

被引:92
作者
Hughes, Carroll W.
Emslie, Graham J.
Crismon, M. Lynn
Posner, Kelly
Birmaher, Boris
Ryan, Neal
Jensen, Peter
Curry, John
Vitiello, Benedetto
Lopez, Molly
Shon, Steve P.
Pliszka, Steven R.
Trivedi, Madhukar H.
机构
[1] Univ Texas, SW Med Ctr, Dept Psychiat, Dallas, TX 75390 USA
[2] Univ Texas, Coll Pharm, Austin, TX 78712 USA
[3] Columbia Univ, New York, NY USA
[4] Western Psychiat Inst & Clin, Pittsburgh, PA USA
[5] Columbia Univ, Ctr Advancement Childrens Mental Hlth, Dept Psychiat, New York, NY 10027 USA
[6] Off Mental Hlth, New York, NY USA
[7] Duke Univ, Durham, NC USA
[8] NIMH, Bethesda, MD 20892 USA
[9] Texas Dept State Hlth Serv, Austin, TX USA
[10] Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78284 USA
关键词
medication algorithm; major depressive disorder; suicidality; childhood psychopharmacology; child and adolescent depression;
D O I
10.1097/chi.0b013e31804a859b
中图分类号
B844 [发展心理学(人类心理学)];
学科分类号
040202 ;
摘要
Objective: To revise and update consensus guidelines for medication treatment algorithms for childhood major depressive disorder based on new scientific evidence and expert clinical consensus when evidence is lacking. Method: A consensus conference was held January 13-14, 2005, that included academic clinicians and researchers, practicing clinicians, administrators, consumers, and families. The focus was to review, update, and incorporate the most current data to inform and recommend specific pharmacological approaches and clinical guidance for treatment of major depressive disorder in children and adolescents. Results: Consensually agreed on medication algorithms for major depression (with and without psychosis) and comorbid attention-deficit disorders were updated. These revised algorithms also incorporated approaches to address issues of suicidality, aggression, and irritability. Stages 1, 2, and 3 of the algorithm consist of selective serotonin reuptake inhibitor and norepinephrine serotonin reuptake inhibitor medications whose use is supported by controlled, acute clinical trials and clinical experience. Recent studies provide support that selective serotonin reuptake inhibitors in addition to fluoxetine are still encouraged as first-line interventions. The need for additional assessments, precautions, and monitoring is emphasized, as well as continuation and maintenance treatment. Conclusions: Evidence and expert clinical consensus support the use of selected antidepressants in the treatment of depression in youths. The use of the recommended antidepressant medications requires appropriate monitoring of suicidality and potential adverse effects and consideration of other evidence-based treatment alternatives such as cognitive behavioral therapies.
引用
收藏
页码:667 / 686
页数:20
相关论文
共 130 条
[1]  
AKISKAL HS, 1995, ARCH GEN PSYCHIAT, V52, P114
[3]  
[Anonymous], 1992, Electroconvulsive Therapy
[4]  
[Anonymous], PSYCHIAT NEWS
[5]  
[Anonymous], WEB BAS INJ STAT QUE
[6]   Sertraline pharmacokinetics and dynamics in adolescents [J].
Axelson, DA ;
Perel, JM ;
Birmaher, B ;
Rudolph, GR ;
Nuss, S ;
Bridge, J ;
Brent, DA .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 2002, 41 (09) :1037-1044
[7]   Risk factors for suicide and attempted suicide among young people [J].
Beautrais, AL .
AUSTRALIAN AND NEW ZEALAND JOURNAL OF PSYCHIATRY, 2000, 34 (03) :420-436
[8]   An international, multicenter, placebo-controlled trial of paroxetine in adolescents with major depressive disorder [J].
Berard, R ;
Fong, R ;
Carpenter, DJ ;
Thomason, C ;
Wilkinson, C .
JOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY, 2006, 16 (1-2) :59-75
[9]  
BERTAGNOLLI MW, 1990, REV ECT CHILDREN ADO
[10]   A DOUBLE-BLIND PLACEBO CONTROLLED-STUDY OF DESIPRAMINE IN THE TREATMENT OF ADD .1. EFFICACY [J].
BIEDERMAN, J ;
BALDESSARINI, RJ ;
WRIGHT, V ;
KNEE, D ;
HARMATZ, JS .
JOURNAL OF THE AMERICAN ACADEMY OF CHILD AND ADOLESCENT PSYCHIATRY, 1989, 28 (05) :777-784