המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-30 8:57:22 EDT (Reuters Health)
WESTPORT, CT (Reuters Health) – Paroxetine (Paxil, GlaxoSmithKline) appears to be a well tolerated, effective therapy for adolescents with major depression, according to a report published in the July issue of the Journal of the American Academy of Child and Adolescent Psychiatry. Imipramine, however, seems to perform no better than placebo in this setting.
Dr. Martin B. Keller from the Brown University School of Medicine in Providence, Rhode Island and colleagues assessed the efficacy and tolerability of paroxetine and imipramine in 275 adolescents with major depression. The subjects were randomized to receive an 8-week course of paroxetine 20 mg/day to 40 mg/day, imipramine with gradual upward titration to 200 mg/day to 300 mg/day, or placebo.
Paroxetine-treated subjects demonstrated significantly greater improvements in several depression test scores than placebo-treated subjects, the authors note. Imipramine, however, produced a response comparable to that of placebo. Parent- or self-rated measures of response were similar for all three groups.
Withdrawal rates for adverse effects associated with placebo, paroxetine, and imipramine were 6.9%, 9.7%, and 31.5%, respectively, the investigators state. Nearly one third of the imipramine withdrawals were due to adverse cardiovascular effects.
"Major depression in adolescents is an increasingly recognized clinical problem that is remarkably understudied," the researchers point out. "This is the first study to compare efficacy of a selective serotonin reuptake inhibitor (SSRI) and a tricyclic antidepressant with placebo in the treatment of major depression in adolescents," they add.
"The SSRIs are the medications of choice for the treatment of major depression in adolescents because they are the only agents that have been shown to be efficacious in this population. They have a safer side-effect profile than other antidepressants, particularly in overdose, and they can be administered once daily," Dr. Keller's team concludes.
J Am Acad Child Adolesc Psychiatry 2001;40:762-772.
-Westport Newsroom 203 319 2700