[Critical evaluation of the use of antidepressants in adolescence].

Abstract

In the introduction the authors highlight the clinical theoretical and practical importance of affection disorders, especially depressive ones, during childhood and adolescence, their relationships of continuity and the limitations of psychopharmacological studies with antidepressants and other medicines. The authors review the bibliography consulted about the use of antidepressants in depressive disorders during adolescence following this order: authors and years, medicine used, type of population, number of cases, proportion of males and females, age ranges, dose in mg/kg/day, ranges of plasmatic concentrations, most frequent secondary and unwanted side effects, time of duration of the study, comorbidity, existence of a previous washing stage, as well as placebo and global results. The studies with triciclical antidepressants (TAD) are classified into open ones and controlled ones. Among the open ones, they review the studies by Dugas et al (1980), Geller et al (1985), Ryan et al (1986), Strober et al (1990), and Ambrosini et al (1994). Among the controlled ones, they review the studies by Kramer and Feiguine (1981), Geller et al (1990), Boulos et al (1991), and Kutcher et al (1994). In the third part, the studies of enhancement of TAD with lithium by Ryan et al (1988 a and b) and Strober et al (1992) are analysed. In the fourth part, the studies of enhancement of TAD with the IMAO by Ryan et al (1988-1990) are evaluated. In the fifth part, the ten studies with ISRS (fluvoxamine, fluoxetine, paroxetine and sertraline) on the treatment of depression during adolescence are also discussed. In the final comments there is a summary of the clinical perspective of this kind of psychopharmacological therapy. Four tables and 73 bibliographical references are included.